1- During the Acid-Base Balance virtual lab activity, there was a…

1- During the Acid-Base Balance virtual lab activity, there was a patient, Frank Miller, who was found outside a shopping mall in considerable distress. He lost consciousness and was transported by ambulance to the hospital.

• His tests showed high levels of   [ Select ]  [“diuretics”, “salicylates”, “disulfiram”]  and   [ Select ]  [“alcohol”, “aspirin”, “amphetamines”]  , thus his diagnosis was   [ Select ]  [“disulfiram complications”, “ethanol induced respiratory distress”, “acute alcohol toxicity”]  .

Let’s work through the logic of how his diagnosis leads to his acid-base disturbance, as well as how his body is able to compensate (or not) for the acid-base disturbance:

• When your patient mixed disulfiram and alcohol, this caused a/an   [ Select ]  [“toxicity of the combination”, “accumulation of acetylaldehyde”, “respiratory depression due to the alcohol”]  .
• Because of this, he experienced severe symptoms, including   [ Select ]  [“vomiting”, “tiredness”, “hyperventilation”]  .
• When this happens,   [ Select ]  [“bicarbonate from pancreatic secretions”, “toxic acetylaldehyde”, “stomach acid”, “carbon dioxide”, “acidic saliva”]  is lost from the body, which causes   [ Select ]  [“acidosis”, “alkalosis”]  .
• The origin of this disturbance is   [ Select ]  [“metabolic”, “respiratory”]  , because of   [ Select ]  [“a decrease in fixed (metabolic) acid in the blood”, “a decrease in volatile (respiratory) acid in the blood”]  .
• This loss shifts the carbonic acid equation (CO₂ + H₂O –> H₂CO₃ –> H⁺ + HCO₃^–) to the   [ Select ]  [“left”, “right”]  .
• The resulting   [ Select ]  [“increase”, “decrease”]  of CO₂ is detected by the patient’s central chemoreceptors, which signal to the respiratory control center to   [ Select ]  [“increase”, “decrease”]  ventilation.
• By changing ventilation in this manner, the patient was able to   [ Select ]  [“accumulate”, “reduce”]  CO₂ levels in his blood, partially compensating for his acid-base disturbance.
• We know he was only able to partially compensate for the disturbance, because   [ Select ]  [“his pH has not returned to 7.4”, “his breathing is not shallow enough to accumulate enough CO2”, “the long arm on the Davenport Diagram is too similar in length to the short arm”]  .

2- During the Acid-Base Balance virtual lab activity, there was a patient, Lana Washington, who was found unconscious at her apartment and brought to the hospital. It was discovered that she had overdosed on barbiturates and alcohol. Her tests showed high barbiturate and alcohol levels in her blood, as well as abnormal arterial blood gases.

Let’s work through the logic of how her diagnosis (barbiturate and alcohol overdose) leads to her acid-base disturbance, as well as how her body is able to compensate (or not) for the acid-base disturbance:

• Barbiturates and alcohol both act as central nervous system   [ Select ]  [“stimulants”, “depressants”]  .
• This means that they both   [ Select ]  [“depress the respiratory control center”, “stimulate the respiratory control center”, “depress the oxygen-carrying capacity of the blood”, “stimulate the oxygen-carrying capacity of the blood”]  , causing dramatically   [ Select ]  [“decreased”, “increased”]  ventilation.
• You can often easily observe this in a patient, because they demonstrate   [ Select ]  [“hypoventilation”, “hyperventilation”]  .
• This change in ventilation leads to   [ Select ]  [“increased”, “decreased”]  pressure gradients for alveolar exchange of oxygen and carbon dioxide.
• As a result, your patient’s arterial oxygen is   [ Select ]  [“less”, “greater”]  than normal, and her arterial carbon dioxide is   [ Select ]  [“greater”, “less”]  than normal.
• The abnormal arterial oxygen level leads to   [ Select ]  [“glycosuria and polyphagia”, “anaerobic respiration”, “aerobic respiration”, “alternative fuel sources for energy-producing pathways”]  , which creates   [ Select ]  [“lactic acid”, “acidic cardiovascular failure byproducts”, “stomach (gastric) acid”, “ketoacids”]  as a byproduct.
• Because of the build-up of this byproduct in your patient’s blood, they have   [ Select ]  [“acidosis”, “alkalosis”]  , and the origin of the disturbance is   [ Select ]  [“metabolic”, “respiratory”]  , because this type of acid is   [ Select ]  [“volatile”, “fixed”]  .
• The abnormal carbon dioxide level combines with water to create   [ Select ]  [“excess hydrogen ions”, “too few bicarbonate ions”, “too few hydrogen ions”]  in her blood, which also causes her   [ Select ]  [“acidosis”, “alkalosis”]  ; the origin of this disturbance is   [ Select ]  [“metabolic”, “respiratory”]  , because this type of acid is   [ Select ]  [“volatile”, “fixed”]  .
• Since the origin of her acid-base disturbance is   [ Select ]  [“respiratory”, “metabolic”, “both metabolic and respiratory”]  , neither system is able to successfully compensate for the challenge, which is why her Davenport Diagram reveals her acid-base disturbance is   [ Select ]  [“partially compensated”, “fully compensated”, “uncompensated”]  .

3-During the Acid-Base Balance virtual lab activity, there was a patient, John Gregson, who went hiking at high altitude and consequently suffered from an acid-base disturbance. Please follow the pattern in the previous questions to explain how the patient’s diagnosis led to his acid-base disturbance. In your answer, make sure to include the following:

1. What was your patient’s diagnosis? Which clinical test(s) helped you determine the diagnosis, and HOW did they help you determine the diagnosis?
2. What was your patient’s acid-base status and the origin of the disturbance?
3. How did the diagnosis lead to the acid-base disturbance? Please make sure to thoroughly explain all the steps that connect the diagnosis to the acid-base disturbance.
4. Was the patient compensating? If so, how were they compensating? How does the compensation help correct the initial acid-base disturbance?

4- During the Acid-Base Balance virtual lab activity, there was a patient, Suri Barza, who was an 11-year-old suffering from frequent urination, excessive thirst, and abdominal discomfort. Please follow the pattern in the previous questions to explain how the patient’s diagnosis led to her acid-base disturbance. In your answer, make sure to include the following:

1. What was your patient’s diagnosis? Which clinical test(s) helped you determine the diagnosis, and HOW did they help you determine the diagnosis?
2. What was your patient’s acid-base status and the origin of the disturbance?
3. How did the diagnosis lead to the acid-base disturbance? Please make sure to thoroughly explain all the steps that connect the diagnosis to the acid-base disturbance.
4. Was the patient compensating? If so, how were they compensating? How does the compensation help correct the initial acid-base disturbance?