Classic Cases 2 Flashcards
Predominate Cation intracellular
Potassium
Predominate cation extracellularly
Sodium
Normal pH
7.35-7.45
Normal Na+ value
135 - 145 mmol
Normal K+ value
3.0- 5.0 mol
Normal H+ concentration
0.0004 mmol
Effect of acid on protein
Acid causes protein denaturing
Predominate extracellular buffer
Bicarbonate Buffer System
Formula for bicarbonate buffer system
CO2+H2O = H2CO3 = H+HCO3
What are hormones?
Amines & amino acids
Peptides, polypeptides, glycoproteins & proteins
Steroids
Fatty acid derivatives
Anterior Pituitary Hormones
FSH LH Adrenochorticotropic(ACTH) Thyroid Stimulating (TSH) Growth Hormone(GH) Melanocyte Stimulating Hormone(MSH) Prolactin
Posterior Pituitary Hormones
Oxytocin Antidiuretic hormone(ADH)
Characteristics of adrenal insufficiency
- decreased adernal cortex function
- decreased cortisol and aldosterone
What is Addison’s disease and symptoms
- Primary adrenal insufficiency
- Bronze pigmentation of skin
- Hypoglycemia
- Postural hypotension
- weight loss
- weakness
- GI disturbances
what does decreased aldosterone result in
Increased urinary loss of sodium, chloride and water
Decreased excretion of potassium
what does decreased cortisol do in the body
Poor tolerance of stress
Hypoglycemia, lethargy, weakness, fever
Anorexia, nausea, vomiting and weight loss
What is secondary adrenal insufficiency
A lack of ACTH secretion from the pituitary, leading to a reduced production of cortisol
What is addisonian crisis
Acute onset or worsening of primary adrenal insufficiency
What is cushing’s syndrome
Hypercortisolism
What are the 3 forms/causes of Cushing’s syndrome
Pituritary
Adrenal
Ectopic Cushing’s
Symptoms of Cushing’s syndrome
Moon Face HTN Cardiac Hypertrophy Buffalo Hump Obesity Abdominal Striae Amenorrhea Muscle Weakness
Myxedema Coma and symptoms
- Profound hypothyroidism ALOC Hypothermia Hypoventilating Hypoglycemia Bradycardia Decreased inotropy Hyponatremia
Hypothyroidism symptoms
Hair loss Enlarged thyroid Dry, coarse skin Cold extremities and swelling of limbs Poor appetite Slow heartrate
Congenital Hypothyroidism
Can result from lack of thyroid gland, abnormal synthesis or deficient TSH
Hyperthyroidism
Excessive delivery of T3 and T4 to tissues
Manifests as increased O2 consumption and use of metabolic fuels
Thyroid Storm
- Develops in a patient with longstanding untreated hyperthyroidism
- Precipitated by infection, DKA or trauma
What 3 things does insulin do
- Promotes glucose uptake by target cells & provides for glucose storage as glycogen
- Prevents fat and glycogen breakdown and inhibits gluconeogenesis
- Increases protein synthesis
What does glucagon do?
Initiates glycogenolysis to raise glucose levels
Also increases transport of amino acids into the liver and stimulates conversion to glucose
DKA
Occurs when ketone production exceeds cellular use and renal excretion
May often be the sentinel event leading to a diagnosis of Type 1 Diabetes
DKA presentation
Polyuria & polydipsia over 2 days is common
Nausea/vomiting
Abdominal pain and tenderness without co-occurring disease
Fatigue, progressing to unconsciousness
Hypotension and tachycardia
Kussmaul’s respirations
Hyperglycemic Hyperosmolar Non-Ketotic Syndrome(HHNK) Causes
May occur in:
T2DM
Acute pancreatitis
Severe infection
HHNK presentation
Dehydration
Neurologic Compromise
Seizures, hemiparesis, aphasia, nystagmus, hallucinations
Excessive thirst
Generally progressive over days and may be mistaken for a stroke
Causes of Seizures
Vascular Infection Trauma/toxins AV malformation Metabolic Idiopathic Neoplasm
