G1.iii · Buffer Systems

This viva will examine renal acid base physiology and pharmacology. Describe what happens to bicarbonate once it reaches the kidney. (Image removed from report.)

This viva will explore your knowledge of acid base physiology. What is an acid and how much acid does the body produce daily?

This viva will test your knowledge on acid-base physiology. Describe the buffer systems.

This viva is about acid base physiology. What are acids and bases? Give an example of each found in the body.

This viva is about intravenous fluids and buffers. Using the diagram below explain how fluid is distributed throughout the body of a healthy 70 kg adult male. (Image removed from report.)

This viva tested knowledge of buffer systems in the body and the renal handling of acid. It went on to discuss drug ionization, pKa and dissociation and then the pharmacology of local anaesthetic agents

a period of prolonged vomiting. An arterial blood gas analysis was performed on room air, revealing the following findings. pH 7.59 (7.35 – 7.45) PaCO2 58 mmHg (35 – 45) PaO2 72 mmHg (90 – 110) HCO3- 59 mmol/L (22 – 32) Interpret the findings. This viva tested the candidate’s knowledge of renal physiology related to the control of urinary pH, effects of acetazolamide and frusemide upon metabolic acid base state and respiratory response to metabolic acid base changes. The main points expected for a pass were knowledge of : • Respiratory response to changes in metabolic acid base. Use of correctly labelled graph or common formulae • Renal handling of H+ at the proximal and distal tubules. • Mechanism of HCO3- reabsorption and regeneration • Urinary buffers such as phosphate, ammonia and glutamine • Mechanism of frusemide associated metabolic alkalosis • Affect of acetazolamide on HCO3- The use of illustrations greatly assisted candidates to answer questions within this viva Syllabus : D1-2e, D2a and B1c-2a & b Reference : Textbook of Medical Physiology by A. C Guyton & J. E Hall.