SlideShare a Scribd company logo
Acid BaseAcid Base
Balance, AcidBalance, Acid
Base disordersBase disorders
Dr Ifat Ara Begum
Associate Professor
Dept of Biochemistry
Dhaka Medical College
Dhaka
1
 
2
Some related
topics
Acid & BaseAcid & Base
3
Points Acid Base
Definitio
n
Molecules that
can donate proton
(H+
) in aqueous
solution
Molecules that can
accept proton (H+
)
in aqueous
solution
pH <7 >7
When
dissolve
d in
water
Produces H+
Produces OH-
Types Strong acid
Weak acid
Strong base
Weak base
Proton is the hydrogen atom with itsProton is the hydrogen atom with its
electron removedelectron removed
4
5
6
Conjugate base of acid
The remaining anionic
part of an acid after
removal of proton from
the acid
In strong acid, it is
weak & vice versa
Conjugate acid of base
It is the acid formed
by a base after
accepting proton
In strong base, it is
weak & vice versa
7
Strength of an acid / base
is defined in terms of the
tendency to donate (or
accept) the hydrogen ion to
(from) the solvent
(i.e. water in biological
systems)
Sources of Acid/Base in our bodySources of Acid/Base in our body
8
 Exogenous source:
Foods rich in acid (meat)
Ingestion of acids (salicylic acid)
Intravenous infusion
 Endogenous source:
Produced at cellular level during
metabolism
9
Sources of Volatile
acid:
 15 – 20 mol/D
 Oxidation of :
 Glucose
 FA
AA
Sources of NVA:
 230 mmol/D
 Oxidation of :
 Basic AA
 S containing AA
PO4 containing
substances
Sources of Base (nonvolatile):
 160 mmol/D
 Oxidation of Acidic AA
 Metabolism of dietary organic anions
like citrate, acetate etc
‘‘Our body is net acid producer’Our body is net acid producer’
10
 NVA & base neutralize each
other at one to one ratio.
 So, after neutralization, 70
mmol/D NVA is left behind
(230-160 = 70)
 This 70 mmol/D of NVA,
along with 15-20 mol/D of
volatile acid makes the body
env. acidic
Metabolic acid or base production dependsMetabolic acid or base production depends
on:on:
11
 Insulin status
Blood flow to tissues
Oxygen supply to tissues
Dietary habit
Route for excretion of acid/base from bodyRoute for excretion of acid/base from body
12
Pulmonary route
For excretion of
volatile acids only
High capacity system
On complete failure for
few minutes, it reduces
pH grossly
Renal route
For excretion of NVA &
bases
Low capacity system
On complete failure for
few minutes, no effect
on pH at all
What is pH?What is pH?
13
14
15
How pH can be determined?How pH can be determined?
17
 Instrumentally by pH meter
 Using H-H Equation (From serum
HCO3 conc. & PCO2)
18
Importance of normal
body pH
 Supports optimum
enzyme activity
 O2 transport &
chemical control of
respiration
 Maintains:
 The native molecular
form & structural
conformation of
biomolecules (esp.
protein) to keep them
functionally active
Why Life threatens
beyond clinically safe
range of pH?
 Altered :
 Enzyme activity
 Membrane
permeability
 CNS activity
 Electrolyte
distribution
 Increased myocardial
irritability
Decreased cellular
viability
19
How pH is regulated?How pH is regulated?
20
First Line Defense
 Chemical buffer system: It acts within second
to minutes
 Pulmonary system: It acts within minutes to
hours by regulating CO2 content in blood
Second line Defense
 Renal system: It acts within hours to days by
regulating serum bicarbonate and excretion
of acid
BufferBuffer
 Any substance / A mixture of weak acid & its
conjugate base / A mixture of weak acid & its
salt with strong base
that can accept / release H+
in a solution
to resist marked changes in H+
conc. & pH of
that solution despite the addition of moderate
amount of acid / base to it
21
 Principle of buffer action:
Conversion of strong acid in to weak acid
 Conversion of strong base in to weak base
22
23
Body
Compartment
Buffer system (In order of
importance)
RBC Hemoglobin, Phosphate, Bicarbonate
Plasma/ ECF Bicarbonate, Phosphate, Protein
Blood Bicarbonate, Hemoglobin , Phosphate,
Protein
ICF Protein, Bicarbonate, Phosphate
Kidney Ammonia, Phosphate, Bicarbonate
Bone Bone buffer
Most effective body buffer: BicarbonateMost effective body buffer: Bicarbonate
buffer system: Why?buffer system: Why?
25
Henderson- Hasselbalch EquationHenderson- Hasselbalch Equation
26
 
28
Acid Base
Disorders
32
Abnormality of either HCO3- or PCO2 ,
keeping 2nd
component normal:
Simple ABD
Abnormality of both HCO3- or PCO2
simultaneously:
Complex ABD
(Clinically, existence of >1 simple
ABD)
Simple ABDSimple ABD
What are the common parameters to checkWhat are the common parameters to check
ABD?ABD?
 pH
 PCO2
 Serum HCO3
-
concentration
 Plasma Anion gap
 Base excess
Normal Acid Base Composition of Arterial BloodNormal Acid Base Composition of Arterial Blood
(ABG analysis)(ABG analysis)
pH PO2
(mm
of
Hg)
O2
saturatio
n (%)
PCO2 (mm of
Hg)
HCO3
conc.
(mmol/L)
7.35
-
7.45
85 -
100
80-100
(>95%)
35 - 45 22-28
Plasma Anion gap: 8 – 16 mEq/L
Base excess : ± 2 mmol/L
Anion gap = UA – UCAnion gap = UA – UC
BE = [HCOBE = [HCO33
--
] p – [HCO] p – [HCO33
--
]std]std
38
The PO2 reflects the amount of
oxygen gas dissolved in the blood. It
primarily measures the effectiveness
of the lungs in pulling oxygen into the
blood stream from the atmosphere
i.e. it provides a good index of
lung function. .
Compensation in ABDCompensation in ABD
ABD Primary
event/defect
Unaffected
component
Secondary
event/
compensation
Metabolic
Acidosis
↓ HCO3
-
PCO2 ↓ in PCO2
Metabolic
Alkalosis
↑ HCO3
-
PCO2 ↑ in PCO2
Respiratory
Acidosis
↑ PCO2 HCO3
-
↑ in HCO3
-
Respiratory
Alkalosis
↓ PCO2 HCO3
-
↓ in HCO3
-
Correction of ABDCorrection of ABD
 Removal of the cause of ABD
ABD Renal activity to normalize HCO3
-
conc
M. Acidosis  Excretion of acidic urine
 Generate new HCO3
-
M.
Alkalosis
 Excretion of alkaline urine
 Inhibition of HCO3
-
reabs. from
PCT to allow its excretion
R. Acidosis  Treatment of hypercapnia
Inhibition of HCO3
-
reabs. from PCT
to allow its excretion
R.
Alkalosis
 Treatment of hypocapnia
 Increased renal HCO3
-
reabs. From
PCT
42
43
44
45
46

More Related Content

What's hot

Acid Base Balance And Disturbance
Acid Base Balance And DisturbanceAcid Base Balance And Disturbance
Acid Base Balance And Disturbance
mvraveendrambbs
 
Acid base disorders
Acid base disordersAcid base disorders
Acid base disorders
Mohamed Elbhnasawy
 
ACID BASE BALANCE
ACID BASE BALANCEACID BASE BALANCE
ACID BASE BALANCE
Dr Nilesh Kate
 
Acid base balance and Imbalance
Acid base balance and ImbalanceAcid base balance and Imbalance
Acid base balance and Imbalance
Anup Shamsher Budhathoki
 
Acid-Base Balance : Basics
Acid-Base Balance : BasicsAcid-Base Balance : Basics
Acid-Base Balance : Basics
CSN Vittal
 
Acid base disorders
Acid base disordersAcid base disorders
Acid base disorders
Pratap Tiwari
 
Metabolic acidosis
Metabolic acidosis Metabolic acidosis
Metabolic acidosis
Anusha Rameshwaram
 
Lecture 7 (acid base balance)
Lecture 7 (acid base balance)Lecture 7 (acid base balance)
Lecture 7 (acid base balance)
Ayub Abdi
 
Acid base balance heraa
Acid base balance  heraaAcid base balance  heraa
Acid base balance heraa
Mahmoud Elnaggar
 
Abg by dr girish
Abg by dr girishAbg by dr girish
Abg by dr girish
Girish jain
 
Acid base balane
Acid base balaneAcid base balane
Acid base balane
Ruby Kharkwal
 
ABG Analysis
ABG Analysis ABG Analysis
Abc acid base
Abc acid baseAbc acid base
Abc acid base
FarragBahbah
 
Acid-Base Disorders
Acid-Base DisordersAcid-Base Disorders
Acid-Base Disorders
Vitrag Shah
 
Acid base balance
Acid base balanceAcid base balance
Acid base balance
Dr Dhavalkumar F. Chaudhary
 
Acid Base, Arterial Blood Gas
Acid Base, Arterial Blood GasAcid Base, Arterial Blood Gas
Acid Base, Arterial Blood Gas
Dee Evardone
 
Metabolic acidosis
Metabolic acidosisMetabolic acidosis
Metabolic acidosis
snich
 
Basics In Arterial Blood Gas Interpretation
Basics In Arterial Blood Gas InterpretationBasics In Arterial Blood Gas Interpretation
Basics In Arterial Blood Gas Interpretation
gueste36950a
 
Acid and Base Balance and Imbalance
Acid and Base Balance and ImbalanceAcid and Base Balance and Imbalance
Acid and Base Balance and Imbalance
Urfeya Mirza
 
Acid base balance (updated in 2020)
Acid base balance (updated in 2020)Acid base balance (updated in 2020)
Acid base balance (updated in 2020)
enamifat
 

What's hot (20)

Acid Base Balance And Disturbance
Acid Base Balance And DisturbanceAcid Base Balance And Disturbance
Acid Base Balance And Disturbance
 
Acid base disorders
Acid base disordersAcid base disorders
Acid base disorders
 
ACID BASE BALANCE
ACID BASE BALANCEACID BASE BALANCE
ACID BASE BALANCE
 
Acid base balance and Imbalance
Acid base balance and ImbalanceAcid base balance and Imbalance
Acid base balance and Imbalance
 
Acid-Base Balance : Basics
Acid-Base Balance : BasicsAcid-Base Balance : Basics
Acid-Base Balance : Basics
 
Acid base disorders
Acid base disordersAcid base disorders
Acid base disorders
 
Metabolic acidosis
Metabolic acidosis Metabolic acidosis
Metabolic acidosis
 
Lecture 7 (acid base balance)
Lecture 7 (acid base balance)Lecture 7 (acid base balance)
Lecture 7 (acid base balance)
 
Acid base balance heraa
Acid base balance  heraaAcid base balance  heraa
Acid base balance heraa
 
Abg by dr girish
Abg by dr girishAbg by dr girish
Abg by dr girish
 
Acid base balane
Acid base balaneAcid base balane
Acid base balane
 
ABG Analysis
ABG Analysis ABG Analysis
ABG Analysis
 
Abc acid base
Abc acid baseAbc acid base
Abc acid base
 
Acid-Base Disorders
Acid-Base DisordersAcid-Base Disorders
Acid-Base Disorders
 
Acid base balance
Acid base balanceAcid base balance
Acid base balance
 
Acid Base, Arterial Blood Gas
Acid Base, Arterial Blood GasAcid Base, Arterial Blood Gas
Acid Base, Arterial Blood Gas
 
Metabolic acidosis
Metabolic acidosisMetabolic acidosis
Metabolic acidosis
 
Basics In Arterial Blood Gas Interpretation
Basics In Arterial Blood Gas InterpretationBasics In Arterial Blood Gas Interpretation
Basics In Arterial Blood Gas Interpretation
 
Acid and Base Balance and Imbalance
Acid and Base Balance and ImbalanceAcid and Base Balance and Imbalance
Acid and Base Balance and Imbalance
 
Acid base balance (updated in 2020)
Acid base balance (updated in 2020)Acid base balance (updated in 2020)
Acid base balance (updated in 2020)
 

Similar to Acid base balance, acid base disorder

Acid-Base Homeostasis
Acid-Base HomeostasisAcid-Base Homeostasis
Acid-Base Homeostasis
DavidIkwuka
 
acid base balance: part 1
acid base balance: part 1acid base balance: part 1
acid base balance: part 1
enamifat
 
Acid base balance.pdf
Acid base balance.pdfAcid base balance.pdf
Acid base balance.pdf
ShivamGodara1
 
Acid base balance (2).ppt
Acid base balance (2).ppt Acid base balance (2).ppt
Acid base balance (2).ppt
aljamhori teaching hospital
 
5.sakina respiratory regulation of ph
5.sakina respiratory regulation of ph5.sakina respiratory regulation of ph
5.sakina respiratory regulation of ph
sakina hasan
 
Acid base balance
Acid base balanceAcid base balance
Acid base balance
ravichandra matcha
 
Blood buffers and their role in regulation of homeostasis
Blood buffers and their role in regulation of homeostasisBlood buffers and their role in regulation of homeostasis
Blood buffers and their role in regulation of homeostasis
hafsanawaz7
 
Buffer solutions. Blood buffer systems and their mechanisms of action. Sahil...
Buffer solutions. Blood buffer systems and  their mechanisms of action. Sahil...Buffer solutions. Blood buffer systems and  their mechanisms of action. Sahil...
Buffer solutions. Blood buffer systems and their mechanisms of action. Sahil...
TigerJi1
 
AcidBase_Balance.biochemistry assigments
AcidBase_Balance.biochemistry assigmentsAcidBase_Balance.biochemistry assigments
AcidBase_Balance.biochemistry assigments
basmaqazi89
 
Acid Base Balance. An important topic in Physiologypptx
Acid Base Balance. An important topic in PhysiologypptxAcid Base Balance. An important topic in Physiologypptx
Acid Base Balance. An important topic in Physiologypptx
Rawal Institute of Health Sciences, ISLAMABAD - PAKISTAN
 
Acid base disorder in neonate
Acid base disorder in neonateAcid base disorder in neonate
Acid base disorder in neonate
tareq rahman
 
Biochem p h of blood(may.13.2010)
Biochem   p h of blood(may.13.2010)Biochem   p h of blood(may.13.2010)
Biochem p h of blood(may.13.2010)
MBBS IMS MSU
 
Regulation of Acid Base Balance
Regulation of Acid Base Balance Regulation of Acid Base Balance
Regulation of Acid Base Balance
Abhirup Sarkar
 
ACID BASE BALANCE.ppt
ACID BASE BALANCE.pptACID BASE BALANCE.ppt
ACID BASE BALANCE.ppt
LawalMajolagbe
 
Vg Ab
Vg  AbVg  Ab
Acid balance / dental courses
Acid balance / dental coursesAcid balance / dental courses
Acid balance / dental courses
Indian dental academy
 
Acid Base Balance and Primary Disturbances - basic concepts
Acid Base Balance and Primary Disturbances - basic conceptsAcid Base Balance and Primary Disturbances - basic concepts
Acid Base Balance and Primary Disturbances - basic concepts
Nyunt Wai
 
Lecture 21
Lecture 21Lecture 21
Lecture 21
MBBS IMS MSU
 
Acid Base Balance In Fishes
Acid Base Balance In FishesAcid Base Balance In Fishes
Acid Base Balance In Fishes
Ferosekhan Shajahan
 
ACID BASE BALANCE IN FISHES
ACID BASE BALANCE IN FISHESACID BASE BALANCE IN FISHES
ACID BASE BALANCE IN FISHES
saravanan8
 

Similar to Acid base balance, acid base disorder (20)

Acid-Base Homeostasis
Acid-Base HomeostasisAcid-Base Homeostasis
Acid-Base Homeostasis
 
acid base balance: part 1
acid base balance: part 1acid base balance: part 1
acid base balance: part 1
 
Acid base balance.pdf
Acid base balance.pdfAcid base balance.pdf
Acid base balance.pdf
 
Acid base balance (2).ppt
Acid base balance (2).ppt Acid base balance (2).ppt
Acid base balance (2).ppt
 
5.sakina respiratory regulation of ph
5.sakina respiratory regulation of ph5.sakina respiratory regulation of ph
5.sakina respiratory regulation of ph
 
Acid base balance
Acid base balanceAcid base balance
Acid base balance
 
Blood buffers and their role in regulation of homeostasis
Blood buffers and their role in regulation of homeostasisBlood buffers and their role in regulation of homeostasis
Blood buffers and their role in regulation of homeostasis
 
Buffer solutions. Blood buffer systems and their mechanisms of action. Sahil...
Buffer solutions. Blood buffer systems and  their mechanisms of action. Sahil...Buffer solutions. Blood buffer systems and  their mechanisms of action. Sahil...
Buffer solutions. Blood buffer systems and their mechanisms of action. Sahil...
 
AcidBase_Balance.biochemistry assigments
AcidBase_Balance.biochemistry assigmentsAcidBase_Balance.biochemistry assigments
AcidBase_Balance.biochemistry assigments
 
Acid Base Balance. An important topic in Physiologypptx
Acid Base Balance. An important topic in PhysiologypptxAcid Base Balance. An important topic in Physiologypptx
Acid Base Balance. An important topic in Physiologypptx
 
Acid base disorder in neonate
Acid base disorder in neonateAcid base disorder in neonate
Acid base disorder in neonate
 
Biochem p h of blood(may.13.2010)
Biochem   p h of blood(may.13.2010)Biochem   p h of blood(may.13.2010)
Biochem p h of blood(may.13.2010)
 
Regulation of Acid Base Balance
Regulation of Acid Base Balance Regulation of Acid Base Balance
Regulation of Acid Base Balance
 
ACID BASE BALANCE.ppt
ACID BASE BALANCE.pptACID BASE BALANCE.ppt
ACID BASE BALANCE.ppt
 
Vg Ab
Vg  AbVg  Ab
Vg Ab
 
Acid balance / dental courses
Acid balance / dental coursesAcid balance / dental courses
Acid balance / dental courses
 
Acid Base Balance and Primary Disturbances - basic concepts
Acid Base Balance and Primary Disturbances - basic conceptsAcid Base Balance and Primary Disturbances - basic concepts
Acid Base Balance and Primary Disturbances - basic concepts
 
Lecture 21
Lecture 21Lecture 21
Lecture 21
 
Acid Base Balance In Fishes
Acid Base Balance In FishesAcid Base Balance In Fishes
Acid Base Balance In Fishes
 
ACID BASE BALANCE IN FISHES
ACID BASE BALANCE IN FISHESACID BASE BALANCE IN FISHES
ACID BASE BALANCE IN FISHES
 

More from enamifat

Thyroid Function test.pptx
Thyroid Function test.pptxThyroid Function test.pptx
Thyroid Function test.pptx
enamifat
 
Chemistry of protein, part 2 (Aug'21)
Chemistry of protein, part 2 (Aug'21)Chemistry of protein, part 2 (Aug'21)
Chemistry of protein, part 2 (Aug'21)
enamifat
 
Chemistry of protein, part 1 (Aug'21)
Chemistry of protein, part 1 (Aug'21)Chemistry of protein, part 1 (Aug'21)
Chemistry of protein, part 1 (Aug'21)
enamifat
 
Replication
ReplicationReplication
Replication
enamifat
 
Central Dogma, Gene, Genetic Code, Codon, Genome, Genotype, Phenotype , Trai...
Central Dogma, Gene,  Genetic Code, Codon, Genome, Genotype, Phenotype , Trai...Central Dogma, Gene,  Genetic Code, Codon, Genome, Genotype, Phenotype , Trai...
Central Dogma, Gene, Genetic Code, Codon, Genome, Genotype, Phenotype , Trai...
enamifat
 
Solution, crystalloids , colloids, isotope
Solution, crystalloids , colloids, isotope Solution, crystalloids , colloids, isotope
Solution, crystalloids , colloids, isotope
enamifat
 
Chemistry of lipid , september 2020
Chemistry of lipid , september 2020Chemistry of lipid , september 2020
Chemistry of lipid , september 2020
enamifat
 
Protein metabolism, july'20
Protein metabolism, july'20Protein metabolism, july'20
Protein metabolism, july'20
enamifat
 
Water soluble vitamins , june, 2020
Water soluble vitamins , june, 2020Water soluble vitamins , june, 2020
Water soluble vitamins , june, 2020
enamifat
 
Rna , ribosome and cell cycle, july 2020
Rna , ribosome and cell cycle, july 2020Rna , ribosome and cell cycle, july 2020
Rna , ribosome and cell cycle, july 2020
enamifat
 
Structure of dna, its organization &amp; functions, july 2020
Structure of dna, its organization &amp; functions, july 2020Structure of dna, its organization &amp; functions, july 2020
Structure of dna, its organization &amp; functions, july 2020
enamifat
 
Introduction to nucleic acid, chemistry of nucleotiides , july 2020
Introduction to nucleic acid, chemistry of nucleotiides , july 2020Introduction to nucleic acid, chemistry of nucleotiides , july 2020
Introduction to nucleic acid, chemistry of nucleotiides , july 2020
enamifat
 
Replication (reviewed, 2018)
Replication (reviewed, 2018)Replication (reviewed, 2018)
Replication (reviewed, 2018)
enamifat
 
Chemistry of enzyme
Chemistry of enzymeChemistry of enzyme
Chemistry of enzyme
enamifat
 
Chemistry of carbohydrates
Chemistry of carbohydratesChemistry of carbohydrates
Chemistry of carbohydrates
enamifat
 
Metabolism of protein
Metabolism of protein Metabolism of protein
Metabolism of protein
enamifat
 
Chemistry of protein
Chemistry of protein Chemistry of protein
Chemistry of protein
enamifat
 
Chemistry of digestion &; absorption
Chemistry of digestion &; absorption Chemistry of digestion &; absorption
Chemistry of digestion &; absorption
enamifat
 
Vitamins
Vitamins Vitamins
Vitamins
enamifat
 
Quality Assurance Program in Medical Education in Bangladesh, Part 1
Quality Assurance Program in Medical Education in Bangladesh, Part 1Quality Assurance Program in Medical Education in Bangladesh, Part 1
Quality Assurance Program in Medical Education in Bangladesh, Part 1
enamifat
 

More from enamifat (20)

Thyroid Function test.pptx
Thyroid Function test.pptxThyroid Function test.pptx
Thyroid Function test.pptx
 
Chemistry of protein, part 2 (Aug'21)
Chemistry of protein, part 2 (Aug'21)Chemistry of protein, part 2 (Aug'21)
Chemistry of protein, part 2 (Aug'21)
 
Chemistry of protein, part 1 (Aug'21)
Chemistry of protein, part 1 (Aug'21)Chemistry of protein, part 1 (Aug'21)
Chemistry of protein, part 1 (Aug'21)
 
Replication
ReplicationReplication
Replication
 
Central Dogma, Gene, Genetic Code, Codon, Genome, Genotype, Phenotype , Trai...
Central Dogma, Gene,  Genetic Code, Codon, Genome, Genotype, Phenotype , Trai...Central Dogma, Gene,  Genetic Code, Codon, Genome, Genotype, Phenotype , Trai...
Central Dogma, Gene, Genetic Code, Codon, Genome, Genotype, Phenotype , Trai...
 
Solution, crystalloids , colloids, isotope
Solution, crystalloids , colloids, isotope Solution, crystalloids , colloids, isotope
Solution, crystalloids , colloids, isotope
 
Chemistry of lipid , september 2020
Chemistry of lipid , september 2020Chemistry of lipid , september 2020
Chemistry of lipid , september 2020
 
Protein metabolism, july'20
Protein metabolism, july'20Protein metabolism, july'20
Protein metabolism, july'20
 
Water soluble vitamins , june, 2020
Water soluble vitamins , june, 2020Water soluble vitamins , june, 2020
Water soluble vitamins , june, 2020
 
Rna , ribosome and cell cycle, july 2020
Rna , ribosome and cell cycle, july 2020Rna , ribosome and cell cycle, july 2020
Rna , ribosome and cell cycle, july 2020
 
Structure of dna, its organization &amp; functions, july 2020
Structure of dna, its organization &amp; functions, july 2020Structure of dna, its organization &amp; functions, july 2020
Structure of dna, its organization &amp; functions, july 2020
 
Introduction to nucleic acid, chemistry of nucleotiides , july 2020
Introduction to nucleic acid, chemistry of nucleotiides , july 2020Introduction to nucleic acid, chemistry of nucleotiides , july 2020
Introduction to nucleic acid, chemistry of nucleotiides , july 2020
 
Replication (reviewed, 2018)
Replication (reviewed, 2018)Replication (reviewed, 2018)
Replication (reviewed, 2018)
 
Chemistry of enzyme
Chemistry of enzymeChemistry of enzyme
Chemistry of enzyme
 
Chemistry of carbohydrates
Chemistry of carbohydratesChemistry of carbohydrates
Chemistry of carbohydrates
 
Metabolism of protein
Metabolism of protein Metabolism of protein
Metabolism of protein
 
Chemistry of protein
Chemistry of protein Chemistry of protein
Chemistry of protein
 
Chemistry of digestion &; absorption
Chemistry of digestion &; absorption Chemistry of digestion &; absorption
Chemistry of digestion &; absorption
 
Vitamins
Vitamins Vitamins
Vitamins
 
Quality Assurance Program in Medical Education in Bangladesh, Part 1
Quality Assurance Program in Medical Education in Bangladesh, Part 1Quality Assurance Program in Medical Education in Bangladesh, Part 1
Quality Assurance Program in Medical Education in Bangladesh, Part 1
 

Recently uploaded

CHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdf
CHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdfCHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdf
CHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdf
rishi2789
 
NAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdf
NAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdfNAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdf
NAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdf
Rahul Sen
 
Travel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff: Health Advice for International TravelersTravel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff: Health Advice for International Travelers
NX Healthcare
 
The Nervous and Chemical Regulation of Respiration
The Nervous and Chemical Regulation of RespirationThe Nervous and Chemical Regulation of Respiration
The Nervous and Chemical Regulation of Respiration
MedicoseAcademics
 
Ageing, the Elderly, Gerontology and Public Health
Ageing, the Elderly, Gerontology and Public HealthAgeing, the Elderly, Gerontology and Public Health
Ageing, the Elderly, Gerontology and Public Health
phuakl
 
Artificial Intelligence Symposium (THAIS)
Artificial Intelligence Symposium (THAIS)Artificial Intelligence Symposium (THAIS)
Artificial Intelligence Symposium (THAIS)
Josep Vidal-Alaball
 
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
Kosmoderma Academy Of Aesthetic Medicine
 
K CỔ TỬ CUNG.pdf tự ghi chép, chữ hơi xấu
K CỔ TỬ CUNG.pdf tự ghi chép, chữ hơi xấuK CỔ TỬ CUNG.pdf tự ghi chép, chữ hơi xấu
K CỔ TỬ CUNG.pdf tự ghi chép, chữ hơi xấu
HongBiThi1
 
Medical Quiz ( Online Quiz for API Meet 2024 ).pdf
Medical Quiz ( Online Quiz for API Meet 2024 ).pdfMedical Quiz ( Online Quiz for API Meet 2024 ).pdf
Medical Quiz ( Online Quiz for API Meet 2024 ).pdf
Jim Jacob Roy
 
SENSORY NEEDS B.SC. NURSING SEMESTER II.
SENSORY NEEDS B.SC. NURSING SEMESTER II.SENSORY NEEDS B.SC. NURSING SEMESTER II.
SENSORY NEEDS B.SC. NURSING SEMESTER II.
KULDEEP VYAS
 
NARCOTICS- POLICY AND PROCEDURES FOR ITS USE
NARCOTICS- POLICY AND PROCEDURES FOR ITS USENARCOTICS- POLICY AND PROCEDURES FOR ITS USE
NARCOTICS- POLICY AND PROCEDURES FOR ITS USE
Dr. Ahana Haroon
 
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdfCHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
rishi2789
 
CBL Seminar 2024_Preliminary Program.pdf
CBL Seminar 2024_Preliminary Program.pdfCBL Seminar 2024_Preliminary Program.pdf
CBL Seminar 2024_Preliminary Program.pdf
suvadeepdas911
 
Histololgy of Female Reproductive System.pptx
Histololgy of Female Reproductive System.pptxHistololgy of Female Reproductive System.pptx
Histololgy of Female Reproductive System.pptx
AyeshaZaid1
 
CLEAR ALIGNER THERAPY IN ORTHODONTICS .pptx
CLEAR ALIGNER THERAPY IN ORTHODONTICS .pptxCLEAR ALIGNER THERAPY IN ORTHODONTICS .pptx
CLEAR ALIGNER THERAPY IN ORTHODONTICS .pptx
Government Dental College & Hospital Srinagar
 
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPromoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
PsychoTech Services
 
Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neu...
Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neu...Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neu...
Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neu...
PVI, PeerView Institute for Medical Education
 
CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1
CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1
CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1
rishi2789
 
Know the difference between Endodontics and Orthodontics.
Know the difference between Endodontics and Orthodontics.Know the difference between Endodontics and Orthodontics.
Know the difference between Endodontics and Orthodontics.
Gokuldas Hospital
 
Breast cancer: Post menopausal endocrine therapy
Breast cancer: Post menopausal endocrine therapyBreast cancer: Post menopausal endocrine therapy
Breast cancer: Post menopausal endocrine therapy
Dr. Sumit KUMAR
 

Recently uploaded (20)

CHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdf
CHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdfCHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdf
CHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdf
 
NAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdf
NAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdfNAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdf
NAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdf
 
Travel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff: Health Advice for International TravelersTravel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff: Health Advice for International Travelers
 
The Nervous and Chemical Regulation of Respiration
The Nervous and Chemical Regulation of RespirationThe Nervous and Chemical Regulation of Respiration
The Nervous and Chemical Regulation of Respiration
 
Ageing, the Elderly, Gerontology and Public Health
Ageing, the Elderly, Gerontology and Public HealthAgeing, the Elderly, Gerontology and Public Health
Ageing, the Elderly, Gerontology and Public Health
 
Artificial Intelligence Symposium (THAIS)
Artificial Intelligence Symposium (THAIS)Artificial Intelligence Symposium (THAIS)
Artificial Intelligence Symposium (THAIS)
 
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
 
K CỔ TỬ CUNG.pdf tự ghi chép, chữ hơi xấu
K CỔ TỬ CUNG.pdf tự ghi chép, chữ hơi xấuK CỔ TỬ CUNG.pdf tự ghi chép, chữ hơi xấu
K CỔ TỬ CUNG.pdf tự ghi chép, chữ hơi xấu
 
Medical Quiz ( Online Quiz for API Meet 2024 ).pdf
Medical Quiz ( Online Quiz for API Meet 2024 ).pdfMedical Quiz ( Online Quiz for API Meet 2024 ).pdf
Medical Quiz ( Online Quiz for API Meet 2024 ).pdf
 
SENSORY NEEDS B.SC. NURSING SEMESTER II.
SENSORY NEEDS B.SC. NURSING SEMESTER II.SENSORY NEEDS B.SC. NURSING SEMESTER II.
SENSORY NEEDS B.SC. NURSING SEMESTER II.
 
NARCOTICS- POLICY AND PROCEDURES FOR ITS USE
NARCOTICS- POLICY AND PROCEDURES FOR ITS USENARCOTICS- POLICY AND PROCEDURES FOR ITS USE
NARCOTICS- POLICY AND PROCEDURES FOR ITS USE
 
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdfCHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
 
CBL Seminar 2024_Preliminary Program.pdf
CBL Seminar 2024_Preliminary Program.pdfCBL Seminar 2024_Preliminary Program.pdf
CBL Seminar 2024_Preliminary Program.pdf
 
Histololgy of Female Reproductive System.pptx
Histololgy of Female Reproductive System.pptxHistololgy of Female Reproductive System.pptx
Histololgy of Female Reproductive System.pptx
 
CLEAR ALIGNER THERAPY IN ORTHODONTICS .pptx
CLEAR ALIGNER THERAPY IN ORTHODONTICS .pptxCLEAR ALIGNER THERAPY IN ORTHODONTICS .pptx
CLEAR ALIGNER THERAPY IN ORTHODONTICS .pptx
 
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPromoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
 
Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neu...
Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neu...Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neu...
Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neu...
 
CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1
CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1
CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1
 
Know the difference between Endodontics and Orthodontics.
Know the difference between Endodontics and Orthodontics.Know the difference between Endodontics and Orthodontics.
Know the difference between Endodontics and Orthodontics.
 
Breast cancer: Post menopausal endocrine therapy
Breast cancer: Post menopausal endocrine therapyBreast cancer: Post menopausal endocrine therapy
Breast cancer: Post menopausal endocrine therapy
 

Acid base balance, acid base disorder

  • 1. Acid BaseAcid Base Balance, AcidBalance, Acid Base disordersBase disorders Dr Ifat Ara Begum Associate Professor Dept of Biochemistry Dhaka Medical College Dhaka 1
  • 3. Acid & BaseAcid & Base 3 Points Acid Base Definitio n Molecules that can donate proton (H+ ) in aqueous solution Molecules that can accept proton (H+ ) in aqueous solution pH <7 >7 When dissolve d in water Produces H+ Produces OH- Types Strong acid Weak acid Strong base Weak base
  • 4. Proton is the hydrogen atom with itsProton is the hydrogen atom with its electron removedelectron removed 4
  • 5. 5
  • 6. 6 Conjugate base of acid The remaining anionic part of an acid after removal of proton from the acid In strong acid, it is weak & vice versa Conjugate acid of base It is the acid formed by a base after accepting proton In strong base, it is weak & vice versa
  • 7. 7 Strength of an acid / base is defined in terms of the tendency to donate (or accept) the hydrogen ion to (from) the solvent (i.e. water in biological systems)
  • 8. Sources of Acid/Base in our bodySources of Acid/Base in our body 8  Exogenous source: Foods rich in acid (meat) Ingestion of acids (salicylic acid) Intravenous infusion  Endogenous source: Produced at cellular level during metabolism
  • 9. 9 Sources of Volatile acid:  15 – 20 mol/D  Oxidation of :  Glucose  FA AA Sources of NVA:  230 mmol/D  Oxidation of :  Basic AA  S containing AA PO4 containing substances Sources of Base (nonvolatile):  160 mmol/D  Oxidation of Acidic AA  Metabolism of dietary organic anions like citrate, acetate etc
  • 10. ‘‘Our body is net acid producer’Our body is net acid producer’ 10  NVA & base neutralize each other at one to one ratio.  So, after neutralization, 70 mmol/D NVA is left behind (230-160 = 70)  This 70 mmol/D of NVA, along with 15-20 mol/D of volatile acid makes the body env. acidic
  • 11. Metabolic acid or base production dependsMetabolic acid or base production depends on:on: 11  Insulin status Blood flow to tissues Oxygen supply to tissues Dietary habit
  • 12. Route for excretion of acid/base from bodyRoute for excretion of acid/base from body 12 Pulmonary route For excretion of volatile acids only High capacity system On complete failure for few minutes, it reduces pH grossly Renal route For excretion of NVA & bases Low capacity system On complete failure for few minutes, no effect on pH at all
  • 13. What is pH?What is pH? 13
  • 14. 14
  • 15. 15
  • 16.
  • 17. How pH can be determined?How pH can be determined? 17  Instrumentally by pH meter  Using H-H Equation (From serum HCO3 conc. & PCO2)
  • 18. 18 Importance of normal body pH  Supports optimum enzyme activity  O2 transport & chemical control of respiration  Maintains:  The native molecular form & structural conformation of biomolecules (esp. protein) to keep them functionally active Why Life threatens beyond clinically safe range of pH?  Altered :  Enzyme activity  Membrane permeability  CNS activity  Electrolyte distribution  Increased myocardial irritability Decreased cellular viability
  • 19. 19
  • 20. How pH is regulated?How pH is regulated? 20 First Line Defense  Chemical buffer system: It acts within second to minutes  Pulmonary system: It acts within minutes to hours by regulating CO2 content in blood Second line Defense  Renal system: It acts within hours to days by regulating serum bicarbonate and excretion of acid
  • 21. BufferBuffer  Any substance / A mixture of weak acid & its conjugate base / A mixture of weak acid & its salt with strong base that can accept / release H+ in a solution to resist marked changes in H+ conc. & pH of that solution despite the addition of moderate amount of acid / base to it 21
  • 22.  Principle of buffer action: Conversion of strong acid in to weak acid  Conversion of strong base in to weak base 22
  • 23. 23
  • 24. Body Compartment Buffer system (In order of importance) RBC Hemoglobin, Phosphate, Bicarbonate Plasma/ ECF Bicarbonate, Phosphate, Protein Blood Bicarbonate, Hemoglobin , Phosphate, Protein ICF Protein, Bicarbonate, Phosphate Kidney Ammonia, Phosphate, Bicarbonate Bone Bone buffer
  • 25. Most effective body buffer: BicarbonateMost effective body buffer: Bicarbonate buffer system: Why?buffer system: Why? 25
  • 26. Henderson- Hasselbalch EquationHenderson- Hasselbalch Equation 26
  • 27.
  • 29.
  • 30.
  • 31.
  • 32. 32 Abnormality of either HCO3- or PCO2 , keeping 2nd component normal: Simple ABD Abnormality of both HCO3- or PCO2 simultaneously: Complex ABD (Clinically, existence of >1 simple ABD)
  • 34. What are the common parameters to checkWhat are the common parameters to check ABD?ABD?  pH  PCO2  Serum HCO3 - concentration  Plasma Anion gap  Base excess
  • 35. Normal Acid Base Composition of Arterial BloodNormal Acid Base Composition of Arterial Blood (ABG analysis)(ABG analysis) pH PO2 (mm of Hg) O2 saturatio n (%) PCO2 (mm of Hg) HCO3 conc. (mmol/L) 7.35 - 7.45 85 - 100 80-100 (>95%) 35 - 45 22-28 Plasma Anion gap: 8 – 16 mEq/L Base excess : ± 2 mmol/L
  • 36. Anion gap = UA – UCAnion gap = UA – UC
  • 37. BE = [HCOBE = [HCO33 -- ] p – [HCO] p – [HCO33 -- ]std]std
  • 38. 38 The PO2 reflects the amount of oxygen gas dissolved in the blood. It primarily measures the effectiveness of the lungs in pulling oxygen into the blood stream from the atmosphere i.e. it provides a good index of lung function. .
  • 40. ABD Primary event/defect Unaffected component Secondary event/ compensation Metabolic Acidosis ↓ HCO3 - PCO2 ↓ in PCO2 Metabolic Alkalosis ↑ HCO3 - PCO2 ↑ in PCO2 Respiratory Acidosis ↑ PCO2 HCO3 - ↑ in HCO3 - Respiratory Alkalosis ↓ PCO2 HCO3 - ↓ in HCO3 -
  • 41. Correction of ABDCorrection of ABD  Removal of the cause of ABD ABD Renal activity to normalize HCO3 - conc M. Acidosis  Excretion of acidic urine  Generate new HCO3 - M. Alkalosis  Excretion of alkaline urine  Inhibition of HCO3 - reabs. from PCT to allow its excretion R. Acidosis  Treatment of hypercapnia Inhibition of HCO3 - reabs. from PCT to allow its excretion R. Alkalosis  Treatment of hypocapnia  Increased renal HCO3 - reabs. From PCT
  • 42. 42
  • 43. 43
  • 44. 44
  • 45. 45
  • 46. 46