Importance of Ph
1.To keep the enzymatic activity
2.To maintain the active structural and functional conformation of biomolecules
3.To maintain the cellular viability
Na-K+ pump failure
sickle cell syndrome
acidaemia
digitalis toxicity
Source of acid
Both exo & endogenous
Acid amount source disposal amount reserve
Volatile 15mole/day lung 15mole/day 30-40
CO2
Non volatile 70mmol/day kidney 70mmol/day 500
H2SO4 protein
H3PO4 PL/P.prot
HCL
LA
KA
Respiratory acidosis Ventilatory failure pneumonia bronchitis Asthma emphysema Depressed nervous Morphine poisoning | Respiratory alkalosis Hyperventilation voluntary hysteric CNS disease affecting respiratory center Salicylate poisoning Hepatic coma |
Metabolic acidosis Normal anion gap (HYPERCHLOREMIC) (git HCO3 loss) diarrhoea fistulae uretero sigmoidostomy renal HCO3 loss RTA acetazolamide ↑HCL production NH4cl ingestion Increased anion gap (NORMOCHLOREMIC) DKA LA RF( acute + chronic) salicylate poisoning | METABOLIC ALKALOSIS Loss of acid vomiting aspiration Excess alkali adminstration (citrate,acetate,lactate,gluconate,HCO3-) Diuretic ECF vol depletion(renal Na+ reab in exchange of H+) Aldosteronism(primary/2nd ary) Cushing’s syndrome Post hypercapnic alkalosis |
Total buffer base = 48meq/L
HCO3- 25-28meq/L
Hb - 15meq/L
prot-
HPO4- -
Standard serum HCO3- conc
body temp 37°c
Pco2 40mmHg
Hb normal concentration
saturated with O2
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