Acetone And Aceto Case Study Answers
1. She has rapid deep breathing.
There is no insulin in her blood which means her muscle cells and other cells in her body are not able to use glucose in respiration as an energy source. Her body signals the breakdown of fats to provide energy in a process called gluconeogenesis. This breakdown of fats produces ketones such as acetone, these molecules are acidic. A build-up of acetone and acetoacetate in Roberta’s blood lowers the pH of her blood. This is known as ketoacidosis. She will begin to rapidly breathe in order to compensate for the high levels of acetone and low pH of her blood.
2. She feels very thirsty despite drinking lots of water.
This is a common symptom of diabetes, another term for this is polydipsia. Roberta feels very …show more content…
thirsty despite drinking large amounts of water, this indicates that she is suffering from hyperglycemia; her blood glucose concentration is too high. Due to this high level of glucose in the blood the kidneys are not able to reabsorb all the glucose from the water. Subsequently there is a build-up of osmotic pressure and water can no longer be reabsorbed back into the blood stream from the collecting duct of the kidney. This leads to excessive water loss from the body, hence patient would feel very thirsty throughout the day.
3. She is urinating much more frequently.
This is known as polyuria which is also another common symptom of diabetes. There is a high concentration of glucose in the blood, therefore less water is reabsorbed into the blood due to the osmotic pressure, and a larger volume of dilute urine is produced. This leads to polyuria because there is no insulin in Roberta’s body to metabolise and reduces the concentration of glucose in her blood. Subsequently, her body will not reabsorb water into her blood, instead water will be passed into her bladder which will be removed via urination.
4. She constantly feels tired and lethargic.
Since her body does not produce any insulin, which helps with the uptake of glucose from the blood into muscle and other cells, Roberta’s muscles are prone to fatigue. Although other respiratory substrates such as fats and amino acids may be used, the supply of ATP will be limited in her body. ATP is vital in the action of myosin filament in the sarcomere, less ATP means less muscle contractions of smaller magnitude will be generated, and muscle fatigue will occur quickly. Glucose is the main source of energy for the body but because there is no insulin hormone to allow the uptake of glucose into cells, diabetics are likely to feel very tired and sluggish.
5. Her breath smells of nail varnish remover.
This indicates that she has ketoacidosis. Since her main source of energy, glucose, cannot be used in respiration, her body is signaling the breakdown of fats in order to release energy. Breakdown of fats into glucose is known as gluconeogenesis. Gluconeogenesis produces ketones, acetone being the simplest form. Ketones are known to be very volatile, therefore her breath smells of nail varnish remover.
1. From your list of 5 cues, give TWO examples of pairs of cues that link together (a cue may be used more than once) and explain how the cues are linked. (10 marks)
To achieve a good mark, you need to provide much more detail than that given for the individual cues in Question 1 and to explain the causal link between the cues. Marks will not be awarded if you merely repeat the information given in Question 1.
Linked cues: (1 mark)
Feeling very thirsty and urinating more frequently.
Explanation: (up to 4 marks)
Due to the destruction of insulin secreting beta cells in the pancreas from type 1 diabetes, there is a continual increase in blood glucose concentration. In order to get rid of the excess glucose the body attempts to filter glucose out of the blood via kidneys. However due to the high concentration of glucose in the blood, the osmotic pressure builds up, subsequently water is not reabsorbed back into her blood from the collecting duct and is instead passed out in the urine. This process will occur throughout the day leading to even more loss of water from the blood. Since most of the water in her body is lost in the large volume of urine, Roberta will feel dehydrated and in turn very thirsty most of the time. These two symptoms are closely linked. When she drinks excessive amounts of water, this water joins the blood stream. Eventually the blood glucose concentration rises again causing the kidneys to fail to reabsorb water into her blood. Also, her overall blood volume will increase due to the high volume of water she has drank, therefore the release of anti-diuretic hormone (ADH) will decrease. ADH is responsible for reabsorbing water back into the blood by inserting channels into the cells of the walls of the collecting duct. Decreased activity of ADH will lead to less water reabsorption, so more water is lost from the body again via urination, and she will in turn feel thirstier.
Hence polyuria leads to dehydration of the body which in turn leads to polydipsia.
Linked cues: (1 mark)
Breath smelling of nail varnish remover and rapid deep breathing.
Explanation: (up to 4 marks)
Roberta’s breath smells of nail varnish remover as a result of ketoacidosis.
Since there is no insulin to transport glucose from the blood stream into cells of tissues, her body is breaking down fats to meet the demand for energy of her muscles and other cells. Gluconeogenesis results in the production of ketones such as acetone and acetoacetate. Ketones are acidic and volatile, as the concentration of ketones in the blood rises, there is a decrease in blood pH to 7.28 in Roberta’s case, (optimum blood pH 7.35) and the blood becomes an acidic environment. Her breath smells of acetone because ketones are volatile compounds. In order to get rid of the acetones in her respiratory system her breathing rate will increase, and ketones evaporate from her breath. The acidic environment of her blood is not suitable for the enzymes and proteins such as haemoglobin, in order to compensate for this her breathing becomes more rapid and deep. This rapid breathing increases the level of oxygen in the blood, and concentration of ketones such as acetone decrease over time, restoring the bloods pH for a …show more content…
while.
3. Identify one laboratory test that you think would be necessary to carry out on Roberta in the future. Explain how the test is performed (do not include details of how to collect the sample). In the context of this case, why have you ordered this test and how would you interpret the results of this test?
(10 marks: 1 mark for the test + 4 marks for its explanation + 5 marks for the interpretation of its results)
Test (1 mark) A1C Test
Explanation (4 marks)
This test is designed to monitor how well you have been managing your blood glucose levels for the past three months, in contrast to other tests which measure blood glucose levels at specific times. The A1C test measures the percentage of glycated haemoglobin, since haemoglobin has a life span of 120 days, this test only takes into account the past 3 months. The A1C test includes pricking the patient’s finger to obtain a drop of blood. This drop is then analysed using a Quo-Test HbA1 analyser and a result of the percentage of glycated haemoglobin in the blood is produced. This test has been ordered because it helps patients in the long time considering they are terminally ill and, especially young children, will need special care and advice. This test is better than the fasting blood glucose test because that only indicates your blood glucose levels at one moment in time, which could fluctuate the next day. Giving a sudden dosage of glucose sweet drink could be dangerous for a patient who cannot regulate blood glucose efficiently.
Interpretation (5 marks)
This test should be repeated in order to obtain reliable results for the patient, as one test may be a false result. The result can then be compared to already known results.
For a normal healthy person the result would be between 4.5% and 6%.
A high result indicates that a high percentage of glucose is bound to haemoglobin and has not been metabolised. Somebody at risk would have a percentage of above 8%.This indicates a higher risk of hyperglycaemia and so the patient has not controlled their blood sugar levels properly. Since a diabetic patient’s body is not able to uptake glucose and reset high blood glucose levels back to normal immediately, they need to be cautious with the amount of sugar present in their diet.
The lifespan of a red blood cell is 120 days and the glycation of haemoglobin takes 90-120 days, if the percentage of glycated haemoglobin is higher than 8% it means that there is a high concentration of glucose in the blood which is unhealthy.
According to an article by the American Diabetes Association in January 2006, a glycated haemoglobin percentage of less than 6% shows excellent degree of control and this corresponds to an average blood glucose concentration of 135mg/dL compared to a normal person’s blood glucose concentration which is 79.2 mg/dL to 110 mg/dL. A percentage of 9% shows fair degree of control and greater than 12% indicates extremely poor degree of control of blood glucose
concentration.
There is no insulin in her blood which means her muscle cells and other cells in her body are not able to use glucose in respiration as an energy source. Her body signals the breakdown of fats to provide energy in a process called gluconeogenesis. This breakdown of fats produces ketones such as acetone, these molecules are acidic. A build-up of acetone and acetoacetate in Roberta’s blood lowers the pH of her blood. This is known as ketoacidosis. She will begin to rapidly breathe in order to compensate for the high levels of acetone and low pH of her blood.
2. She feels very thirsty despite drinking lots of water.
This is a common symptom of diabetes, another term for this is polydipsia. Roberta feels very …show more content…
thirsty despite drinking large amounts of water, this indicates that she is suffering from hyperglycemia; her blood glucose concentration is too high. Due to this high level of glucose in the blood the kidneys are not able to reabsorb all the glucose from the water. Subsequently there is a build-up of osmotic pressure and water can no longer be reabsorbed back into the blood stream from the collecting duct of the kidney. This leads to excessive water loss from the body, hence patient would feel very thirsty throughout the day.
3. She is urinating much more frequently.
This is known as polyuria which is also another common symptom of diabetes. There is a high concentration of glucose in the blood, therefore less water is reabsorbed into the blood due to the osmotic pressure, and a larger volume of dilute urine is produced. This leads to polyuria because there is no insulin in Roberta’s body to metabolise and reduces the concentration of glucose in her blood. Subsequently, her body will not reabsorb water into her blood, instead water will be passed into her bladder which will be removed via urination.
4. She constantly feels tired and lethargic.
Since her body does not produce any insulin, which helps with the uptake of glucose from the blood into muscle and other cells, Roberta’s muscles are prone to fatigue. Although other respiratory substrates such as fats and amino acids may be used, the supply of ATP will be limited in her body. ATP is vital in the action of myosin filament in the sarcomere, less ATP means less muscle contractions of smaller magnitude will be generated, and muscle fatigue will occur quickly. Glucose is the main source of energy for the body but because there is no insulin hormone to allow the uptake of glucose into cells, diabetics are likely to feel very tired and sluggish.
5. Her breath smells of nail varnish remover.
This indicates that she has ketoacidosis. Since her main source of energy, glucose, cannot be used in respiration, her body is signaling the breakdown of fats in order to release energy. Breakdown of fats into glucose is known as gluconeogenesis. Gluconeogenesis produces ketones, acetone being the simplest form. Ketones are known to be very volatile, therefore her breath smells of nail varnish remover.
1. From your list of 5 cues, give TWO examples of pairs of cues that link together (a cue may be used more than once) and explain how the cues are linked. (10 marks)
To achieve a good mark, you need to provide much more detail than that given for the individual cues in Question 1 and to explain the causal link between the cues. Marks will not be awarded if you merely repeat the information given in Question 1.
Linked cues: (1 mark)
Feeling very thirsty and urinating more frequently.
Explanation: (up to 4 marks)
Due to the destruction of insulin secreting beta cells in the pancreas from type 1 diabetes, there is a continual increase in blood glucose concentration. In order to get rid of the excess glucose the body attempts to filter glucose out of the blood via kidneys. However due to the high concentration of glucose in the blood, the osmotic pressure builds up, subsequently water is not reabsorbed back into her blood from the collecting duct and is instead passed out in the urine. This process will occur throughout the day leading to even more loss of water from the blood. Since most of the water in her body is lost in the large volume of urine, Roberta will feel dehydrated and in turn very thirsty most of the time. These two symptoms are closely linked. When she drinks excessive amounts of water, this water joins the blood stream. Eventually the blood glucose concentration rises again causing the kidneys to fail to reabsorb water into her blood. Also, her overall blood volume will increase due to the high volume of water she has drank, therefore the release of anti-diuretic hormone (ADH) will decrease. ADH is responsible for reabsorbing water back into the blood by inserting channels into the cells of the walls of the collecting duct. Decreased activity of ADH will lead to less water reabsorption, so more water is lost from the body again via urination, and she will in turn feel thirstier.
Hence polyuria leads to dehydration of the body which in turn leads to polydipsia.
Linked cues: (1 mark)
Breath smelling of nail varnish remover and rapid deep breathing.
Explanation: (up to 4 marks)
Roberta’s breath smells of nail varnish remover as a result of ketoacidosis.
Since there is no insulin to transport glucose from the blood stream into cells of tissues, her body is breaking down fats to meet the demand for energy of her muscles and other cells. Gluconeogenesis results in the production of ketones such as acetone and acetoacetate. Ketones are acidic and volatile, as the concentration of ketones in the blood rises, there is a decrease in blood pH to 7.28 in Roberta’s case, (optimum blood pH 7.35) and the blood becomes an acidic environment. Her breath smells of acetone because ketones are volatile compounds. In order to get rid of the acetones in her respiratory system her breathing rate will increase, and ketones evaporate from her breath. The acidic environment of her blood is not suitable for the enzymes and proteins such as haemoglobin, in order to compensate for this her breathing becomes more rapid and deep. This rapid breathing increases the level of oxygen in the blood, and concentration of ketones such as acetone decrease over time, restoring the bloods pH for a …show more content…
while.
3. Identify one laboratory test that you think would be necessary to carry out on Roberta in the future. Explain how the test is performed (do not include details of how to collect the sample). In the context of this case, why have you ordered this test and how would you interpret the results of this test?
(10 marks: 1 mark for the test + 4 marks for its explanation + 5 marks for the interpretation of its results)
Test (1 mark) A1C Test
Explanation (4 marks)
This test is designed to monitor how well you have been managing your blood glucose levels for the past three months, in contrast to other tests which measure blood glucose levels at specific times. The A1C test measures the percentage of glycated haemoglobin, since haemoglobin has a life span of 120 days, this test only takes into account the past 3 months. The A1C test includes pricking the patient’s finger to obtain a drop of blood. This drop is then analysed using a Quo-Test HbA1 analyser and a result of the percentage of glycated haemoglobin in the blood is produced. This test has been ordered because it helps patients in the long time considering they are terminally ill and, especially young children, will need special care and advice. This test is better than the fasting blood glucose test because that only indicates your blood glucose levels at one moment in time, which could fluctuate the next day. Giving a sudden dosage of glucose sweet drink could be dangerous for a patient who cannot regulate blood glucose efficiently.
Interpretation (5 marks)
This test should be repeated in order to obtain reliable results for the patient, as one test may be a false result. The result can then be compared to already known results.
For a normal healthy person the result would be between 4.5% and 6%.
A high result indicates that a high percentage of glucose is bound to haemoglobin and has not been metabolised. Somebody at risk would have a percentage of above 8%.This indicates a higher risk of hyperglycaemia and so the patient has not controlled their blood sugar levels properly. Since a diabetic patient’s body is not able to uptake glucose and reset high blood glucose levels back to normal immediately, they need to be cautious with the amount of sugar present in their diet.
The lifespan of a red blood cell is 120 days and the glycation of haemoglobin takes 90-120 days, if the percentage of glycated haemoglobin is higher than 8% it means that there is a high concentration of glucose in the blood which is unhealthy.
According to an article by the American Diabetes Association in January 2006, a glycated haemoglobin percentage of less than 6% shows excellent degree of control and this corresponds to an average blood glucose concentration of 135mg/dL compared to a normal person’s blood glucose concentration which is 79.2 mg/dL to 110 mg/dL. A percentage of 9% shows fair degree of control and greater than 12% indicates extremely poor degree of control of blood glucose
concentration.