2. A man arrives in the emergency room. His primary complaint is \"difficulty br
ID: 78789 • Letter: 2
Question
2. A man arrives in the emergency room. His primary complaint is "difficulty breathing" for the last several days. A blood test reveals arterial co2 of 46mmHg and blood pH of 7.31. (a) Is the man hypoventilating or hyperventilating? Explain. (2pts) (b) Use the chemical equations we covered in class to explain the relationship between blood Pco2 and blood pH. (2pts) (c) Would a urinalysis mostly likely show a lower-than-normal or higher-than-normal urine pH in this patient? Briefly explain. (2pts)Explanation / Answer
2. To deal with this physiology question we need to know the oxygen and carbon-di-oxide exchange what happens in our body, our constant change would bring the system in a homeostatic condition when we maintain a balance. Here the case is a abnormal breathing problem to show where the blood Pco2 levels are changed as well as the pH is altered.
(a) This particular case is he cause for 'hyperventilation'. In case while patient is hyperventilating they breathe abnormally, that is to say more than normal that causes the blood Pco2 to drop or decrease. The Co2 is not really taking out of the alveoli, so the condition changes or alters the blood Co2 as well as pH level. The blood pH changes from normal to higher range that is to become more alkaline. The example from the query shows that, slightly higher pH and lowered Pco2. Finally we must know that blood always have a slighty alkaline Ph, which is between pH 7.3-7.5. (i)
(b) It is commonly seen in case of relation between the blood Co2 levels and pH of the blood that a change in pCO2 of 10 mmHg will cause a change in pH of 0.08 in the opposite direction.
Equations:
Acute Resp. Acidosis: Change in pH = 0.008 x (40 - PaCO2)
Chronic Resp. Acidosis: Change in pH = 0.003 x (40 - PaCO2)
Acute Resp. Alkalosis: Change in pH = 0.008 x (40 - PaCO2)
Chronic Resp. Alkalosis: Change in pH = 0.017 x (40 - PaCO2), (ii)
(c) IN the patient having hyperventilation, stomach and urinary pH become too low (too acidic), this promotes some diseases like gastritis and ulcers, or urinary stones. (iii)
References:
(i) emedicine health, (Hyperventilation article), (source URL: http://www.emedicinehealth.com/hyperventilation/article_em.htm),
(ii) From an e-magazine 'Medscape', topic: Respiratory Acidosis, author's -Ryland P Byrd, Jr, MD Professor of Medicine, Division of Pulmonary Disease and Critical Care Medicine, James H Quillen College of Medicine, East Tennessee State University. (URL: http://emedicine.medscape.com/article/301574-overview),
(iii) An article "CO2, Blood pH and Respiratory Alkalosis: Causes and Effects", from website normal breathing.com, (URL: http://www.normalbreathing.com/CO2-blood-pH-respiratory-alkalosis.php).
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