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One Headache After Another: Physiology Edition

Co Authors:

Ann T.S. Taylor
Department of Chemistry
Wabash College

William H. Cliff
Department of Biology
Niagara University


Topamax®, developed to treat epilepsy, is also used as a preventative for migraine. In this case study, students read about a woman experiencing a side-effect of Topamax and from there move to a review of acid-base balance in the human body. The case study questions force the students to think about basic concepts related to buffers, pH, and equilibria, and challenge them to make specific connections. The case has two versions: one for physiologists and a second one for chemists/biochemists (titled "One Headache After Another: Biochemistry Edition"). This is the physiology version.  Both versions cover acid-base balance to a similar extent, with the physiology version covering more of the factors involved with metabolic acidosis and exercise physiology. Both versions are geared to upper-level undergraduates.

  • Recall the definition of a buffer and the Henderson Hasselbalch equation.
  • Predict the changes in [H+] in the blood when different components of the bicarbonate buffer system are altered.
  • Explain the cellular mechanisms whereby the kidney regulates the concentration of bicarbonate and nonvolatile acids in the blood.
  • Distinguish between the transport processes responsible for bicarbonate reabsorption and for H+ secretion and reaction of H+ with buffers in the urine.
  • Describe the respiratory mechanism that compensates for metabolic acidosis.
  • Compare and contrast the different causes for metabolic acidosis.
  • Explain the effect of exercise on acid-base balance.
Keywords: pH; buffer; acid/base; bicarbonate equilibria; LeChatlier principle; metabolic acidosis; physiological regulation of pH; carbonic anhydrase; Henderson Hasselbalch equation; topiramate; Topamax; respiratory system; renal system; kidneys
Topical Area: N/A
Educational Level: Undergraduate upper division
Formats: PDF
Type/Method: Directed, Interrupted
Language: English
Subject Headings: Physiology   Biology (General)   Medicine (General)   Sports Science  
Date Posted: 12/28/2009
Date Modified: N/A
Copyright: Copyright held by the National Center for Case Study Teaching in Science, University at Buffalo, State University of New York. Please see our usage guidelines, which outline our policy concerning permissible reproduction of this work.

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