Homeostasis Case Study, Acid, Base Bohr effect
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Case copyright held by the National Center for Case Study Teaching in Science, University at Bualo, State University of New York. Originally published February , . Please see our usage guidelines, which outline our policy concerning permissible reproduction of this work. Licensed image in title block ©martashov | Fotolia, .NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCEWhy Homeostasis Is Important to Everyday ActivitiesPart I – Where Is Blake?“Where is Blake?” Ashton asked, apparently expecting Blake, his room-mate, to be following Sam into their apartment.“I thought he was with you,” replied Sam, confused by Ashton’s ques-tion. “Blake told me you and he had a heart-to-heart talk at the party about his drinking. He told me he decided to leave with you to come back to the apartment.”“We did talk and agreed to call it a night, but he didn’t leave with me,” said Ashton. “He just doesn’t get it. It’s so stupid to be chugging beers and drinking RockStar; he just ends up being ‘wide awake drunk’!”Several hours passed before Blake tumbled through the apartment door and collapsed on the kitchen oor. At rst, the roommates thought it was just a typical Blake prank. But Blake seemed to be having a panic attack. He was visibly anxious and his breathing was out of control. “Blake, dude, calm down!” howled Ashton, but Blake didn’t even seem to notice him.“What are we going to do?” yelled Sam, upset and concerned for his friend.“Call 911 and help me get him up on the couch!” yelled Ashton, after taking Blake’s pulse and nding it really weak.By the time the rst responders had made their way up to the apartment, Blake had regained consciousness but was still clearly in distress.Questions1. What observations can you make about this scenario without providing judgment or conclusions?2. What information would you ask if you were one of the rst responders?E\Brian J. Dingmann Math, Science and Technology Department University of Minnesota CrookstonBlakecollapedandhadapanicattackhe wasaniouswoutofcontrolBreathingaswellasaweakpulseif BlakewasonanymedicationsifthishashappendbeforeWhatheseatenanddranktodayhowlongwashe unconsious beforehealthhistory
NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCEPage “Why Homeostasis Is Important to Everyday Activities” by Brian J. DingmannPart II – Is Blake Going to Be Okay?Blake was confused and short of breath, and he was complaining that his ankles were killing him. As the rst responders took Blake’s vitals, Blake told them he felt dizzy and had a tingling sensation in his hands and arms. He also said that his chest was “heavy.” Susan, the EMT on duty that night, had unfortunately seen this situation increasingly often over the last several years. She nished taking Blake’s vitals and interviewing him.“So is Blake going to be okay?” asked Ashton, still trying to get a hold of his emotions.Susan and her partner had succeeded in calming Blake down and had his breathing under control. “He’s clearly drunk,” she said. “But has he also been taking some type of stimulant?” After a short pause, Ashton explained how Blake liked to go hard at parties by drinking energy drinks and alcohol. “I’m so confused. Blake is just drunk, right?” Sam interjected.Susan explained, “Blake is suering from the eects of respiratory alkalosis brought on by his panic attack and subsequent hyperventilation.”She grabbed a piece of paper and began to explain what happens when someone hyperventilates. She drew the equation below to demonstrate what happens chemically in your body when you hyperventilate. She also explained that a normal respiratory rate is around 12 to 16 breaths per minute and added that Blake’s respiration rate was probably over 25 breaths per minute.CO2+ H2O lH2CO3lHCO3-+ H+Questions1. Draw your prediction for what will happen to the binding anity of hemoglobin for oxygen if you increased the pH or created a more alkaline situation.(Hint:you need two lines on the graph to show “normal” and an increase in pH.)2. How does pH inuence oxygen saturation of hemoglobin at the same partial pressure?3. How does pH aect hemoglobin anity for oxygen in the body tissue that is metabolically active? What is the signicance of this hemoglobin anity dierence?4. How would the respiration rate impact this curve given the changes in blood pH?ThehigherthePH.tnowertheoxygensaturationitwouldalsoDecreaseBothwillIncrease
NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCEPage “Why Homeostasis Is Important to Everyday Activities” by Brian J. DingmannPart III – Mixing Alcohol with Energy DrinksSusan told both Sam and Ashton that Blake was fortunate to be stable and not in worse shape. She showed Sam and Ashton the following abstract from one of her research papers that she was using for an assignment she was working on for her degree. Despite the fact that it was published before they were born, the take-home message did sink in. ere were a lot of big words in the abstract, but they knew what a coma was and perhaps Blake had been lucky tonight.Vet Hum Toxicol. 1991 Oct;33(5):482–5.Acid-base balance in alcohol users seen in an emergency roomLamminpaa A1, Vilska J.Author information• 1Poison Control Center, Children's Hospital, University of Helsinki, Finland.AbstractOver 10% of emergency room patients are diagnosed as having alcohol (6.0%) or drug intoxication. In the present study 196 alcohol intoxications treated in a hospital were studied retrospectively; 49.2% of the patients had abnormal acid-base values, alcoholics more often than non-alcoholics (p = 0.04). Mean blood ethanol concentration (BAC) was 310 mg/dl (SD 120); alcoholics had higher concentrations of alcohol. BAC was the higher the lower the serum pH was (p less than 0.002, r = -0.45). The deeper the coma the lower the serum pH (p less than 0.05) and the higher the BAC (p less than 0.0001). Respiratory acidosis (31.7%) was an important nding in those intoxicated. Metabolic acidosis (7.9%) could be explained by the presence metabolites of ethanol in the serum and by decreased extra-cellular uid volume. Metabolic alkalosis related to vomiting and an extra-cellular uid volume decrease was found in 7.9% of the patients. Respiratory alkalosis was a rare nding (1.6%). Hypokalemia (22.5%) and hypernatremia (15.3%) were the most important electrolyte changes. Chronic alcoholics had lower serum potassium than had non-alcoholics; 3.6% (n = 7) of the patients had to be intubated. Acid-base disturbances were frequent in adults with alcohol intoxication. Serum pH correlated well with the state of consciousness and the BAC.Questions1. Dene the following terms: a. respiratory acidosisb. metabolic acidosisc. coma2. Compare/contrast respiratory acidosis to the case study scenario.3. Suppose you were to drink an energy drink (with caeine or another stimulant like guarana or gensing) while consuming alcohol. Would there be an impact on the amount of alcohol consumed? Please explain in terms of the acid-base balance in your body.BreathingSlowsPHmakingBloodacidicBuildupofacidStateofDeepunconsiousness943IsinBodypaincanchange4ItyestherewouldbeanIncreaseofalcoholConsumptiDuetostimulantresultinginacidosisfromtheAlcohol