1 Acid Base Disorders and Genetics Case Study March 5, 2020
2 Acid Base Disorders and Genetics Case Study 1. The clinical scenario is most consistent with which acid base disorder? Metabolic acidosis with a normal anion gap 2. What data in the clinical scenario supports your diagnosis? History of profuse diarrhea for 3 days High respiratory rate, 24 breaths per minute Low carbon dioxide (CO2) level, 18 mEq/L (mmol/L) Normal anion gap, 10 mEq/L
3 3. What caused this person’s acid base imbalance? Profuse diarrhea caused an acute bicarbonate loss, inducing metabolic acidosis. 4. Describe the key pathophysiologic concepts. a. How does this acid base imbalance cause the potassium imbalance noted in this patient’s labs? Profuse diarrhea caused a significant amount of bicarbonate loss. A higher concentration of bicarbonate is found in diarrhea versus plasma, earning diarrhea a common cause of gastrointestinal bicarbonate loss (Berend, 2017). The bicarbonate loss creates a higher serum concentration of hydrogen causing the buffer systems to compensate. The cellular buffer system maintains an ionic balance by an ion exchange of hydrogen for potassium intracellularly (Huether, 2019). This ion exchange decreases extracellular hydrogen concentration while increasing extracellular potassium concentration resulting in hyperkalemia.
- Fall '15
- pH, UTA, Zygosity, sickle cell trait, Phenylketonuria