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Physiology of Acid Base Balance : Renal physiology USMLE step 1
Acid-base balance in the body is maintained through a delicate balance of various mechanisms that work together to keep the pH of the blood within a narrow range. The primary mechanisms involved in acid-base balance include:
Buffer systems: Buffer systems are the first line of defense against changes in pH. Buffers can absorb excess H+ ions, preventing them from significantly affecting the pH of the blood. The three major buffer systems in the body are the bicarbonate buffer system, the phosphate buffer system, and the protein buffer system.
Respiratory regulation: The respiratory system plays a key role in regulating acid-base balance through the elimination of carbon dioxide (CO2), which can combine with water to form carbonic acid. Increased ventilation results in the elimination of more CO2, which helps to decrease the amount of carbonic acid in the blood, thereby increasing pH. Decreased ventilation leads to the retention of more CO2, which increases carbonic acid and decreases pH.
Renal regulation: The kidneys also play a critical role in regulating acid-base balance through the reabsorption and excretion of bicarbonate ions, production and excretion of ammonium ions, regulation of hydrogen ion secretion, and regulation of other ions.
Cellular buffering: Intracellular and extracellular buffering systems within cells also play a role in maintaining acid-base balance by absorbing and releasing H+ ions as needed.
Understanding the mechanisms involved in acid-base balance is important for the USMLE Step 1 exam, as well as for clinical practice, as disruptions in acid-base balance can have significant consequences for patients.
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