Part 1: Oregon State University Anatomy & Physiology Course – 26.4: Acid-Base Ba

Part 1: Oregon State University Anatomy & Physiology Course – 26.4: Acid-Base Balance (Links to an external site.)
* Use link below to answer questions, no outside resources
Link:
26.4 Acid-Base Balance – Anatomy & Physiology (oregonstate.education)
The link above is required reading using Oregon State University’s open source textbook for their Anatomy & Physiology course. This is a supplement to the acid-base regulation lecture discussions in Chapters 13 & 14 of our course.
The key here is that you have two systems, respiratory and renal, working together to address situations where acid/base homeostasis is disturbed.
Part 2: Clinical Case Study – Diabetic ketoacidosis
Read the case summary below and then answer the questions that follow.
Case: During your shift in the ER, a 21-year old noncompliant male with a history of type I (insulin-dependent) diabetes mellitus was found in a coma. Your triage assessment and the lab testing revealed the following:
Hyperglycemia: High blood glucose.
High urine glucose.
High urine ketones and serum ketones.
Low serum bicarbonate <12 mEq/L. Exaggerated respiration. Breath has acetone odor. Hypotensive: blood pressure was 90/60 mm Hg. Tachycardia: Pulse weak and rapid (120 bpm). Based on your understanding of both the respiratory and renal regulation of blood pH, answer the following: Is this patient experiencing respiratory or metabolic acidosis? Based on your answer to #1, discuss the mechanism(s) which led to this complication. The formula below represents the respiratory & renal systems' regulation of acid-base balance (remember that the enzyme carbonic anhydrase catalyzes the forward reaction between carbon dioxide and water). CO2 + H2O ↔ H2CO3 ↔ H+ + HCO3– Review this formula and discuss the mechanisms involved in the forward and reverse components of the reaction by answering the following: When CO2 + H2O combine to form carbonic acid, discuss the respiratory mechanisms involved to regulate the levels of CO2 Explain why exaggerated respiration (increased ventilation) help to decrease the levels of H+ When carbonic acid dissociates into free H+ + HCO3– what role do the levels of bicarbonate play in regulating H+ ion levels? Discuss at least (2) of the renal mechanisms used to regulate HCO3– levels. * Use write answers in a bullet-pointed list, a series of steps - do not write in paragraph form. Textbook: Chapter 13: Respiratory Physiology (mheducation.com) Chapter 14: The Kidneys and Regulation of Water and Inorganic Ions (mheducation.com)

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