Questions to prepare for classes and examination
• The concept of acid-base homeostasis.
• The main buffer systems of the blood.
• Physiological mechanisms responsible for the normal acid-base balance:
— role of the respiratory system;
— role of the kidneys.
• Simple and mixed acid-base disorders.
• Typical forms of disorders of acid-base balance.
• Metabolic acidosis: causes and symptoms.
• The specific examples of metabolic acidosis:
— high-anion gap acidosis;
— hyperchloremic metabolic acidosis.
• Metabolic alkalosis: causes and symptoms.
• Mechanisms and examples of metabolic alkalosis.
• Respiratory acidosis: causes and mechanisms.
• Respiratory alkalosis: causes and mechanisms.
• Primary and compensatory changes in various types of acidosis and alkalosis. Clinical manifestations of alkalosis and acidosis.
• Laboratory parameters used in diagnostics of acid-base dysbalance.
N 61
A group of mountain-climbers in which a physician was included planned to climb a mountain peak of 6.200 m. Climbing up to the level of 2.900 m was successful, but at this altitude the physician, being an inexperienced climber, felt fatigue, muscle weakness, dizziness, buzzing in the ears (tinnitus). During a one-hour halt the physician collected samples of the capillary blood of his own (B1) and his mate (A1). Then the group continued the ascent. At the height of 5.000 m the physician felt acute shortness of breath, severe weakness, heaviness in the body, vision disturbances, and became ataxic. For this reason he decided to stop climbing. The state of the experienced climbers was satisfactory. After the repeated withdrawal of blood samples (A2, B2) all the climbers returned to the camp at the level of 3.000 m.