Question

Explain the acid-balance associated with the following etiology and what the physiological effect/rational for each: increased base bicarbonate decreased base bicarbonate increased carbonic acid (CO2) decreased carbonic acid (CO2) severe shock sedative or opioid overdose baking soda use as antacid renal failure anxiety, fear, pain prolonged vomiting prolonged diarrhea hyperventilation/tachypnea

Answer 1

1) Increased base bicarbonate:

Increased base bicarbonate is seen when the patient develop alkalosis that means the blood pH exceeds above 7.45. The decreased level of carbon dioxide which is an acid, results in excessive base bicarbonate in blood and thereby increases the blood pH.

2) decreased base bicarbonate:

The decreased base bicarbonate is seen when patient develops acidosis that means the blood pH is less than 7.35. There is increased production of hydrogen in the body or inability to produce enough bicarbonate due to inability to form bicarbonate in kidneys. These hydrogen ions diffuses into the blood lowering the blood pH.

3) Increased and carbonic acid:

The carbondioxide of blood reacts with water catalyzed by carbonic anhydrase to form carbonic acid which rapidly dissociates to form bicarbonate ion and hydrogen ion. The effects of carbondioxide level is directly linked with the level of carbonic acid. The acidosis causes by increased carbonic acid i.e respiratory acidosis and decreased bicarbonate i.e metabolic acidosis. In case of hypoventilation, the excessive carbondioxide results in excessive carbonic acid accumulation in blood. The pH of blood goes down.

4) Decreased carbonic acid:

The decreased carbonic acid causes alkalosis i.e respiratory alkalosis and increased bicarbonate i.e metabloic alkalosis. During hyperventilation, carbonic acid deficit occurs as a result the compensatory mechanism by kidneys occurs i.e production of bicarbonate.