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CASE HISTORY Brianna Was a 2-Month-Old,formula-Fed Infant in a Rural Community in Community

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CASE HISTORY
Brianna was a 2-month-old,formula-fed infant in a rural community in Nebraska.Brianna's mother noticed signs of blueness around the baby's mouth and fingers.One night after feeding,Brianna had trouble breathing,and her face had a peculiar lavender color.The infant became lethargic,salivated excessively,and had diarrhea and vomiting.An EMT came and took blood samples,which appeared brown and failed to turn pink when exposed to air.The EMT diagnosed methemoglobinemia,a condition in which toxic levels of nitrite oxidize hemoglobin and prevent it from receiving oxygen.The nitriteoxidized hemoglobin is called methemoglobin;elevated levels can cause asphyxiation and death.A solution of methylene blue,a reducing agent,was administered by IV to reduce (add electrons to) the hemoglobin in Brianna's blood.
Nitrite forms in the digestive tract by bacterial reduction of nitrate during anaerobic respiration.The well water from which Brianna's formula was prepared was tested and found to contain high levels of nitrate,enough to cause methemoglobinemia.Brianna's parents were surprised because they had felt no ill effect from the water.But an infant's stomach pH is high,allowing bacteria to reduce nitrate to nitrite,which may then oxidize hemoglobin.
The nitrite in the baby's blood was formed by her intestinal bacteria using nitrate (NO3⁻) as a terminal electron acceptor for anaerobic respiration,with nitrite (NO₂⁻) as the product.Bacteria can multiply more quickly by utilizing oxygen as a terminal electron acceptor in which process?

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Definitions:

Contract Rate

The agreed-upon interest rate in a lending agreement, bond, or other financial contracts.

Market Rate

The prevailing interest rate available in the market for securities of a similar risk and maturity, or the standard rate charged or paid for a specific service or commodity.

Face Amount

The nominal value or principal amount of a security stated by the issuer, due to be paid at maturity.

Straight-Line Method

A method of calculating depreciation of an asset, which spreads the cost of the asset evenly over its useful life.

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