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S. One > Basic Principles > Flashcards

Basic Principles Flashcards

1
Q

Electrolytes of the low volume state

A 
Inc total Na
Dec serum Na (dilutional effect)
Dec Cl
Dec K
Dec Ca (bound to albumin)
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2
Q

pH of low volume state

A

Alkolotic
(Except diarrhea, RTA Type II, and DKA)
because Aldosterone pumps H+

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3
Q

pH of vomiters

A

Alkolotic because vomiting out H+, low volume state

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4
Q

pH from diarrhea

A

Acidotic because stool has bicarb from pancreas

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5
Q

What happened if pulse inc >10 on standing?

A

Hypovolemic shock

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6
Q

What happened if pulse inc <5 on standing?

A

Autonomic dysfunction

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7
Q

Most common signs of the low energy state?

A

Tachypnea and dyspnea

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8
Q

Most common symptoms of the low energy state?

A

Weakness and SOB

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9
Q

Most common infections of the low energy state?

A

UTI and respiratory infections

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10
Q

Most common cause of death in the low energy state?

A

Heart failure

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11
Q

What are the symptoms of the low energy state?

A 
Rapidly dividing cells
CNS: mental retardation, dementia, dec activity
CV: heart failure, pericardial effusion
Muscle: weakness, SOB, vasodilation, impotence, urinary retention, constipation
Skin: dry
Nails: brittle
Hair: dry, brittle, alopecia 
Bone marrow: suppressed
Vascular endothelium: vasculitis 
Lungs: infection, dec cilia, SOB
Kidney: PCT affected first
GI: N/V/D
Bladder: urinary retention 
Sperm: decreased 
Germ cells: predisposed to cancer
Breasts: atrophic 
Endometrium: amenorrhea, atrophic
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12
Q

What organ is sacrificed first in the low energy state?

A

Kidney, followed by the heart, followed by the brain

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13
Q

What organ are we worried about/most protected in the low energy state?

A

Brain, followed by the heart, followed by the kidney

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14
Q

What feels the most effects of the low energy state?

A

Bone marrow - most rapidly dividing cell lines

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15
Q

What cancers does the low energy state predispose to?

A

Skin, GI, bone marrow

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16
Q

What cancers are most common?

A

Breast/prostate
Lung
Colon

17
Q

What cancers have the highest mortality?

A

Lung
Breast/prostate
Colon

18
Q

Explain all Restrictive Lung Diseases

A

Interstitial problem, non bacterial: dec diffusion and perfusion

Small stiff lungs (dec VC)
Trouble breathing in —> FEV1/FVC > 0.8
ABG: dec pO2 —> inc RR, dec pCO2, inc pH
CXR: reticulo-nodular pattern, ground glass appearance 
MC COD: cod pulmonale

Ex. NM diseases (breathing out is passive), drugs, autoimmune disease

Tx: pressure support on vent, inc O2, inc RR, inc inspiratory time, dec TV

19
Q

Explain all Obstructive Lung Diseases

A

Airway problem, bacterial

Big, mucus filled lungs (inc RV, inc Reid index = inc airway thickness/airway lumen)
Trouble breathing out —> FEV1/FVC < 0.8
ABG: inc pCO2 —> inc RR, dec pH
MC COD: bronchiectasis

Ex: COPD

Tx: manipulate rate on vent, inc RR, inc expiratory time, inc O2 only if needed

20
Q

Symptoms of a “more likely to depolarize” state?

A

Brain: psychosis, seizures, jitteriness
Skeletal muscle: muscle spasms, cramps
Smooth muscle: diarrhea
Cardiac: tachycardia, arrhythmias

21
Q

Symptoms of a “less likely to depolarize “ state?

A

Brain: lethargy, mental status changes, depression
Skeletal muscle: weakness, SOB
Smooth muscle: constipation
Cardiac: hypotension, bradycardia

22
Q

What is the humoral immune response?

A

B cells and neutrophils patrol the blood looking for bacteria

23
Q

What is the cell-mediated immune response?

A

T cells and macrophages patrol the tissue looking for non bacteria

24
Q

What are macrophages called in each area of the body?

A 
Blood: monocytes
Brain: microglia
Lung: T1 pneumocytes 
Liver: Kupffer cells
Spleen: RES cells 
Lymph: dendritic cells 
Kidney: mesangial cells
Peyer’s patches: M cells
Skin: Langerhans cells
Bone: osteoclasts
Connective tissue: histiocytes, giant cells, epitheloid cells
25
Q

What is the CBC for every vasculitis?

A

Dec RBC, platelets
Inc WBC, T cells, MP, ESR
Schistocytes

26
Q

Time course of the inflammatory response?

A 
1 hr: swelling
4.5 hrs: neutrophils show up
24 hrs: neutrophils predominate
3 days: neutrophils peak
4 days: T cells and macrophages show up
7 days: T cells and macrophages peak, fibroblasts show up
30 days: fibroblasts peak
3-6 months: fibrosis complete
27
Q

Necrosis

A

Non programmed cell death

Noisy, inflammation, nucleus destroyed first

28
Q

Apoptosis

A

Programmed cell death

Quiet, no inflammation, nucleus guided

29
Q

Pyknosis

A

Nucleus turns into blobs “pick blobs”

30
Q

Karyohexxis

A

Nucleus fragments

31
Q

Karyolysis

A

Nucleus dissolves

32
Q

What state does estrogen mimic?

A

The neuromuscular disease state. Estrogen is a muscle relaxant.

33
Q

What does high GABA levels lead to?

A

Bradycardia, lethargy, constipation, impotence, and memory loss

34
Q

What are the 4 bad things all acids do? Ex. Alcohol

A

Denatures proteins, Kussmaul breathing, increases GABA

S. One (24 decks)

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