10 December 2010 Sign up for exam day and time: Take Abstract: Grading 50% Original, 50% Revision. Sign up for exam day and time: Tuesday 2-5, Thursday 9- 12 or Friday 9-12 Take handout: The Response to Ingestion of 800 ml of isotonic saline (7g NaCl in water) Check website & email for notifications regarding exam and potential essay questions. Times when you can review test folders

Acid-Base Balance A little more on Clearance: Clearance of glucose = 0 ml/min which means…. Clearance of X = 120 ml/min which means…. Clearance of antibiotic XXX = 500 ml/min which means… Lung-kidney connection Acid-Base Balance

Any changes in ventilation after you vomit?

Figure 14.31 Normally, all filtered bicarbonate is “reabsorbed”

Figure 14.32 This process is increased during metabolic acidosis Excess H+ eliminated in urine bound to phosphate buffer.

Figure 14.33 This process is increased during metabolic acidosis Filtration Reabsorption Secretion Metabolism Metabolism of glutamine in tubular cells generate bicarbonate buffer. This process is increased during metabolic acidosis

Who Cares?

Father-in-law with emphysema (respiratory case studies lab) PaCO2 =30 mmHg, PaO2 = 60 mmHg plasma pH = 7.47 Hyperventilating: ventilation in excess of metabolism to compensate for loss of alveolar surface area for diffusion of O2 Commensurate loss of CO2 RESPIRATORY ___________ Renal compensation……… retain ___ and eliminate _____ Review 3 previous slides.

Loss of HCl in vomitus would be compensated by……..

The End? Reincarnation