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Discussion Topic #4: Respiratory & Renal
Discussion Topic #4: Respiratory & Renal
Acid-Base Homeostasis: Type 1 Diabetes Patient Case Study
Part 1: Oregon State University Anatomy & Physiology Course – 26.4: Acid-Base Balance (Links to an external site.)
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? Why?
- How does the following formula represent 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–