Chapter 1: The Facts of Life

Chemistry is the logic of Biological phenomena

Albert Lehninger: living things are composed of lifeless tissues

Richard Feynman: living things can be understood in wiggling and jigglings of
atoms

A. Distinctive Properties of Living Systems

1. Organisms are complicated and highly organized
- With degree of organization in their 3D architecture (hierarchy)
- Composed of simple sets of building blocks
- Vary in atoms and interactions
2. Biological structures serve functional purposes
- Protein, nucleic acid, lipids, carbohydrates, small molecules
3. Living systems actively engaged in energy transformations
- Convert energy (producers-consumers)
- ATP & NADPH special energized biomolecules (power sources)
Inanimate (lifeless) matter moving to an increasing disorder or
maximum entropy
(entropy- randomness or disorder of the components of a
chemical system)
Energy consumed by org. to maintain stability and order
4. Living systems capacity for self-replication
- Asexual (division) in bacteria
- Sexual
- Molecules of inanimate world cant replicate (abiotic)
- High degree of fidelity- very close to original copy- pass of
genes/heredity

B. Biomolecules: Molecules of Life

- H, C, O, N make up 99% in human body
Capable of forming covalent bonds by e- sharing (property
unites to chem of life)
o C, N and O can share two electron pairs to form
double bonds with one another within
biomolecules- enhance chemical versatility
o C can form covalent bonds with itself + tetrahedral
shape; these properties hold the potential for an
incredible variety of linear, branched, and cyclic
compounds of C. enhanced by other atoms
C. Biomolecular Hierarchy
- biomolecules are built accrdg to a structural hierarchy
Simple molecules- units for building complex structures
1. Inorganic Precursors interact to each other to form metabolites
- Water, carbon dioxide, ammonium, nitrate, dinitrogen
2. Metabolites simple organic comp. that are intermediates in cellular energy
transformation and in biosynthesis of various sets of building blocks (3)
Amino acids
Sugars
Nucleotides
Fatty acids
Glycerol
4. Macromolecules covalent bonding share electron (produced by the
polymerization of
relatively small compounds)
* Protein
* Polysaccharides
* Polynucleotides (DNA & RNA)

* Lipids
5. Supramolecular Complexes interaction among macromolecules (noncovalent bond)
- hydrogen bond
- ionic attractions
- van der Waals forces (specific distance)
- hydrophobic interactions
6. Organelles entities of considerable dimensions compared with the cell
itself
Membranes supramolecular assemblies define the boundaries of cells
(phospholipid bilayer)
- Not easily classified as supramolecular assemblies or organelles,
have properties of both
- Supramolecular in construction because they are complexes of
proteins & lipids maintained by noncovalent forces
o Hydrophobic interaction- barrier to the free passage of
inorganic ions and most other charged or polar compounds
hydrophobic tends to occupy inner portion of
enzyme (protein)
Presence of membrane: for proper organelle
function
Protein and lipid composition are
characterized by the organelles function
How do properties of biomolecules reflect their fitness to the living
condition:

Cell unit of life

o Necessity of information and energy in maintaining living state
Biomolecules have the capacity to contain the information of life
Translate the information so structures essential to life are
synthesized
o Interactions bet. the structures are the processes of life
Orderly mechanism for abstracting energy from environment
must exist in order to obtain the energy needed to drive the
processes
Biochemical reaction needs energy energy stored in bonds
(biomolecules) break the bonds if in need of energy
Potential for such qualities:
o Have a sense or directionality (own system) mechanism for
recognition
o Informational contain information which are not repetitive
- If repetitive no information is stored
o Three dimensional architecture
o Weak Forces Maintain Biological Structure and Determine Biomolecular
Interactions
- Organism survived in specific conditions (disrupt interactions
weak bonds)
1. Van der Waals forces
-

two dipoles weakly attract each other, bringing the two nuclei
closer. As the two nuclei draw closer together, their electron clouds
begin to repel each other. At the point where the van der Waals
attraction exactly balances this repulsive force, the nuclei are said
to be in van der Waals contact. Each atom has a characteristic van
der Waals radius, a measure of how close that atom will allow
another to approach
negatively charged electron clouds fluctuate instantaneously in
time are attracted to positively charged nuclei and electrons of
nearby atoms
stable bonds have lower energies; nearer distance energy
increases (repulsion)

operate in limited interatomic distance 0.3 to 0.6 mm

2. Hydrogen Bonds
-

form bet. a hydrogen atom covalently bonded to an

electronegative atom (O or N) and a second electronegative
atom that serves as the hydrogen bond acceptor; BETWEEN
POLAR GROUPS
maki pag bond sa lahat ng electronegative atom na may lone
pairs
cylindrically symmetrical and tend to be highly directional, forms
straight bonds bet. donor, hydrogen and the acceptors (lone
pairs are linear to other molecules)
more lone pairs H is attracted

3. Ionic Interactions
-

attractive forces bet oppositely charged structures (positive &

negative ion)
- stronger than H bonds
- electric charge is radically distributed; these interactions may lack the
directionality of hydrogen bonds or precise fit of van der waals
interactions
Between dimensions
o Ions species possessing discrete charges
o Permanent dipoles permanent separation of + & - charge
o Induced dipoles temporary separation induced by the environment
Dipole separation of charges
4. Hydrophobic Interactions
-

Result from strong tendency of water to exclude nonpolar groups or

molecules; Forces that hold nonpolar regions of molecules together
Without interaction entropy of water is raised bc fewer water mol
are arranged in orderly arrays
Strength of interaction results from the systems achieving
greatest thermodynamic stability by minimizing the number of ordered
water molecules required to surround hydrophobic portions of the
solute molecules.
Increase H bonds, push hydrophobic decrease surface area

BIOCHEMISTRY molecular recognition through structural complementarity

molecular logic of life
-

complicated and highly organized patterns of life depend on ability of

biomolecules to recognize and interact with one another in very
specific ways
o no reaction if not compliment sa structure
o specific interaction > inhibitors
protein recognizes its specific metabolites substrate
should interact
Biological function is achieved through mechanisms based on structural
complementarity and weak chemical interactions.

e.g. supramolecular complexes occurs because of recognition and

interaction between their various macromolecular components, as
governed by the weak
forces formed between them.
Because biomolecular interactions are governed by weak forces, living
systems are restricted to a narrow range of physical conditions
Denaturation loss of structural order in complex
macromolecules; loss of function
As a consequence, cells cannot tolerate reactions in which large
amounts of energy are released, nor can they generate a large
energy burst to drive energy-requiring processes.
Every step, gets ATP so reaction is possible
Instead, such transformations take place via sequential series of
chemical reactions whose overall effect achieves dramatic energy
changes, even though any given reaction in the series proceeds with
only modest input or release of energy.
Metabolism ordered reaction pathways by w/c cellular
chemistry proceeds and biological energy transformations are
accomplished
Used of enzymes catalyzed metabolic reactions

Chapter 2: Water
-

Most abundant substance in living systems; life originated in seas

Water and ionization products hydrogen ions and hydroxide ions,
influence the structure, properties and functions of many biomolecules
proteins, nucleic acids and lipids
Difference in the concn of hydrogen ions on opposite sides of a
membrane represents an energized condition essential to biological
mechanisms of energy transformation
o Concn gradient movement of ions
Non covalent interactions responsible for strength and specificity of
recognition on biomol. influenced by solvent properties of water and
ability to form H bonds with itself and solutes

Properties of Water

Higher boiling point, melting point, heat of vaporization and surface tension
o Attractions bet. adjacent water mol that give liquid water great internal
cohesion
High intermolecular forces of attraction bet. H2O
Maximum density is found in liquid state, with negative volume of melting
(ice occupies more space than the liquid form solid form floats)
Permanent Dipoles two atoms in molecule have substantially diff.
electronegativity: One atom attracts electrons more than another, more
negative. While the other atom becomes more positive
Hydrogen bonding in water is key to its properties
o Each shares an electron pair with the central oxygen atom
H-O-H bond angle is 104.5 degree
Oxygen nucleus attracts electrons more strongly than hydrogen
nucleus (proton)
O is more electronegative sharing electrons of H and O
are unequal
o Result is two electric dipoles in water mol H bears
partial positive charge and O partial negative
charge
o Hydrogen Bond electrostatic attraction bet. oxygen atom and
hydrogen of diff mol.
4 hydrogen bonds in one H2O molecule
o H-bonding is cooperative: H2O mol serving as an H-bond donor
becomes a better H-bond acceptor
Solid form distanced, density lower

 Liquid twist
Hydrogen bonding in ice: fixed in space and forms max 4 H bonds
creating regular crystal lattice
Solvent properties of water derive from its polar nature (universal solvent)
o Hydration shells surrounding ions
Water has high dielectric constant
- Ability to surround ions in dipole interactions and diminish + and
- attractions between the water molecules interacting with ions
o measure of how well substance separate ions attracted to each
other
Water forms H bonds with Polar solutes
- Readily form hydrogen bonds with polar functional groups (O, N and C)
- Has positive and negative partial ends
o Hydrogen acceptor with lone pairs (O, N, C)
o Donor lahat ng may H mabigay
Hydrophobic Interactions apparent affinity of nonpolar structures
- Strength of the interaction it results from the systems achieving
greatest thermodynamic stability by minimizing the number of
ordered water molecules required to surround hydrophobic portions of
solute molecules
- water molecules participate in as many H-bonded interactions with one
another as the temperature permits
- H-bonded water network rearranges toward formation of a local cage
like (clathrate) structure surrounding each insoluble solute molecule
o Attraction bet nonpolar solutes is an entropy-driven process due
to net decrease in order
Amphiphilic molecules both strongly polar and nonpolar groups
- Polar interacts with the solvent and tends to dissolve; non polar avoid
contact with water
o Micelle stable structures of amphipathic compounds in water
NP cluster together and P arranged to maximize their
interaction
Colligative Properties
- Presence of solute (dissolved substance) disturbs the structure of
liquid, thereby changing its properties depends on the solute
o Misbehave ang water localize place of order in water
CP influence of solute on water is reflected in a set of
char. Changes in behavior
o Solutes alter the colligative properties of aqueous solutions by
lowering effective concn of water
Freezing point depression molecules that collide with the crystal are
solute, not water
o FPD crystalline lattice more energy, low temperature to
separate
Freezing of water 0 degrees ; above 0 melt
Put salt (fpd) melt bc ipa low below 0 na ang
freezing
Boiling point elevation
o BP vapor pressure is equal to external force
o Change BP in more atmospheric pressure place
Vapor pressure lowering
o VP - Equal ratio escape of mol. of gas and liquid during
evaporation
Osmotic pressure effects
o pressure necessary to push water back through the membrane
at a rate exactly equaled by the water influx is the osmotic
pressure of the solution
o To minimize the osmotic pressure created by the contents of
their cytosol, cells tend to store substances such as amino acids
and sugars in polymeric form
o

Imposing local order on water molecules, solutes make it more difficult for water to
assume its crystalline lattice (freeze) or escape into the atmosphere (boil or
vaporize)

Osmosis, water movement across a

semipermeable
membrane driven by differences in
osmotic pressure
hypertonic solution, one with higher
osmolarity than the cytosol, the cell
shrinks as water flows out
hypotonic solution, with lower osmolarity
than the cytosol, the cell swells as water
enters.

natural environments, cells generally

contain
higher concentrations of biomolecules and
ions than
their surroundings, so osmotic pressure
tends to drive
water into cells. If not somehow
counterbalanced, this inward movement of
water would distend the plasma
membrane and eventually cause bursting
of the cell (lysis)

Buffer

Neutralize an acid or base

Compose of weak organic acid and its conjugate base
Resist change in pH
When weak acids are dissolved in water, they contribute H+ by ionizing;
weak bases consume H+ by becoming protonated. These processes are also
governed by equilibrium constants
Total hydrogen ion concn from all sources is measurable and expressed as
the pH
o Equilibrium constant (Keq= products/reactants)
o PH

Acids may be defined as proton donors and bases as proton acceptors. A

proton donor and its corresponding proton acceptor make up a conjugate
acid-base pair
o acetic acid and acetate anion
C

Each acid has a characteristic tendency to lose its proton in an aqueous solution.
The stronger the acid, the greater its tendency to lose its proton. The tendency of
any acid (HA) to lose a proton and form its conjugate base (A-) is defined by the
equilibrium constant (Keq) for the reversible reaction:
HA
Ka equilibrium or dissociation constants
Ka -> pKa = use -log

ACID-BASE BALANCE (Human Body)

Acid release proton or yield H+ hydrogen ion or hydronium ion H3O+ (low
pH)
Base yield hydroxyl ions (OH-) accepts protons or H+
pk/pKa- negative log of the ionization constant of acid (Ka)
o strong acids pk < 3 maraming na ionize
o strong ase pk > 9
ph negative log of hydrogen ion concn (H+)
o ph= pka = log base/acid
o represent H concn

Strong acid complete dissociation of compound (hydrochloric and sulfuric acid)

Weak acid incomplete dissociation (carbonic acid and acetic acid)

- dissociate porrly in water (release protons pero konte lang)

Buffers stabilize ph by providing or removing H+
- Resist changes in ph when acid is added
- Combination of weak acid and conjugate base (anion released by
dissociation)
o molecules of weak acid exist in equilibrium with its dissociation
products

Base- reacts with acid ; weak base maging water halos lahat

Buffer capacity and buffer range

- The ability to resist ph change
o More concentrated the components of a buffer, the greater
buffer capacity
o Ph of buffer is distinct from its buffer capacity

Physiological buffers regulate ph minimize not prevent; normal metabolic

functions
o Blood buffer if acids not removed, ph will drop and interfere with all
enzymes
7.35 7.45 normal ph range of arterial blood
Acidosis 7.35 below (hanggang 6.8)
Alkalosis 7.45 greater(hanggang 8.0)
o Beyond scale cause death (survival range)
Sources of acid in the body body produces more acids and base
o Metabolism of food
Sulfuric acid from sulphuri from amino acids of proteins
Lactic acid from sugars
Ketoacids from fats
o Metabolism of drugs
o Inborn errors of metabolism
In blood more bicarbonate than carbonic acid
Fixed (Non-Volatile) Acids
o Ingested not converted to gas
o Excreted through liquid form (kidney)
Volatile Acids
o Carbonic acid (H2CO3)
Released through lungs by formation of CO2
o Equilibrium w/ its dissolved gaseous component (PaCO2)

NOTE: increase H+ - accumulation of acids and loss of base

Buffering capacity in Body

o 52% - in cells
o 5% - in RBC
o 43% - in extracellular space
40% - bicarbonate buffer (important)
Proteins
Phosphate buffer system
3 Control Systems
Chemical Acid-Base
body fluids that immediately combine with acids or base to
prevent excessive changes in pH.
Respiratory Center (Ventilation)
Removal of CO2 gas reduce carbonic acid in body (lungsoccurs in minutes)
Kidneys (Renal)
excrete either acid or alkaline urine, thereby adjusting the pH of
the blood

response over hours or days but more powerful regulatory

system
Buffers: (Chemical)
Bicarbonate (HCO3-) extracellular fluid
Proteins, hemoglobin, phosphate cells
Phosphates, ammonia urine

1. Bicarbonate Buffer
o Maintain a 20:1 ratio : HCO3- : H2CO3 (bicarbonate to carbonic
acid);

If proton increases, reverse reaction (left side); hyperventilate daghan

acid to release CO2 > maintain equilibrium to dissociate
Carbonic anhydrase catalyze the reaction

Lower ph forward reaction (produce H+ to react to OH-)

o Kidneys excrete HCO3
Raises ph reverse reaction (H+ bind to bicarbonate and dissociate via
lungs)
o Acid to alkaline, kidneys excrete H+ and lungs excrete C02
Decrease in H+ - ph will increase

Too muc H+ released CO2 in reserved lower concn of H+

1.H2CO3 dissociates into CO2 and

H2O, allowing H3O+ to be eliminated
as CO2 by the lungs

2.Changes in PCO2 modify the

ventilation rate
3.HCO3- concentration can be altered
by kidneys

Limitaions of Carbonic Acid buffer system

-

Respiratory system and respiratory control centers are normal

Ability to buffer acids is limited by availability of bicarbonate ions
Pka of carbonic acid is 6.35 while ph of blood is 7.4 weak buffering
power
2. Phosphate Buffer
- very effective but not found in high concentrations in extracellular fluid
- Important in the intracellular fluid (ICF) and renal tubules
o PH OF 6.8 more concentrated and function closer
3. Protein Buffers
a. Amino Acids accepts and release H+
o Alkaline medium AA acts as acid by releasing H+ to neutralize
base
o Acidic AA acts as base by absorbing H+ to neutralize acid
Blood: acid comes: hydronium ions (H3O) neutralize by
-COO grp
o Base added H3O neutralize by -NH3+ grp
b. Hemoglobin binds CO2 transport hydrogen and oxygen
- maintain blood ph by changing from oxyhemoglobin to
deoxyhemoglobin

Buffer Systems in Body Fluids

Total body water 60% of total body weight
40% - Intracellular fluid
20% - Extracellular fluid
o The environment bath water provides cells nutrition,
oxygenation, waste removal, temp. and alkaline environment
80% - interstitial fluid
20% plasma
Physiological Buffer Systems

Respiratory Regulation
- Exhalation of CO2 provide O2 to cells and remove CO2
- Works on volatile acids
- Body ph adjusted by changing rate and depth of breathing
Ventilation rates & effect on ph balance
o Increased removal of CO2 and H2O

Renal Regulation
- Eliminate large amounts of fixed acid excrete base HCO3
- Conserve and produce bicarbonate ions
- Kidney fails, ph balance fails
- Only the kidneys can rid the body of acids generated by cellular
metabolism (nonvolatile or fixed acids), while also regulating blood
levels of alkaline substances and renewing chemical buffer
components
o Kidney can retain or excrete bicarbonate as needed
Importance:
- Every H+ buffered by HCO3 a bicarbonate ion is consumed -> HCO3+ H+
- To maintain capacity of the buffer system bicarbonate must be
regenerated
o Bicarbonate has equimolar amount of H+ formed from carbonic
acid and H2O
- HCO3- formation can continue if H+ are removed
o Process occurs in cells of the renal tubules H+ are secreted
into the urine and bicarbonates is generated in the body
Filtered through glomerulus- plasma and glomerular
filtrate have HCO3 concentration 4300 mmol of HCO3
filtered in 24 hrs
W/out re-generation of HCO3 acidosis state
o Carbonate dehydratase enzyme involved in renal
bicarbonate regeneartion
Formation of CO2 and H2O from carbonic acid in renal
tubular lumen
CO2 diffuses across luminal membrane into tubular cells
o Luminal side impermeable to bicarbonate ions
di maka cross directly ang bicarbonate carbonic acid convert CO2 &
H2O to cross

bicarbonate ions pass into the extracellular fluid and the hydrogen ions are secreted
back into the lumen in exchange for sodium ions which pass into the extracellular
fluid

Renal hydrogen ion secretion

Regeneration of bicarbonate does not involve net excretion of
hydrogen ions as the H+ is consumed in the reaction with the filtered
bicarbonate in the tubular lumen (step 4).
Hydrogen ion excretion requires the same reactions occurring in the
renal tubular cells but also requires a suitable buffer in urine
Phosphate Buffer
o Principal buffer system in urine; combines with hydrogen ions
HPO42- + H+ H2PO4o Minimun urine ph that can be generated is 4.6- urine output is 1.5L
phosphate buffer system increases hydrogen ion excretion
capacity to 30-40 mmol/24 hours

Ammonia Buffer
o Chronic overproduction of acid
o produced by deamination of glutamine in renal tubular cells
glutaminase- catalyze the reaction
Allows increased ammonia production and hence increased hydrogen ion
excretion via ammonium ions: NH3 + H+ NH4+

Regulation of blood ph
- Lungs and kidneys important role
o Lungs through retention or elimination of CO2 by changing rate
and volume of ventilation
o Kidneys- excrete acid, primarily in the ammonium anion (NH4+)
and reclaiming HCO3- from the glomerular filtrate (and add it
back to the blood)
Buffering Systems and their buffers used
o Respiratory bicarbonate
o Blood bicarbonate, phosphate, protein
o Kidneys bicarbonate, phosphate, ammonia

Henderson-Hasselbalch Equation
-

Rel. bet. ph and the bicarbonate-carbonic acid buffer system in plasma;

calculate ph
pH = pK + log A/HA
HCO3/H2CO3 System
o Ph= Pk + log [HCO3]/[H2CO3] > (PCO2 X 0.0301)

Normal is : 20 = Kidney = metabolic

1 Lungs
respiratory
- The ratio of HCO3- (salt) to H2CO3 ( acid) is normally 20:1
- Allows blood pH of 7.40
The pH falls (acidosis) as bicarbonate decreases in relation to
carbonic acid
The pH rises (alkalosis) as bicarbonate increases in relation to
carbonic acid
Problems with Buffer Systems
- Provide only temporary solution to acidbase imbalance
-

Do not eliminate H+ ions

Supply of buffer molecules is limited

Maintenance of Acid-Base Balance

-

Requires balancing H+ gains and losses

- For homeostasis to be preserved, captured H+ must either be:

permanently tied up in water molecules through CO2 removal at lungs
OR
removed from body fluids through secretion at kidney
- Thus, problems with either of these organs cause problems
with acid/base balance
-

Coordinates actions of buffer systems with:

*respiratory mechanisms
*renal mechanisms

Respiratory Compensation
- Change in respiratory rate that helps stabilize ph of ECF
- Affects carbonic acid-bicarbonate buffer system
When Pco2 RISES, ph falls as addition of CO2 drives system to the right
(add H)
FALLS, ph rises as removal of CO2 drives system to the left (remove H)
Renal Mechanisms
- Secretes or absorbs H+ or HCO3
- Generating additional buffers
o Renal Compensation
Change rates of H+ and HCO3 secretion or reabsorption by
kidneys in response to changes in plasma ph
o Assist lungs by eliminating any CO2 that enters renal
tubules
o H+ secreted into tubular fluid:
o Proximal convoluted tubule (PCT)
o Distal convoluted tubule (DCT)
o Collecting system

Regulation of Plasma ph Acidosis

Renal responses to acidosis:

-

Secretes H+
Activity of buffers in tubular fluid
Removal of CO2
Reabsorption of NaHCO3

Regulation of plasma ph Alkalosis

Renal response:
-

H+ secretion declines
Tubule cells do not reclaim bicarbonates in tubular fluid
Collecting system transports HCO3 out into tubular fluid while
releasing strong acid (HCl) into peritubular fluid

Conditions Affecting AcidBase Balance

1.Disorders affecting:
-

circulating buffers

respiratory performance

renal function

2.Cardiovascular conditions:
-

heart failure

hypotension

3.Conditions affecting the CNS:

-

neural damage or disease that affects respiratory and cardiovascular

reflexes

Disturbances of A-B Balance

Acute phase initial change

 Compensated/Chronic phase condition persists, physiological

adjustments
Disorders:

Respiratory Acid-Base Disorders

-

Imbalance bet CO2 generation in peripheral tissue and CO2 excretion

in lungs

Respiratory Acidosis most common problem; cant eliminate CO2

o

Sign: low plasma ph due to hypercapnia (high levels of CO2)

Caused: hypoventilation

Acute: cardiac arrest, drowning

Chronic: COPD, CHF

compensated by: increased respiratory rate, buffering by non-carbonic

acid buffers, increased H+ secretion

Respiratory Alkalosis decrease CO2 compensate to increase it

o

Sign: high plasma due to hypocapnia

Caused: hyperventilation stress/panic

Loss of consciousness resolves or breathing into bag to increase PCO2;

only acute

Metabolic Acid-Base Disorders

o

Generation of organic or fixed acids; Affects HCO3

Metabolic Acidosis
o

Caused: produce large numbers of fixed or organic acid, H+

overloads buffer system

Lactic acidosis anaerobic cellular respiration; complication of

hypoxia caused by respiratory acidosis

Ketoacidosis excess ketone bodies (starvation, untreated

diabetes)

Impaired H+ secretion severe bicarbonate loss (diarrhea loss of

HCO3)

Compensated by: respiratory: increase respiratory rate (eliminate CO2)

Renal: secrete H+, reabsorb and generate HCO3

Metabolic Alkalosis
o

Caused: elevated HCO3 & reduced H+

Alkaline tide gastric HCl generation after a mean

Vomiting increased HCl

Compensation:

Respiratory reduced RR

Increase HCO3 loss at kidney, retention of HCl

Normal Values for Blood Buffer in Arterial Blood

pH: 7.35 7.45

PCO2: 35 45 mm Hg

H2CO3: 2.4 mmoles/L of plasma

HCO3-: 24 mmoles/L of plasma (22-26 mEq/L)

PO2: 80 110 mm Hg

Number One:
Determine if the patient is
demonstrating an acidotic (remember:
pH less than 7.35) or alkalotic (pH
greater than 7.45) condition.

If the patient is alkalotic with a HC03

greater than 26 mEq/L it is
METABOLIC!

Number Two:

Number Three: Is the patient

compensating?

If the patient is acidotic with a pC02

greater than 45 mmHg it is
RESPIRATORY

Are both components (HCO3 and

pCO2) shifting in the same direction?

If the patient is alkalotic with a pC02

less than 35 mmHg it is RESPIRATORY!
If the patient is acidotic with a HC03
less than 22 mEq/L it is METABOLIC!

Both going up or both going down?

If so, the patient is compensating.
Their buffering systems are
functioning and are trying to bring the
acid-base balance back to normal.