Please answer all the questions, Thank you! A 23- year old male has been admitte
ID: 74263 • Letter: P
Question
Please answer all the questions, Thank you!
A 23- year old male has been admitted for vomiting over the last 2 days, with minimal fluid intake. He went to the emergency room of a nearby hospital and the following data was obtained upon examination and testing.
Hematology:
Hematocrit: 60% plasma pH: 7.49 (normal is 7.35 to 7.45)
pCO2: 47 mmHg (normal is 35 to 45 mmHg)
HCO3-: 31 (normal is 22 to 26 mEq/L)
Urinalysis
Appearance: dark yellow to brown
Specific gravity: 1.025 (normal is 1.015 to 1.030)
Blood: negative
Protein: mild
pH 8.5
Questions:
1. Define acidosis and alkalosis. In general terms how can a patient develop an acidosis, an alkalosis?
2. What is the acid-base disorder this individual is suffering from; explain your answer using the hematological data?
3. Has compensation occurred? If so, is it partial or complete, explain your answer?
4. Why does the patients have an alkaline urine?
Explanation / Answer
1.
Acidosis is an increased acidity in the blood and other body tissue (i.e. an increased hydrogen ion concentration). Acidosis occurs when your kidneys and lungs can’t keep your body’s pH in balance. Many of the body’s processes produce acid. For instance, your lungs and kidneys can usually compensate for slight pH imbalances, but problems with these organs can lead to excess acid in your body.
Alkalosis refers to a process reducing hydrogen ion concentration of arterial blood plasma (alkalemia). In contrast to acidemia (serum pH 7.35 or lower), alkalemia occurs when the serum pH is higher than normal (7.45 or higher). It can occur due to decreased blood levels of carbon dioxide, which is an acid. It can also occur due to increased blood levels of bicarbonate, which is a base.
2.
The individual is suffering from alkalosis as evidenced by increase of bicarbonate ions in urine and elevated pH.
3.
In chronic metabolic alkalosis, the PaCO2 should increase by roughly 5 mmHg for every 10 mEq/L increase in serum HCO3. In our case, the PaCO2 shows an increase of 2 mmHg for 5 mEq/L increase in serum HCO3. Thus, complete compensation has occured.
4.
Urine pH is used to classify urine as either a dilute acid or base solution. Seven is the point of neutrality on the pH scale. The lower the pH, the greater the acidity of a solution; the higher the pH, the greater the alkalinity. Alkaline urine, usually containing bicarbonate-carbonic acid buffer, is normally excreted when there is an excess of base or alkali in the body. Moreover, due to vomiting loss of gastric juice leaves the body fluids with a net increase of basic substances and a pH shift toward alkaline values.