Question

Can someone help with both of these?

Patient Case Question 15. Explain the pathophysiologic basis that underlies the patient’s high blood pH. The patient has an elevated blood pH of 7.50

Patient Case Question 12. The patient has no medical history of diabetes mellitus, yet her fasting serum glucose concentration is elevated. Propose a reasonable explanation. The patient has a fasting serum glucose level of 138mg/dL.

Answer 1

15. High Blood pH

pH refers to the hydrogen ion concentration of a solution, that tells how acidic or alkaline the solution is. The expansion of pH is potential Hydrogen. The neutral pH is 7.

Blood pH

Normal pH of blood is 7.35 to 7.45. The blood is slightly alkaline.

Elevated blood pH( in this case the patient has 7.50 blood pH);

Elevated blood pH is also known as Alkalosis ( an abnormally increased alkalinity in the blood). This condition can occur due to various reasons such as decreased carbon dioxide, increased bicarbonate levels in conditions like kidney diseases, severe vomiting and rapid and deep breathing.

Pathophysiologic basis

a) Respiratory Alkalosis is can be due to rapid and deep breathing ( hyperventilation), that leads to loss of Carbon dioxide resulting in increased dissociation of Carbonic acid , leads to increased excretion of bicarbonate to blood. That in turn results in high alkalinity of blood.

b) Metabolic Alkalosis can occur due to severe and continuous vomiting that results in loss of gastric acid ( hydrochloric acid) , hypochloremia, hypokalemia. Hydrogen loss stimulate the secretion of bicarbonate in the blood that causes increased alkalinity of the blood.

12. Fasting Serum glucose level :( 138mg/dL in this case)

Fasting Serum glucose level is normally in a non diabetic patient is less than 100 mg/ dL. If a non diabetic patient fasting Serum glucose level is high , it may be due to injury or any major illness. The common causes are:

* Medical conditions such as Cushing syndrome

Cushing syndrome is a condition having high levels of steroids such as cortisol and stress hormones in the blood. Cortisol increases blood sugar level by increasing the production of glucose from liver.

* Severe Burns, injury

In severely burned patients , there is increased metabolism, altered immune response, hyperglycemia may occur due to systemic response to burns. Burns also increases gluconeogenesis from liver and increases insulin resistance, results in high sugar level.

* Intravenous nutrition

* medications such as steroids ( cortisol causes increase in blood sugar level by increasing gluconeogenesis from liver and increasing insulin resistance)

Certain infections , lack of physical exercise, Obesity may also cause an increase in fasting Serum glucose levels .