Fred suffers from chronic emphysema. Blood tests show that his blood pH is normal but his bicarbonate levels are elevated significantly. Explain why the blood pH is unaffected.
What will be an ideal response?
As long as the ratio of bicarbonate ion to carbonic acid is 20:1, the pH of body fluids will remain normal. Since Fred's condition is chronic (long term), his body has compensated for the excess carbonic acid (the result of hypercapnia due to poor ventilation) by increasing the amount of bicarbonate to match the elevated level of acid. This process involves the kidneys, where some of the excess carbon dioxide is converted into carbonic acid and the carbonic acid is allowed to dissociate. The hydrogen ions are secreted, and the newly formed bicarbonate is conserved to maintain a proper buffering capacity.
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