This document discusses respiratory and metabolic acidosis and alkalosis. It covers:
- The definitions and mechanisms of respiratory acidosis, respiratory alkalosis, metabolic acidosis, and metabolic alkalosis.
- The causes, signs and symptoms, and compensation mechanisms for each condition.
- Specific types like acute vs chronic respiratory acidosis, and chloride responsive vs chloride resistant metabolic alkalosis.
- How the kidneys, lungs, and buffering systems work to regulate pH and compensate for acid-base imbalances.
This PPT is mainly useful for MBBS as well as other branch of Medicine to have an basic idea about Electrolytes. Also about What to see & What to do in cases of Electrolytes Imbalances.
this slide focuses on all the acid base disorder pertaining to the respiratory system. it focus on the compensatory mechanism, causes, clinical features and treatment.
Glucose tolerance test- Indications, contraindications, preparation of a patient, precautions, types of GTT, normal curve, diabetic curve, renal glycosuria, lag curve, Criteria for diagnosis of DM
This PPT is mainly useful for MBBS as well as other branch of Medicine to have an basic idea about Electrolytes. Also about What to see & What to do in cases of Electrolytes Imbalances.
this slide focuses on all the acid base disorder pertaining to the respiratory system. it focus on the compensatory mechanism, causes, clinical features and treatment.
Glucose tolerance test- Indications, contraindications, preparation of a patient, precautions, types of GTT, normal curve, diabetic curve, renal glycosuria, lag curve, Criteria for diagnosis of DM
ABG test measures the blood gas tension values of the arterial partial pressure of oxygen, and the arterial partial pressure of carbon dioxide, and the blood's pH
Richard's entangled aventures in wonderlandRichard Gill
Since the loophole-free Bell experiments of 2020 and the Nobel prizes in physics of 2022, critics of Bell's work have retreated to the fortress of super-determinism. Now, super-determinism is a derogatory word - it just means "determinism". Palmer, Hance and Hossenfelder argue that quantum mechanics and determinism are not incompatible, using a sophisticated mathematical construction based on a subtle thinning of allowed states and measurements in quantum mechanics, such that what is left appears to make Bell's argument fail, without altering the empirical predictions of quantum mechanics. I think however that it is a smoke screen, and the slogan "lost in math" comes to my mind. I will discuss some other recent disproofs of Bell's theorem using the language of causality based on causal graphs. Causal thinking is also central to law and justice. I will mention surprising connections to my work on serial killer nurse cases, in particular the Dutch case of Lucia de Berk and the current UK case of Lucy Letby.
This presentation explores a brief idea about the structural and functional attributes of nucleotides, the structure and function of genetic materials along with the impact of UV rays and pH upon them.
Professional air quality monitoring systems provide immediate, on-site data for analysis, compliance, and decision-making.
Monitor common gases, weather parameters, particulates.
Cancer cell metabolism: special Reference to Lactate PathwayAADYARAJPANDEY1
Normal Cell Metabolism:
Cellular respiration describes the series of steps that cells use to break down sugar and other chemicals to get the energy we need to function.
Energy is stored in the bonds of glucose and when glucose is broken down, much of that energy is released.
Cell utilize energy in the form of ATP.
The first step of respiration is called glycolysis. In a series of steps, glycolysis breaks glucose into two smaller molecules - a chemical called pyruvate. A small amount of ATP is formed during this process.
Most healthy cells continue the breakdown in a second process, called the Kreb's cycle. The Kreb's cycle allows cells to “burn” the pyruvates made in glycolysis to get more ATP.
The last step in the breakdown of glucose is called oxidative phosphorylation (Ox-Phos).
It takes place in specialized cell structures called mitochondria. This process produces a large amount of ATP. Importantly, cells need oxygen to complete oxidative phosphorylation.
If a cell completes only glycolysis, only 2 molecules of ATP are made per glucose. However, if the cell completes the entire respiration process (glycolysis - Kreb's - oxidative phosphorylation), about 36 molecules of ATP are created, giving it much more energy to use.
IN CANCER CELL:
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
introduction to WARBERG PHENOMENA:
WARBURG EFFECT Usually, cancer cells are highly glycolytic (glucose addiction) and take up more glucose than do normal cells from outside.
Otto Heinrich Warburg (; 8 October 1883 – 1 August 1970) In 1931 was awarded the Nobel Prize in Physiology for his "discovery of the nature and mode of action of the respiratory enzyme.
WARNBURG EFFECT : cancer cells under aerobic (well-oxygenated) conditions to metabolize glucose to lactate (aerobic glycolysis) is known as the Warburg effect. Warburg made the observation that tumor slices consume glucose and secrete lactate at a higher rate than normal tissues.
Multi-source connectivity as the driver of solar wind variability in the heli...Sérgio Sacani
The ambient solar wind that flls the heliosphere originates from multiple
sources in the solar corona and is highly structured. It is often described
as high-speed, relatively homogeneous, plasma streams from coronal
holes and slow-speed, highly variable, streams whose source regions are
under debate. A key goal of ESA/NASA’s Solar Orbiter mission is to identify
solar wind sources and understand what drives the complexity seen in the
heliosphere. By combining magnetic feld modelling and spectroscopic
techniques with high-resolution observations and measurements, we show
that the solar wind variability detected in situ by Solar Orbiter in March
2022 is driven by spatio-temporal changes in the magnetic connectivity to
multiple sources in the solar atmosphere. The magnetic feld footpoints
connected to the spacecraft moved from the boundaries of a coronal hole
to one active region (12961) and then across to another region (12957). This
is refected in the in situ measurements, which show the transition from fast
to highly Alfvénic then to slow solar wind that is disrupted by the arrival of
a coronal mass ejection. Our results describe solar wind variability at 0.5 au
but are applicable to near-Earth observatories.
Richard's aventures in two entangled wonderlandsRichard Gill
Since the loophole-free Bell experiments of 2020 and the Nobel prizes in physics of 2022, critics of Bell's work have retreated to the fortress of super-determinism. Now, super-determinism is a derogatory word - it just means "determinism". Palmer, Hance and Hossenfelder argue that quantum mechanics and determinism are not incompatible, using a sophisticated mathematical construction based on a subtle thinning of allowed states and measurements in quantum mechanics, such that what is left appears to make Bell's argument fail, without altering the empirical predictions of quantum mechanics. I think however that it is a smoke screen, and the slogan "lost in math" comes to my mind. I will discuss some other recent disproofs of Bell's theorem using the language of causality based on causal graphs. Causal thinking is also central to law and justice. I will mention surprising connections to my work on serial killer nurse cases, in particular the Dutch case of Lucia de Berk and the current UK case of Lucy Letby.
THE IMPORTANCE OF MARTIAN ATMOSPHERE SAMPLE RETURN.Sérgio Sacani
The return of a sample of near-surface atmosphere from Mars would facilitate answers to several first-order science questions surrounding the formation and evolution of the planet. One of the important aspects of terrestrial planet formation in general is the role that primary atmospheres played in influencing the chemistry and structure of the planets and their antecedents. Studies of the martian atmosphere can be used to investigate the role of a primary atmosphere in its history. Atmosphere samples would also inform our understanding of the near-surface chemistry of the planet, and ultimately the prospects for life. High-precision isotopic analyses of constituent gases are needed to address these questions, requiring that the analyses are made on returned samples rather than in situ.
Slide 1: Title Slide
Extrachromosomal Inheritance
Slide 2: Introduction to Extrachromosomal Inheritance
Definition: Extrachromosomal inheritance refers to the transmission of genetic material that is not found within the nucleus.
Key Components: Involves genes located in mitochondria, chloroplasts, and plasmids.
Slide 3: Mitochondrial Inheritance
Mitochondria: Organelles responsible for energy production.
Mitochondrial DNA (mtDNA): Circular DNA molecule found in mitochondria.
Inheritance Pattern: Maternally inherited, meaning it is passed from mothers to all their offspring.
Diseases: Examples include Leber’s hereditary optic neuropathy (LHON) and mitochondrial myopathy.
Slide 4: Chloroplast Inheritance
Chloroplasts: Organelles responsible for photosynthesis in plants.
Chloroplast DNA (cpDNA): Circular DNA molecule found in chloroplasts.
Inheritance Pattern: Often maternally inherited in most plants, but can vary in some species.
Examples: Variegation in plants, where leaf color patterns are determined by chloroplast DNA.
Slide 5: Plasmid Inheritance
Plasmids: Small, circular DNA molecules found in bacteria and some eukaryotes.
Features: Can carry antibiotic resistance genes and can be transferred between cells through processes like conjugation.
Significance: Important in biotechnology for gene cloning and genetic engineering.
Slide 6: Mechanisms of Extrachromosomal Inheritance
Non-Mendelian Patterns: Do not follow Mendel’s laws of inheritance.
Cytoplasmic Segregation: During cell division, organelles like mitochondria and chloroplasts are randomly distributed to daughter cells.
Heteroplasmy: Presence of more than one type of organellar genome within a cell, leading to variation in expression.
Slide 7: Examples of Extrachromosomal Inheritance
Four O’clock Plant (Mirabilis jalapa): Shows variegated leaves due to different cpDNA in leaf cells.
Petite Mutants in Yeast: Result from mutations in mitochondrial DNA affecting respiration.
Slide 8: Importance of Extrachromosomal Inheritance
Evolution: Provides insight into the evolution of eukaryotic cells.
Medicine: Understanding mitochondrial inheritance helps in diagnosing and treating mitochondrial diseases.
Agriculture: Chloroplast inheritance can be used in plant breeding and genetic modification.
Slide 9: Recent Research and Advances
Gene Editing: Techniques like CRISPR-Cas9 are being used to edit mitochondrial and chloroplast DNA.
Therapies: Development of mitochondrial replacement therapy (MRT) for preventing mitochondrial diseases.
Slide 10: Conclusion
Summary: Extrachromosomal inheritance involves the transmission of genetic material outside the nucleus and plays a crucial role in genetics, medicine, and biotechnology.
Future Directions: Continued research and technological advancements hold promise for new treatments and applications.
Slide 11: Questions and Discussion
Invite Audience: Open the floor for any questions or further discussion on the topic.
Introduction:
RNA interference (RNAi) or Post-Transcriptional Gene Silencing (PTGS) is an important biological process for modulating eukaryotic gene expression.
It is highly conserved process of posttranscriptional gene silencing by which double stranded RNA (dsRNA) causes sequence-specific degradation of mRNA sequences.
dsRNA-induced gene silencing (RNAi) is reported in a wide range of eukaryotes ranging from worms, insects, mammals and plants.
This process mediates resistance to both endogenous parasitic and exogenous pathogenic nucleic acids, and regulates the expression of protein-coding genes.
What are small ncRNAs?
micro RNA (miRNA)
short interfering RNA (siRNA)
Properties of small non-coding RNA:
Involved in silencing mRNA transcripts.
Called “small” because they are usually only about 21-24 nucleotides long.
Synthesized by first cutting up longer precursor sequences (like the 61nt one that Lee discovered).
Silence an mRNA by base pairing with some sequence on the mRNA.
Discovery of siRNA?
The first small RNA:
In 1993 Rosalind Lee (Victor Ambros lab) was studying a non- coding gene in C. elegans, lin-4, that was involved in silencing of another gene, lin-14, at the appropriate time in the
development of the worm C. elegans.
Two small transcripts of lin-4 (22nt and 61nt) were found to be complementary to a sequence in the 3' UTR of lin-14.
Because lin-4 encoded no protein, she deduced that it must be these transcripts that are causing the silencing by RNA-RNA interactions.
Types of RNAi ( non coding RNA)
MiRNA
Length (23-25 nt)
Trans acting
Binds with target MRNA in mismatch
Translation inhibition
Si RNA
Length 21 nt.
Cis acting
Bind with target Mrna in perfect complementary sequence
Piwi-RNA
Length ; 25 to 36 nt.
Expressed in Germ Cells
Regulates trnasposomes activity
MECHANISM OF RNAI:
First the double-stranded RNA teams up with a protein complex named Dicer, which cuts the long RNA into short pieces.
Then another protein complex called RISC (RNA-induced silencing complex) discards one of the two RNA strands.
The RISC-docked, single-stranded RNA then pairs with the homologous mRNA and destroys it.
THE RISC COMPLEX:
RISC is large(>500kD) RNA multi- protein Binding complex which triggers MRNA degradation in response to MRNA
Unwinding of double stranded Si RNA by ATP independent Helicase
Active component of RISC is Ago proteins( ENDONUCLEASE) which cleave target MRNA.
DICER: endonuclease (RNase Family III)
Argonaute: Central Component of the RNA-Induced Silencing Complex (RISC)
One strand of the dsRNA produced by Dicer is retained in the RISC complex in association with Argonaute
ARGONAUTE PROTEIN :
1.PAZ(PIWI/Argonaute/ Zwille)- Recognition of target MRNA
2.PIWI (p-element induced wimpy Testis)- breaks Phosphodiester bond of mRNA.)RNAse H activity.
MiRNA:
The Double-stranded RNAs are naturally produced in eukaryotic cells during development, and they have a key role in regulating gene expression .
1. RESPIRATORY AND
METABOLIC ACIDOSIS
& ALKALOSIS
By Monisha Jayabalan
Ist MSc Medical Biochemistry
Dr.A.L.mudaliar post graduate institute of basic
medical sciences, University of Madras, Taramani.
14-03-2015 1
2. • Acids are hydrogen ion whereas A base is an
ion or a molecule that can accept an H+.
• H+ regulation is essential because the
activities of almost all enzyme systems in the
body are influenced by H+ concentration
• Acid-Base homeostasis is concerned about the
proper balancing of acid and bases, also called
the pH
14-03-2015 2
3. ACIDOSIS is the reduction in the pH due to
the presence of excess H+ ions
ALKALOSIS is the decrease in the pH
14-03-2015 3
4. Defences Against Changes in Hydrogen Ion
Concentration
1.Chemical acid- base buffer system
2.Respiratory centers
3.kidneys
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5. CHEMICAL ACID –BASE BUFFER SYSTEM
• This is the first line of defense.
• Chemical buffers include bicarbonate buffer,
phosphate buffer and protein buffer
• The bicarbonate buffering system is especially key,
as carbon dioxide (CO2) can be shifted through
carbonic acid (H2CO3) to hydrogen ions and
bicarbonate (HCO3-)
14-03-2015 5
6. Respiratory Regulation of Acid-Base Balance
• This is the second line of defense in acid-base
disturbances
• An increase in ventilation eliminates CO2 from
extracellular fluid, which, by mass action, reduces the
H+ concentration.
• Conversely, decreased ventilation increases CO2, thus
also increasing H+ concentration in the extracellular
fluid.
14-03-2015 6
7. • The buffering power of respiratory centers are one
to two times as great as the buffering power of all
the chemical buffers in the EC fluid combined
14-03-2015 7
8. RESPIRATORY ACIDOSIS
• Respiratory acidosis is a medical emergency in which
decreased ventilation causes increased blood carbon
dioxide concentration and ultimately leads to
decrease in the pH level
• During Alveolar hypoventilation there is an increase in
CO2 thus leads to an increased PaCO2.
Acidosis refers to disorders that lower
cell/tissue pH to < 7.35
Acidemia refers to an arterial pH < 7.3
14-03-2015 8
10. ACUTE RESPIRATORY ACIDOSIS
• PaCO2 is elevated above the upper limit of the
reference range (over 6.3 kPa or 45 mm Hg) with an
accompanying acidemia (pH <7.36).
• occurs when an abrupt failure of ventilation occurs
• failure in ventilation may be caused by depression of
the central respiratory center, inability to ventilate
adequately due to neuromuscular disease, or airway
obstruction related to asthma or chronic obstructive
pulmonary disease (COPD) exacerbation.
14-03-2015 10
11. CHRONIC RESPIRATORY ACIDOSIS
• Chronic respiratory acidosis may be secondary to
many disorders,including COPD
• Chronic respiratory acidosis also may be secondary to
Pickwickian syndrome, neuromuscular disorders, and
severe restrictive ventilatory defects as observed in
interstitial fibrosis and thoracic deformities.
14-03-2015 11
12. MECHANISM
• acute respiratory acidosis, compensation occurs in 2
steps.
• The initial response is cellular buffering that occurs
over minutes to hours. Cellular buffering elevates
plasma bicarbonate (HCO3
−) only slightly,
approximately 1 mEq/L for each 10-mm Hg increase in
PaCO2.
• The second step is renal compensation that occurs
over 3–5 days. With renal compensation, renal
excretion of carbonic acid is increased and
bicarbonate reabsorption is increased. For instance,
PEPCK is upregulated in renal proximal tubule brush
border cells, in order to secrete more NH3 and thus
to produce more HCO3
−
14-03-2015 12
13. RESPIRATORY ALKALOSIS
• Respiratory alkalosis is a medical condition in which
increased respiration elevates the blood pH beyond
the normal range (7.35-7.45) with a concurrent
reduction in arterial levels of CO2.
Alkalosis refers to disorders that elevate
cellular pH to > 7.45.
Alkalemia refers to an arterial pH > 7.45.
14-03-2015 13
15. ACUTE RESPIRATORY ALKALOSIS
• Acute respiratory alkalosis occurs rapidly. For every
10 mmHg drop in PCO2 in arterial blood, there is a
corresponding 2 mEq/L drop in bicarbonate ion due to
acute compensation. During acute respiratory
alkalosis, the person may lose consciousness where
the rate of ventilation will resume to normal.
14-03-2015 15
16. CHRONIC RESPIRATORY ALKALOSIS
• Chronic respiratory alkalosis is a more long-standing
condition. For every 10 mmHg drop in PCO2 in arterial
blood, there is a corresponding 5 mEq/L drop in
bicarbonate ion. The drop of 5 mEq/L of bicarbonate
ion is a compensation effect which reduces the
alkalosis effect of the drop in PCO2 in blood. This is
termed metabolic compensation.
14-03-2015 16
17. CAUSES
• psychiatric causes
• CNS causes
• drug use: doxapram, aspirin, caffeine and coffee
abuse
• moving into high altitude areas, where the low
atmospheric pressure of oxygen stimulates increased
ventilation
• lung disease such as pneumonia
• fever
• pregnancy
• high levels of NH4+ leading to brain swelling and
decreased blood flow to the brain
14-03-2015 17
18. MECHANISM
• Respiratory alkalosis generally occurs when some
stimulus makes a person hyperventilate. The
increased breathing produces increased alveolar
respiration, expelling CO2 from the circulation. This
alters the dynamic chemical equilibrium of carbon
dioxide in the circulatory system, and the system
reacts according to Le Chatelier's principle.
Circulating hydrogen ions and bicarbonate are shifted
through the carbonic acid (H2CO3) intermediate to
make more CO2 via the enzyme carbonic anhydrase.
14-03-2015 18
19. RENAL COMPENSATION
• Renal compensation is a mechanism by which the
kidneys can regulate the plasma pH. It is slower than
respiratory compensation, but has a greater ability to
restore normal values.
• In respiratory acidosis, the kidney produces and
excretes ammonium (NH4
+) and monophosphate,
generating bicarbonate in the process while clearing
acid.[1]
• In respiratory alkalosis, less HCO3
− is reabsorbed,
thus lowering the pH.[2]
14-03-2015 19
20. METABOLIC ACIDOSIS
• Metabolic acidosis is a condition that occurs when the
body produces excessive quantities of acid or when
the kidneys are not removing enough acid from the
body
• If untreated it leads to ACIDEMIA
• The consequences are so serious leading to coma and
death
14-03-2015 20
21. Signs and symptoms
• Symptoms are not specific
• Symptoms may include chest pain
• , palpitations,
• headache,
• altered mental status such as severe anxiety due to
hypoxia,
• decreased visual acuity,
• nausea,
• vomiting,
14-03-2015 21
22. • abdominal pain
• altered appetite and weight gain
• muscle weakness
• bone pain and joint pain.
• Extreme acidemia leads to neurological and cardiac
complications:
• Neurological: lethargy, stupor, coma, seizures.
• Cardiac: arrhythmias (ventricular tachycardia),
decreased response to epinephrine; both lead to
hypotension (low blood pressure).
14-03-2015 22
23. CAUSES
• Metabolic acidosis occurs when the body produces too
much acid, or when the kidneys are not removing
enough acid from the body. There are several types
of metabolic acidosis. The main causes are best
grouped by their influence on the anion gap.
The anion gap is the difference in the
measured cations and the measured anions
in serum, plasma, or urine.
14-03-2015 23
24. INCREASED ANION GAP
• lactic acidosis
• ketoacidosis
• chronic renal failure (accumulation of sulphates,
phosphates, urea)
• intoxication:
o organic acids (salicylates, ethanol, methanol, formaldehyde,
ethylene glycol, paraldehyde)
o Sulphates, metformin(Glucophage)
• massive rhabdomyolysis
14-03-2015 24
25. NORMAL ANION GAP
• longstanding diarrhoea (bicarbonate loss)
• bicarbonate loss due to taking topiramate
• pancreatic fistula
• uretero-sigmoidostomy
• intoxication:
o ammonium chloride
o acetazolamide (Diamox)
o isopropyl alcohol
• renal failure (occasionally)
• inhalant abuse
• toluene
14-03-2015 25
26. COMPENSATION MECHANISM
• Metabolic acidosis is either due to increased
generation of acid or an inability to generate
sufficient bicarbonate. The body regulates the
acidity of the blood by four buffering mechanisms.
• bicarbonate buffering system
• Intracellular buffering by absorption of hydrogen
atoms by various molecules, including proteins,
phosphates and carbonate in bone.
• Respiratory compensation
• Renal compensation
14-03-2015 26
27. METABOLIC ALKALOSIS
• Metabolic alkalosis is a metabolic condition in which
the pH of tissue is elevated beyond the normal range
(7.35-7.45).
• This is the result of decreased hydrogen ion
concentration, leading to increased bicarbonate.
14-03-2015 27
29. CHLORIDE RESPONSIVE
• Loss of hydrogen ions - Most often occurs via two
mechanisms, either vomiting or via the kidney.
o Vomiting results in the loss of hydrochloric acid
o Severe vomiting also causes loss of potassium (hypokalaemia)
and sodium (hyponatremia). The kidneys compensate for
these losses by retaining sodium in the collecting ducts at
the expense of hydrogen ions (sparing sodium/potassium
pumps to prevent further loss of potassium), leading to
metabolic alkalosis.
• Congenital chloride diarrhea - rare for being a
diarrhea that causes alkalosis instead of acidosis.
14-03-2015 29
30. • Contraction alkalosis
• Diuretic therapy - loop diuretics and thiazides
• Post hypercapnia - Hypoventilation (decreased
respiratory rate) causes hypercapnia (increased levels
of CO2), which results in respiratory acidosis. Renal
compensation with excess bicarbonate occurs to
lessen the effect of the acidosis. Once carbon
dioxide levels return to base line, the higher
bicarbonate levels reveal themselves putting the
patient into metabolic alkalosis.
• Cystic Fibrosis
14-03-2015 30
31. CHLORIDE RESISTANT
• Retention of bicarbonate
• Shift of hydrogen ions into intracellular space -
Seen in hypokalemia.
• Alkalotic agents - Alkalotic agents, such as
bicarbonate (administrated in cases of peptic ulcer or
hyperacidity) or antacids, administered in excess can
lead to an alkalosis.
• Hyperaldosteronism
14-03-2015 31
32. • Excess Glycyrrhizin consumption
• Bartter syndrome and Gitelman syndrome -
• Liddle syndrome
• 11β-hydroxylase deficiency and 17α-hydroxylase
deficiency - both characterized by hypertension
• Aminoglycoside toxicity can induce a hypokalemic
metabolic alkalosis via activating the calcium sensing
receptor in the thick ascending limb of the nephron,
inactivating the NKCC2 cotransporter, creating a
Bartter's syndrome like effect.
14-03-2015 32
33. RESPIRATORY COMPENSATION
• Respiratory compensation is a mechanism by which
plasma pH can be altered by varying the respiratory
rate. It is faster than renal compensation, but has
less ability to restore normal values.
• In metabolic acidosis, chemoreceptors sense a
deranged acid-base system, and there is increased
breathing.
• In metabolic alkalosis, the breathing rate is
decreased.
14-03-2015 33
