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Acid-Base Physiology : A Direct Approach - James L. Gamble

Acid-Base Physiology

A Direct Approach

Paperback Published: 30th September 2000
ISBN: 9780801863615
Number Of Pages: 148
For Ages: 22+ years old

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This book develops a scientific approach to the study of clinical acid-base physiology, giving emphasis to the areas of most significance in diagnosis and therapy.

Prefacep. xi
A Review of Fundamentalsp. xiii
From Buffers to Diagnosis
Buffer Systemsp. 1
Buffering That Relates to Change in pHp. 3
Buffering That Relates to Change in the Concentration of Bicarbonatep. 8
Buffer Distribution in Body Compartments and Buffering in Metabolic Acidosisp. 10
Buffering in Metabolic Acidosisp. 12
Relationships in Respiratory Disordersp. 15
The Concept of Respiratory Acidp. 15
Control of Concentration of Dissolved CO[subscript 2]p. 15
Buffering in Respiratory Acidosisp. 16
Acute Buffering Reaction to Carbonic Acidp. 17
A Paradox--Tissue Buffering in Metabolic Acidosisp. 20
CO[subscript 2]-Carbonic Acid System: Role of Lung and Kidneyp. 20
Henderson-Hasselbalch Equationp. 20
Open and Closed Systemsp. 22
The Four Primary Events and the Four Compensatory Responsesp. 25
Diagnosisp. 27
Recommended Approachp. 29
Role of pHp. 30
Referencesp. 32
Renal Excretion of Acid and Reabsorption of Bicarbonate
The Problem and the Pathwayp. 33
Transport and Excretion of Acid Products of Cellular Metabolismp. 34
Weak and Strong Acidsp. 34
Excretion of Weak and Strong Acids, Na-H Exchanges and Secretion of Hydrogen Ionsp. 37
Excretion of Weak Acidsp. 37
Excretion of Strong Acids and Formation of Ammoniap. 39
The Primary Event and Regulation of Extracellular Concentrationsp. 41
Bicarbonate and the Kidney: Recovery, Reabsorption, and Regulationp. 42
Increased Pco[subscript 2] as Cause for Increased Addition of Bicarbonate to Extracellular Fluidp. 44
Terminology and Ratesp. 46
Clinical Correlationsp. 46
Compensation in Respiratory Acidosisp. 46
Diagnostic Evaluation of "Mixed" Acid-Base Diseasep. 47
Excretion of Excess Alkalip. 49
Accumulation of Organic Acids and the "Anion Gap"p. 51
Titratable Acidp. 51
Disorders of Bicarbonate Reabsorptionp. 52
Acidosis and Chronic Renal Failurep. 53
Referencesp. 53
Quantitative Approaches in Diagnosis and Therapy
Sodium and Chloride and Regulation of the Acidity of the Extracellular Fluidp. 55
Volumes and Concentrationsp. 58
Measurement of the Volume of Extracellular Fluidp. 59
Osmotic Effects and Intra/Extracellular Shifts of Waterp. 61
Replacement Therapyp. 64
Essential Components: H[superscript +] and OH[superscript -], or Na[superscript +] and Cl[superscript -]p. 64
Management of Therapyp. 65
Referencesp. 69
The Mechanism of Tissue Buffering in Metabolic Acidosis
Quantitative Relationshipsp. 71
The Primary Problemp. 73
Homeostasis and Intracellular CO[subscript 2]-Carbonic Acid Reactionsp. 74
Tentative Valuation of Intracellular Changesp. 76
Possible Mechanisms in Musclep. 78
Bone as a Source of Bufferingp. 79
Referencesp. 80
Model Experiments
Methods and Assumptionsp. 81
Plasma and Interstitial Fluids as a Single Functional Compartment in Acid-Base Physiologyp. 82
Metabolic Acidosisp. 82
Metabolic Alkalosisp. 84
Respiratory Alkalosis and Acidosisp. 86
Unknownsp. 87
Answers to the Exercises in Experiment 4p. 88
Clinical Relevance of the Experimentsp. 91
Concentrations versus Quantitiesp. 91
Arithmetic and Therapyp. 91
Referencesp. 93
Case Histories
Problems in Acid-Base Physiology as Seen in the Hospitalp. 94
Metabolic Alkalosis due to Loss of Gastric Contentsp. 94
Respiratory Acidosisp. 96
Respiratory Alkalosis due to Hyperventilationp. 96
Metabolic Acidosis Resulting from Diarrhea and Associated with Hypertonicityp. 97
Metabolic Alkalosis Induced by Diuretic Therapyp. 101
Metabolic Acidosis Complicating Diabetesp. 102
Pathophysiology and Treatment of Diabetic Acidosisp. 103
Potassium Deficiency and Potassium Therapyp. 106
Causes of Potassium Deficiencyp. 106
Symptoms and Signsp. 107
Therapyp. 107
Referencesp. 107
Estimation and Evaluation of Plasma Bicarbonatep. 109
The Van Slyke Gasometric analysisp. 109
Automated Analysis and Collection of Bloodp. 109
The Astrup and Siggaard-Andersen Methodp. 110
"Standard Bicarbonate," "Base Excess," and "Buffer Base"p. 110
An Alternative Approach: pH versus nmoles/literp. 113
Nomogram for Application of the Henderson-Hasselbalch Equationp. 114
Referencesp. 116
Exercises for the Student
Questions Concerned with Diagnosisp. 117
CO[subscript 2] Questionsp. 119
Questions for Discussionp. 119
Answers to the Questionsp. 120
Indexp. 125
Table of Contents provided by Syndetics. All Rights Reserved.

ISBN: 9780801863615
ISBN-10: 0801863619
Series: Johns Hopkins Series in Contemporary Medicine and Public Health
Audience: Professional
For Ages: 22+ years old
Format: Paperback
Language: English
Number Of Pages: 148
Published: 30th September 2000
Country of Publication: US
Dimensions (cm): 23.01 x 15.39  x 0.99
Weight (kg): 0.24