Biomedical Sciences Coursework About Acid-Base Balance (Coursework Sample)

Essay Topic
Author’s name
Name of Institution
ACID-BASE BALANCE
1. Role of excessive alcohol consumption in acid-base disturbance
Acid base imbalance causes the blood plasma to fall out of homeostatic range of 7.35 to 7.45 (Hogan, 2007). Excess of acids and bases is acidosis and alkalosis respectively. Long term alcohol abuse can lead to enlargement of the kidneys which affects hormones responsible for kidney function. This would affect the body’s ability to filter blood causing an alteration of electrolytes and water with a rise in toxic wastes. Eventually the kidneys would fail and since the kidneys play role in regulation of electrolytes, their failure causes an imbalance. The body can only process one unit of alcohol in an hour, consumption of more than one unit would lead to alcohol poisoning, and this depresses the nervous system. Breathing is consequently slowed leading to a rise in the level of carbon dioxide and thus a decrease in pH. This action is referred to as respiratory acidosis.
2. Increase in sodium level following excessive alcohol consumption
In an effort to get rid of the excess liquor, the gag reflex is initiated. Gastric acid is expelled in the process, leading to a loss of hydrogen and chloride ions. This process can eventually lead to metabolic alkalosis. Vomiting also makes it difficult to keep food down as well as fluids further preventing the replenishment of the electrolytes.
High level of sodium is referred to as hypernatremia. It is caused by dehydration of which alcohol is a major contributor. In this condition, the sodium content is at a normal level but since water has been depleted the sodium content is high at that level. Alcohol reduces the production of anti-diuretic hormone. This hormone is primarily used in reabsorption of water. It does this by increasing the permeability of the collecting ducts and distal convoluted tubule (Laycock, 2010). Vasopressin also causes an acute increase in sodium salts uptake in the ascending loop of Henle which helps in ensuring proper reabsorption of water. With lower levels of vasopressin, less water is reabsorbed by the renal system. The acute increase in sodium which aids in reabsorption are also cut short. The result is excretion of dilute urine. Continuous elimination of water causes dehydration, blood plasma becomes concentrated and sodium content becomes higher as a result.
Dehydration also occurs via the gag reflex through expulsion of stomach contents. The body is unable to absorb adequate water due to the halted of production of vasopressin and so intake of water is not sufficient in replenishing the water content.
3. The cause of ion gap in excessive alcohol consumption.
The condition that leads to a wide anion gap is referred to as alcoholic ketoacidosis. It occurs when there is accumulation of acetoacetic acid and hydroxybutyric acid precipitated when a person ceases taking alcohol abruptly or when s/he reduces consumption. It has also been associated with little intake of food prior to drinking, binge drinking and persistent vomiting. It occurs because of depletion of fluids, glycogen and dinucleotide. Alcohol is metabolized using a cytosolic enzyme named Alcohol dehydrogenase to acetaldehyde which is further metabolized to aldehyde dehydrogenase. Both processes require the consumption of nicotinamide adenine dinucleotide. They also impair conversion of lactate to pyruvate causing an increase in lactic levels. The reduced renal function as a result of alcohol is also a contributor. This is due to the accumulation of acids.
Cessation of alcohol intake is normally coupled with physically discomfort especially in the abdominal area. Ingestion of food is thereby hindered causing an elevated ketoacid production and starvation. The lack of food means there is a decrease in insulin activity. The body reacts by burning more lipids and fats for energy. The liver undergoes gluconeogenesis resulting in accumulation of Acetyl – CoA which is converted to ketoacids (Nilsson & Piccini, 2006).
4. Respiratory and renal system compensatory response for acid – base disturbance
Compensatory responses occur through the kidneys, lungs and body buffers. Rise of hydrogen ions is buffered by intracellular and extracellular buffers. Intracellular buffers being phosphates and haemoglobin while extracellular include carbonate and protein buffers. The kidney maintains homeostasis by regulating excretion of hydrogen. This ensures that plasma bicarbonate is within a tolerable limit. The kidneys also reabsorb bicarbonates and remove the acid produce by the body. The renal system maintains electro neutrality by ensuring equal absorption of anions and cations or through concurrent excretion of both of them. The kidneys respond to acidity by a reabsorbing more bicarbonate and collecting ducts secrete more hydrogen. Response to alkalosis by the kidney involves reduction in glutamine metabolism and excretion of more bicarbonate by decreasing H+ secretion in epithelial cells (Rogers, 2012).
When the body pH falls, the body responds by increasing the rate of breathing. The excess carbon dioxide is removed from the system followed by a rise in pH as the number of free hydrogen ions drops. When pH rises, the body responds by lowering the rate of breathing. The level of carbon dioxide rises. After the carbon dioxide dissociates in blood plasma, the number of H+ ions increase causing a drop in pH.
5. Rationale for the low glucose level and high urine ketones associated with excessive alcohol consumption.
Alcohol causes an increase in secretion of insulin which promotes absorption of glucose. The liver is primarily responsible for detoxification, removal of alcohol from the system is a priority as the body registers it as a toxin. It would therefore be impaired in its function of rectifying low blood sugar by converting glycogen or fat to glucose. Many a time excessive consumption is accompanied by starvation or little to no intake of food. As a result, t...