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pH (Maintain balance via:, Acidotic State, Alkalotic State, Compensation,…

- - - - RBC contains Hgb
        
        Where Chloride Shift occurs depending on level of O2 in blood
        
        Acidic State
        
        Carbonic acid forms
        
        Dissociates into bicarbonate (HCO3-) and H+
        
        Bicarbonate leaves RBC
        
        1 more item...
        
        Chloride enters RBC
        
        Alkalotic State
        
        Bicarbonate enters RBC
        
        Combines with H+ to form carbonic acid (H2CO3)
        
        Dissociates into water and CO2
        
        1 more item...
      - It's all about the bicarbonate concentration
    - - Primary buffer system in body
      - 20:1 ratio (bicarbonate : carbonic acid)
        
        "B is lower in the alphabet so worth less"
        
        Maintains pH of 7.4 (in between 7.35 and 7.45)
        
        H+ is controlled by
        
        Lungs
        
        Excreted in the form of water (along with CO2) when carbonic acid dissociates when RBC reaches the lungs
        
        Kidney
        
        Retains/excretes bicarbonate depending on pH
    - - In cells and body fluids, especially active in the kidneys
        
        Like the Hgb system - Depends on bicarbonate concentration
    - - Liver produces plasma proteins with varying number of H+ in their chemical structures
        
        Acidic State
        
        Plasma proteins have fewer H+ in chemical structure
        
        Attracts/Accepts H+
        
        Lowers H+ serum concentration
        
        Alkalotic State
        
        Plasma proteins have higher H+ in chemical structure
        
        Release/Donates H+
        
        Increases H+ serum concentration
  - - - Restores/retains bicarbonate and excretes excess H+ ions (that's not carbonic acid)
        
        Excess H+ excreted as phosphoric acid or combines with ammonia
  - - - Decrease in serum H+
        
        Passive H+ diffusion out of cells
        
        To balance decrease in cellular charge, K+ enters the cell
        
        Hypokalemia
    - - Increase in serum H+
        
        Passive H+ diffusion into cells
        
        To balance increase in cellular charge, K+ leaves the cell
        
        Hyperkalemia
      - You need to remember that acids are H+ donors = Serum H+ would be high
- - - - Increase in carbonic acid
        
        Respiratory Acidosis
        
        Signs and Symptoms
        
        Respiratory: Hypoventilation with hypoxia
        
        Lungs are the problem
        
        Hyperkalemia
        
        Neurological: Coincides with acidosis (low pH causes increased EPSP and lower IPSP) and hypoxia (dizziness and disorientation)
        
        Cardiovascular: Coincides with hyperkalemia (vasodilation, slower/abnormal contraction)
        
        GI: None (remember problem is only with lungs not kidneys)
        
        Neuromuscular: Seizures (from hypoxia)
      - Decrease in bicarbonate
        
        Metabolic acidosis
        
        Signs and Symptoms
        
        Neuromuscular: None (Coz problem is not with lungs so no hypoxia)
        
        Neurological: Coincides with acidosis (low pH causes increased EPSP and lower IPSP)
        
        Cardiovascular: Coincides with hyperkalemia (vasodilation, slower/abnormal contraction)
        
        Respiratory: Hyperventilation (compensatory action by lungs)
        
        GI: K+ is hard on the GI (problem with kidneys) and coincides with excretion of excess K+
- - - - Decrease in carbonic acid
        
        Respiratory alkalosis
        
        Signs and Symptoms
        
        Neurological: Similar to hypokalemia/hyponatremia - Parang gutom
        
        Cardiovascular: Similar to hypokalemia - Drop in BP from unable to repolarize (Tachycardia - From attempting to increase BP)
        
        GI: Nausea and vomiting, EPIGASTRIC PAIN
        
        Neuromuscular: Alkalosis causes preservation of membrane excitability = Affects sensation and reflexes - Tingling of extremities
        
        Respiratory: Hyperventilation (Lung problem)
      - Increase in bicarbonate
        
        Metabolic alkalosis
        
        Signs and Symptoms
        
        GI: Nausea and vomiting, Anorexia
        
        Respiratory: Hypoventilation (Compensatory)
        
        Neuromuscular: Alkalosis causes preservation of membrane excitability = Affects sensation and reflexes - Tingling of fingers and toes
        
        Cardiovascular: Similar to hypokalemia - Drop in BP from unable to repolarize (Tachycardia - From attempting to increase BP)
        
        Neurological: Parang unexplained discomfort