Human Physiology: An Integrated Approach (7th Edition)
7th Edition
ISBN: 9780321981226
Author: Dee Unglaub Silverthorn
Publisher: PEARSON
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Chapter 22, Problem 30RQ
One of the debates in fluid therapy for diabetic ketoacidosis (DKA) is whether to administer bicarbonate (bicarb). Although it is generally accepted that bicarb should be given if the patient’s blood pH is <7.1 (life-threatening), most authorities do not give bicarb otherwise. One reason for not administering bicarb relates to the oxygen-binding capacity of hemoglobin. In DKA, patients have low levels of 2,3-BPG [p. 573]. When acidosis is corrected rapidly, 2,3-BPG is much slower to recover and may take 24 or more hours to return to normal.
Draw and label a graph of the normal oxygen-dissociation curve [p. 573]. Briefly explain and draw lines on the same graph to show:
- (a) what happens to oxygen release during DKA as a result of acidosis and low 2,3-BPG levels.
- (b) what happens to oxygen release when the
metabolic acidosis is rapidly corrected with bicarbonate.
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Table 1: Arterial blood gas concentration in patient
Two hours after aspirin
ingestion
Ten hours after aspirin
ingestion
Normal values
Partial Pressure CO2
26 mm Hg
19 mm Hg
35-45 mm Hg
Partial Pressure O2
113 mm Hg
143 mm Hg
75-100 mm Hg
Bicarbonate [HCO;]
18 mM
21 mM
22-26 mM
pH
7.44
7.55
7.35-7.45
Blood salicylate
concentration, mg/dL
57
117
A 30-year-old female patient with uncontrolled hypertension is suspected by an investi-
gating endocrinologist of having Conn's syndrome. Results of routine biochemistry were
(reference ranges are given in brackets):
Sodium
Potassium
Urea
Creatinine
Alkaline phosphatase
Alanine aminotransferase
Albumin
Bilirubin
Calcium
146 mmol/L
2.1 mmol/L
7.2 mmol/L
146 μmol/L
290 IU/L
20 IU/L
49 g/L
8 μmol/L
2.19 mmol/L
(135-145)
(3.5-5.0)
(3.5-6.6)
(70-150)
(95-320)
(5-42)
(35-50)
(<17)
(2.12-2.62)
(a) Are any of the electrolyte concentrations abnormal, and if so what condition is
suggested?
(b) What further biochemistry investigations would you undertake? Explain your
reasoning.
Chapter 22 Solutions
Human Physiology: An Integrated Approach (7th Edition)
Ch. 22 - Explain the roles of the satiety and feeding...Ch. 22 - Name the four layers of the GI tract wall,...Ch. 22 - Prob. 3CCCh. 22 - Prob. 4CCCh. 22 - Prob. 5CCCh. 22 - Prob. 6CCCh. 22 - Prob. 7CCCh. 22 - Prob. 8CCCh. 22 - Use your understanding of digestive physiology to...Ch. 22 - Prob. 10CC
Ch. 22 - Prob. 11CCCh. 22 - Prob. 12CCCh. 22 - What are the primary target tissues for insulin?Ch. 22 - Why are glucose metabolism and glucose transport...Ch. 22 - What is the advantage to the body of inhibiting...Ch. 22 - Prob. 16CCCh. 22 - Prob. 17CCCh. 22 - Prob. 18CCCh. 22 - Prob. 19CCCh. 22 - Prob. 20CCCh. 22 - Prob. 21CCCh. 22 - Prob. 22CCCh. 22 - Prob. 23CCCh. 22 - Prob. 24CCCh. 22 - Define metabolic, anabolic, and catabolic...Ch. 22 - Prob. 2RQCh. 22 - Prob. 3RQCh. 22 - Prob. 4RQCh. 22 - Define basal metabolic rate (BMR). Under what...Ch. 22 - Prob. 6RQCh. 22 - Prob. 7RQCh. 22 - What is a nutrient pool? What are the three...Ch. 22 - Prob. 9RQCh. 22 - Prob. 10RQCh. 22 - Prob. 11RQCh. 22 - Name the two hormones that regulate glucose...Ch. 22 - Which noncarbohydrate molecules can be made into...Ch. 22 - Under what circumstances are ketone bodies formed?...Ch. 22 - Name two stimuli that increase insulin secretion,...Ch. 22 - Prob. 16RQCh. 22 - What factors release glucagon? What organ is the...Ch. 22 - Prob. 18RQCh. 22 - Prob. 19RQCh. 22 - Prob. 20RQCh. 22 - Prob. 21RQCh. 22 - Prob. 22RQCh. 22 - Prob. 23RQCh. 22 - Prob. 24RQCh. 22 - Explain the current theory of the control of food...Ch. 22 - Prob. 26RQCh. 22 - Scott is a bodybuilder who consumes large amounts...Ch. 22 - Prob. 28RQCh. 22 - Prob. 29RQCh. 22 - One of the debates in fluid therapy for diabetic...Ch. 22 - Prob. 31RQCh. 22 - Prob. 32RQ
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