A+P Flashcards
What is systemic vascular resistance?
Amount of force exerted on circulating blood by the vasculature
What is blood pressure?
cardiac output x systemic vascular resistance
- essentially an easier way to measure cardiac output
What is hypertension defined as?
systolic BP of 140 or more
What medications may a patient with hypertension be described?
ACE inhibitors, Beta blockers, Calcium channel blockers etc
Describe the process of atherosclerosis.
- Endothelial cells lining arteries become damaged
- As a result, LDLs circulating in the blood penetrate the vessel wall
- Result is an inflammatory response as chemical signals from the damaged endothelial cells attract monocytes to the damaged area
- Once inside, monocytes become clogged with LDLs and are called foam cells which accumulate to form a plaque of fatty deposits
- smooth muscle cells migrate to the area and a fibrous cap forms over the top of the plaque
Describe the clotting cascade.
Initiation - Tissues bind to factors
Amplification - thrombin fully activates platelets
Propagation - Thrombin converts soluble finrinogen to insoluble fibrin and starts to form a mesh, fibrin traps platelets and RBCs which leads to the growth of the clot in the artery
Stabilisation - platelet-platelet interaction
What causes hypertension?
loss of arterial elasticity due to hardening and narrowing of the arterial lumen due to atherosclerosis
What are the 3 classifications of hypertension?
Essential = unknown cause, ?genetic, develops over years
Secondary = results from disease or conditions that affect the normal balance of the body e.g. pregnancy
malignant = extremely high and dangerous (>180/120) that causes organ damage, e.g. headache, confusion, kidney dysfunction
What is a clinical symptom of an airway issue?
Unable to talk in full sentences
What are clincial symptoms of a breathing difficulty?
- tachypnoea
- accessory muscle use
- productive cough
- wheeze
- cyanosis
- clubbing
What are clinical symptoms of a circulation difficulty?
- Tachycardia/Bradycardia
- Hyper/hypotension
- Cap refill >2s peripherally
- excessive diaphoresis
What are clinical symptoms of Disability when doing a primary survey?
Altered level of consciousness (Abnormal GCS)
dilated pupils
reduced physical activity
What is emphysema?
- damage to alveoli resulting from environment e.g. tobacco smoking, car fumes
- over extension of the alveoli and destruction of alveolar wall
- decreased surface area for gas exchange
- loss of pulmonary capillaries
- lung tissue loses their elasticity - loss of recoil
- airways lose their muscular integrity and collapse
- over inflation of lungs
- barrel chest
- diaphragm is flattened
What is the difference between intrinsic and extrinsic asthma?
Intrinsic: non allergic - triggers like pollutants, stress exercise
Extrinsic - allergic - substances that can cause an allergic reaction
What is asthma?
Reaction of the trachea, bronchi and bronchioles to various stimuli that would not normally induce a response causing widespread reversible narrowing of the airways
Red flags for life threatening asthma
tripoding
cyanosis
silent chest
sats <92%
exhaustion
What are the two functions of the pancreas?
Endocrine and exocrine
What is type 1 diabetes?
destruction of alpha and beta cells in the islets of langerhans
What is the function of pancreatic alpha cells?
Release glucagon durin ghypoglycaemic episodes
What is the function of pancreatic beta cells?
secrete insulin during hyperglycaemic episodes
Describe the pathophysiology behind type 1 diabetes
- Islets of langerhans attacked by body and pancreatic beta cells are destroyed
- without insulin body cannot metabolise glucose
- BM rises and patient becomes hyperglycaemic
- excess glucose is excreted in urine, which affects osmotic pressure of nephron therefore polyuria
- body begins to break down fat as it requires energy
- by-product of fat breakdown is ketones
Describe the pathophysiology behind DKA
- pancreatic beta cells fail to produce insulin
- Glycaemic levels rise due to reduced glucose uptake by cells
- glycagon acts upon liver to speed up breakdown of fat, creating ketones
- fluid moves from intracellular to extracellular space due to increased osmolarity of the tissue
What is biliary colic?
- most common classical presentation
- symptoms include epigastric/RUQ pain
- colicky in nature, often severe
- may be exacerbated by eating fatty food
- N+V
- not associated with fever or abdo tenderness
Describe the pathophysiology and associated symptoms of cholecystitis
- obstructed bile flow due to stone stuck in cystic duct
- sharp RUQ pain
- spreads to back of below shoulder blade, can occur just after a meal
- N+V
- positive murphys sign
- fever
