Understanding Acid-Base Disturbance: A Case Study Analysis
School
University of Minnesota-Twin Cities**We aren't endorsed by this school
Course
ANSC 3301
Subject
Biology
Date
Dec 11, 2024
Pages
4
Uploaded by MagistrateDinosaurPerson764
CASE STUDY- Acid-Base Regulation – EXTRA CREDITMary hid her fear as she struggled to catch her breath. She had been so excited to gohiking with her children. Chris and Michelle were both home on fall break, and Mary hadbeen looking forward to the family time. But she felt like she was hyperventilating, andnow her chest was starting to hurt.“What, we’ve finally outlasted you on the trails?” Chris joked as he looked over hisshoulder. “Mom, are you ok? You look awful.”“Don’t panic, but I think I need to go to the hospital.”“Michelle! Go get the car!” Chris yelled ahead.After what seemed like an eternity, they arrived at the hospital. As Chris and Michellehelped their mother into the waiting room, the ER attendant noticed them and ushered thefamily into a small room. Dr. Rosen promptly took Mary’s medical history and orderedan EKG, chest x-ray, blood tests, and urinalysis. The tests were completed in short order,and about an hour later, Dr. Rosen appeared in the exam room. “I have some good news.The good news is once we get you off of the Topamax®, you’ll start feeling better. Thismight take a while, so I’m leaving your chart. I hope I’ll be back to review the test resultswith you, but it might be someone else,” said the doctor as the door swung shut.Topamax is given to patients to treat epilepsy and prevent migraines. In Mary’s case, sheis experiencing a side effect of the drug. Carbonic anhydrase in proximal tubule epithelialcells are particularly sensitive to inhibition by Topamax.
1.) What appears to be Mary’s primary disturbance, from the results of her bloodwork listed above?A. Metabolic acidosisB. Respiratory acidosisC. Metabolic alkalosisD. Respiratory alkalosisE.There is insufficient data to make a diagnosis.Again, carbonic anhydrase in proximal tubule epithelial cells is particularly sensitive toinhibition by Topamax. Use the diagram of transport in the epithelial cells of theproximal tubule above and your understanding of the function of the kidney to provide astep-by-step explanation of how the inhibitory action of Topamax caused the disturbancesin Mary’s blood chemistry.2.) Predict the effect of Topamax on the pH of her URINE. (Choose one below.)A. Caused no change in pHB. Led to a decrease in pHC. Led to an increase in pH3.) The same type of acid-base disturbance occurs in all three of the followingcircumstances. Which one is most analogous (most closely matches) Mary’scondition?A. Uncontrolled diabetes mellitus
B. Excess administration or ingestion of an acidifying agent or drugC. Chronic diarrhea4.) Mary has an acid-base disturbance that is being compensated for with anotherbody system. Identify the physiological pathway responsible for the compensatingaction.A. Metabolic compensationB. Respiratory compensation (hypoventilation)C. Respiratory compensation (hyperventilation)D.There is insufficient data to identify a compensatory mechanism.5.) Which of the following treatments would you recommend to correct Mary’sproblem? Explain what effect each treatment would have upon her blood pH.A. Breathing in a paper bagB. An IV containing pure HCO3-in an isotonic solutionC. Holding her breath for as long as she canD.An IV containing pure ammonia in an isotonic solution6.) Why did Mary develop the symptoms of her acid-base disturbance while hikingwhich hadn’t been apparent in her normal daily routine?A. Lactic acid build-up made the acid-base disturbance worseB. Hyperventilation caused an increase in CO2and H+C. An increase in sympathetic tone led to an increase in MAP, whichtriggered the release of atrial natriuretic peptideD.All of the above are true