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J5) Acid-Base Homeostasis: Type 1 Diabetes Patient Case Study. Part 1: Oregon State University Anatomy & Physiology Course - 26.4: Acid-Base Balance The link above is required reading using Oregon State University's open source textbook for their Anatomy & Physiology course. T e. 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: 1. Is this patient experiencing respiratory or metabolic acidosis? 2. Based on your answer to #1, discuss the mechanism(s) which led to this complication. 3. 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). COHOL COU+CUCO-
OF MELODonc aciGODIO. 2. Based on your answer to #1, discuss the mechanism(s) which led to this complication. 3. 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: 1. When CO₂ + H₂O combine to form carbonic acid, discuss the respiratory mechanisms involved to regulate the levels of CO₂ 2. Explain why exaggerated respiration (increased ventilation) help to decrease the levels of H* 3. When carbonic acid dissociates into free H + HCO3 what role do the levels of bicarbonate play in regulating H+ ion levels? 4. Discuss at least (2) of the renal mechanisms used to regulate HCO3 levels.