Blood pH can be impacted by the carbonic acid/bicarbonate system, which utilizes
ID: 193613 • Letter: B
Question
Blood pH can be impacted by the carbonic acid/bicarbonate system, which utilizes the following Case S Dased an The Case of the Mortified Mam: Acies pl and Baffers" y Terry Patt(Natonal Center for Case Sbudy TeaiginScience) The Patient: Paramedics were called to the home of the Mathews family because their 3-year old daughter, Molly had gotten into the medicine cabinet and consumed a large number of aspirin tablets. When the paramedics arrived Molly had vomited several times, with bits of undissolved tablets visible, but seemed sleepy, almost lethargic. She was rushed to the nearest Emergency Room. When she reached the hospital she was unarousable and was breathing rapidly and deeply. She was examined and lab samples were obtained. Question 4: Under normal conditions the carbonic acid/bicarbonote system functions to: A. Maintain blood pH near physiological p Remove excessive H' generated during metabolism C Tronsport CO2 from the tissues to the lungs for exhalation. D. Al of the above. OH Question 5 Why is Moly breathing so rapídly and deeply when she arrives at the Emergency Room, despite being neorly comatose? A. The aspirin hos inhibited her abiNty to use oxygen effectively. B Her body is trying to rid itself of CO C. She is out of breath from all she has been through. D. Her hemoglobin can't deliver oxygen at low p Normal blood bicarbonate levels should be 22-26 mM Above is the structure of aspirin, or acetylsalicylic acid, which is a weak acid with a pka of 3.5. The active, and toxic at high doses, form is the protonated form. Question 6: Which of the following conditions would you expect to be the situation in Molly's case? A. Blood bicarbonate above normai Question 1 What percent of the ingested aspirin is in the active form in the stomach (remember that gastric juice has a pH of1.5)? B Blood bicarbonate within the normal range. C. Blood bicarbonate below normal. 0.01% 1% 50% 99% The physician intubated Molly's trachea and carried out hyperventilation, which he explained to the family was "to avoid hypoventilation and a worsening of her metabolic acidosis." They also administered activated charcoal through a nasogastric tube and IV bicarbonate. D. Question 2 What percent of ingested and absorbed aspirin is in the active form in the blood (average pH of 7.4) under normal conditions? Question 7 What is the purpose of the activated charcoal? A. Absorb the residual aspirin to prevent it from entering her bloodstream. B. Increase the rate of absorption of the aspirin to shorten the duration of the overdose. C. Increase the pH of the stomach. D. Settle her stomach after the vomiting. 0.00013% 0.013% BL c50% D. 100% Question 8: What effect would the bicarbonate have on the carbonic ocid/bicarbonate reaction above? A. Shift it to the left B Shift it to the right. C. Settle it closer to equiibrium. D. No effect. Molly's lab analyses came back and she had a blood pH of 6.8. Question 3 By what factor does the Hof Molly's blood differ from normal blood? A. 0.25XExplanation / Answer
1. 90%
2. 0.013
3. 0.25
4. All of the above
5. Hb cannot deliver oxygen at low ph