Tuesday 4 October 2011

Acid-base imbalance - questions

These are (unedited) questions from Lim Wei Li, a medical student in Year 2. I have e-mailed the questions to my colleagues and to Physiology Dept. I hope to put up some responses/answers soon. Please check back later.
Prof Faridah

dr.i have some things that i dun understand..
Q1 alkalosis causes decrese in free ca ions due to association with protein. but in milk alkali syndrome. the alkaemia will cause the increase in renal absorbtion of ca> hypercalcemia...so..
A) is it alkalosis will cause decrease in ca..provided only if the kidney is dysfunctional? so there is no reabsorption?
b) does alkaemia and alkalosis have different effects on the ca ions? if yes, how? examples?
Q2 the non-anion gap metabolic acidosis in case of renal tubular acidosis type 1,2,4...frm what i understand is during...there is when alkali decrese..>bicarbonate loss. chloride replaces it via reabsorption> so the measued anion gap is the same..does this mean these  renal tubular acidosis are all hyperchloreamic acidosis?
Q3)  from what i understand last year..  acidosis will cause hyperkalaemia.due exchange of acid wif potassium ions...but why renal tubular acidosis type 1 and 4 is related to hypokalaemia?
Q4)dr...from the primer in chemical pathology...pg51 (normal anion gap acidosis is devided to hyper and hypokalaemic)...does this mean that the potassium disruptions only occur when there is normal anion gap...and why so? i dun quite understand the explainations i got from the book...
i hope you can  help me clear up some of these doubts and queries..thanking you in advance..

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