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Acid Base Disorder PDF
Acid Base Disorder PDF
Acid Base Disorder PDF
Any
ionic
or
molecular
substance that can act as a
proton donor.
Strong acidHCl, H2SO4, H3PO4.
Weak acidH2CO3, CH3COOH.
acids??
bases??
Origin of acids
Much more
Intracellular metabolism
Volatile
acids
Fixed
acids
CO2+H2O=H2CO3
Lactic acid
Ketone bodies
Sulfuric acid
Phosphoric acid
Origin of bases
50~100 mmol H+
pH
pH of ECF is between 7.35 and 7.45.
Deviations, outside this range affect
membrane function, alter protein function,
etc.
You cannot survive with a pH <6.8 or >7.7
Acidosis- below 7.35
Alkalosis- above 7.45
buffering
H+ + A
HA
[ H+ ] [ A ]
Ka =
H+ ]
[ HA ]
= Ka
[ HA ]
[A ]
pH = pKa + lg
[ A ]
[ HA ]
ACID-BASE
BUFFERING
KIDNEYS
H load
ECF
Buffers
Lung
RBC
Hb
buffers
ICF
Respiratoryc
ontrol
H K
exchange
H2CO3 CO2
Buffers
others
Renal
H+ excretion
bicarbonate
reabsorption
Expiration
minutes
hours
Release
bone salt
Ca2 H2PO4
Acid
excretion
Immediately
Bone
days
In chronic
metabolic
acidosis
Very slow
Primary
changing
CO2
CO2 + H2O
CA
HCO3
RBC
H2CO3
CA
plasma
C l
HCO3
C l
H+
Hb buffering
Cl transfer
CA carbonic anhydrase
uBuffers
solution.
only
provide
temporary
uLung:
uKidney:
PaCO2
(Partial Pressure of Carbon Dioxide)
The amount of carbon dioxide dissolved in arterial blood.
Normal: 4.39 6.25kPa35 45 mmHg
Average: 5.32 kPa40 mmHg
Respiratory acidosis: > 45 mmHg
HCO3
Normal: 21 26 mmHg
Average: 24 mmHg
pH
pH is a measurement of the acidity of the blood, reflecting
the number of hydrogen ions present.
pH = - log [H+]
pH7.45alkalosis
pH7.35acidosis
pH 7.35 - 7.45
Acid-base balance.
Acidosis or alkalosis with complete compensation.
A mixed acidosis and alkalosis, both events have opposite
effects on pH, may also have a normal pH.
Step
analisis
kasus
Compensation
The body response to acid-base imbalance is called
compensation
Complete if brought back within normal limits
Partial compensation if range is still outside norms.
If underlying problem is metabolic, hyperventilation or
hypoventilation can help respiratory compensation.
If problem is respiratory, renal mechanisms can bring
about metabolic compensation.
Asidosis
pCO2
HCO3??
N : belum terjadi kompensasi
: kompensasi renal (parsial)
: mixed (respiratory &
metabolic disorder)
HCO3
PCO2??
N : belum terjadi kompensasi
: kompensasi paru (parsial)
: mixed disorder
Alkalosis
pCO2
HCO3??
N : belum terjadi kompensasi
: mixed (respiratory &
metabolic disorder)
: kompensasi renal (parsial)
HCO3
PCO2??
N : belum terjadi kompensasi
: mixed disorder
: kompensasi paru (parsial)
Lactic acidosis
Source ketoacidosis
Acids
Fixed acids
Salicylic acidosis
AG : anion gap
generate
intake
Source
Bases
Loss
impossible
From GIdiarrhea
From kidneyproximal/distal tubular acidosis
Increased AG
Primary
[HCO3]
Normal AG
Metabolic
acidosis
Metabolic
alkalosis
Primary [HCO3]
Source impossible
Fixed acids
Loss
Bases
Loss of H+
Severe
vomiting
Loss of Cl
Loss of K +
Loss body fluid
Respiratory
acidosis
Volatile acid
inhalation
Respiratory
alkalosis
Volatile acid
Filtered
Nephron
Secreted
Reabsorbed
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