Question

Patients with uncontrolled diabetes may enter a state called diabetic ketoacidosis, a form of metabolic acidosis in which low blood pH is caused by the excessive accumulation of acidic ketone bodies in the blood, due to excessive catabolism of stored fats (NOTE: while not relevant to this question, it might be interesting and a good review to make sure you understand why impaired insulin signaling would cause this to occur!). If this acidosis becomes severe and life-threatening, patients will eventually exhibit Kussmaul breathing: very deep, rapid, gasping breaths. which of the following scenarios explains why that is the case?

A Low blood pH increases the firing rate of central and peripheral chemoreceptors which increases the bursting rate of brainstem respiratory rhythmicity center neurons which increases the strength and rate of diaphragm contractions.

B Low blood pH increases the bursting rate of brainstem respiratory rhythmicity center neurons which increases the firing rate of central and peripheral chemoreceptors which increases the strength and rate of diaphragm contractions.

C Low blood pH decreases the bursting rate of brainstem respiratory rhythmicity center neurons which increases the firing rate of central and peripheral chemoreceptors which decreases the strength and rate of diaphragm contractions.

D Low blood pH increases the firing rate of central and peripheral chemoreceptors which decreases the bursting rate of brainstem respiratory rhythmicity center neurons which increases the strength and rate of diaphragm contractions. E Low blood pH decreases the firing rate of central and peripheral chemoreceptors which increases the bursting rate of brainstem respiratory rhythmicity center neurons which decreases the strength and rate of diaphragm contractions.

Answer 1

Answer-(A) (Low blood pH increases the firing rate of central and peripheral chemoreceptors which increases the bursting rate of brainstem respiratory rhythmicity center neurons which increases the strength and rate of diaphragm contractions)

*

Kussmaul breathing is state of hyperventilation to compensate for the metabolic acidosis caused in diabetic patients.

In kussmaul breathing , initially there is increase in both tidal volume and respiratory rate but later respiratory rate become normal and tidal volume is increased.

As there is more CO2 in the blood and decrease in the pH, the CO2 will diffuse across blood brain barrier and their combine with water to form carbonic acid which dissociates into hydrogen ion and bicarbonate ions, these hydrogen ions stimulate chemoreceptors which in turn stimulates repiratory center in the medulla and increases the bursting rate, which reaches to the respiratory system ultimately increasin the strength and contraction of diphragm.