Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Patho > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What is PMN

A

A white blood cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is opsonization

A

Cell is altered in a way that makes it easy to be killed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is Pyrexia

A

Something that causes fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is insensible perspiration

A

You can’t measure how much sweat is being lost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 3 purposes of inflammatory response

A

Neutralize harmful agents/bacteria. Limit the spread of damage/wall-off injury. Prepare damaged tissue for repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 5 cardinal signs of inflammation

A

Redness, swelling, heat, pain, and loss of function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe acute inflammation

A

Usually a defined starting point (bee sting e.g.) IT is short, lasts 2 weeks or less. Trigger is identifiable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe chronic inflammation

A

Lasts longer than 2 weeks. More “diffuse” usually can’t identify the reason for the inflammation. Causes scar tissue to form and deformity to set in.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe 3 steps in inflammation

A

Increased vascular permeability and vasodilation. Recruitment of emigration and WBCs (chemotaxis). Phagocytosis of antigens and debris.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Give 5 step pathway for inflammation response

A

Injury - Vasoactive chemicals - vasodilation - Emigration of neutrophils and macrophages into tissue - Phagocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe the vascular stage of inflammation

A

Momentary vasoconstriction followed by vasodilation and capillary leakage. Increases the volume of blood delivered to the damaged tissue thus delivering the necessary components of the blood to handle the issue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the effects of increased vascular permeability

A

Histamine-prostaglandin-leukotrines released from mast cells. Vasodilation, capillarity permeability and blood volume are all increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Increased blood volume increases hydrostatic pressure resulting in what

A

Pain, heat, redness, and swelling (edema)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe granulocytes in the cellular stage of inflammation

A

Neutrophils arrive first and engulf/phagocytize and eliminate bacterial invaders. Left shift of excess immature neutrophils (bands) are released into the blood stream. Eosinophils release substances causing vasodilation. Basophils also release vasodilation substances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe monocytes in the cellular stage of inflammation

A

Actions similar to neutrophils but have a longer life span and mature into macrophages they are released once the neutrophils are exhausted.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe lymphocytes in the cellular stage of inflammation

A

Locate and destroy viral pathogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does it mean if you have more macrophages than other wbc’s

A

The inflammation is likely chronic because the monocytes are hanging around and maturing into macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Name 4 steps of cells in inflammation response

A

Margination - emigration - chemotaxis - Phagocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe margination

A

WBCs and platelets stick to the walls of blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe emigration

A

cells move through the capillary spaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What do bradykinins, histamines, and prostaglandins lead to

A

The capillary leak that increases hydrostatic pressure and thus pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is C-reactive protein indicative of

A

That there is an inflammatory response going on

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe local manifestations of inflammation

A

Exudates: serous drainage, hemorrhagic/sanguinous drainage, serosanguinous drainage, fibrinous drainage, purulent or suppurative drainage. Also ulceration or wound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What does serous drainage look like

A

Pale urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is serosanguinous drainage

A

A combination of sanguinous (blood) and serous (pale urine color) fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is fibrinous drainage

A

The drainage has fibrin products in it so it’s clear yellow and consistency is like jello (congealed serous fluid it seems to look like)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are some systemic manifestations of inflammation

A

Leukocytosis, fever, elevated C-reactive protein. Lymphadenopathy (due to rapid increase in lymphocytes), lethargy, anemia, weight loss, sleepiness, ESR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is an ESR

A

Erythrocyte sedimentation rate: How fast are red blood cells falling through fibrin to get to the bottom of the tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Name 3 chronic inflammation etiology

A

Certain pathogens, environmental exposure and autoimmune disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Describe macrophages and granulomas in chronic inflammation

A

Macrophages release factors both promoting healing and re-injuring. Granulomas composed of macrophages, fibroblasts, and connective tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Describe fibroblasts in healing

A

Synthesize CT, can migrate where needed, and facilitate normal cell growth. Fibrin is like the framework for healing a wound.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Describe endothelial cells in the healing process

A

Develop new capillary beds from existing vessels, they bring in nutrients to promote healing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Describe myofibroblast in the healing process

A

Develop a wound edge, promotes wound contracture (closure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Which cells are constantly regenerating

A

Labile cells such as skin, mucous membranes, and bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Which cells regenerate only “when needed”

A

stable cells such as liver, pancreas, endocrine glands, and renal tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Which cells have poor regeneration

A

Permanent cells such as neurons and muscle cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Describe connective tissue replacement in the formation of granulation tissue

A

Fibroblasts initiate healing, collagen develops from fibroblasts, contraction pulls the wound edges together leading to closure and then scar formation occurs - scars do not function like the parent tissue its essentially just a patch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is primary healing

A

Healed by like cells such as in a very clean cut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is secondary healing

A

granulation tissue is required because tissues aren’t lined up.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is tertiary healing

A

granulation forms and delayed closing is required. It’s essentially just delayed secondary, often times it is due to a contaminated wound.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Name 7 complications of wound healing

A

Keloid formation, contractures, dehiscence, evisceration, stricture formation, fistula formation, and adhesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Name 10 things that delay healing

A

Malnutrition, oxygen delivery, Impaired inflammatory/immune response, infection/contamination, foreign bodies, dehiscence, evisceration, circulation, obesity, and age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is a contracture

A

An injury over a joint, as the the fibroblasts contract to heal the wound the joint is also constricted in so you lose rom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is a stricture

A

A band of scarring around a pipe (around the trachea with chronic smoking e.g.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is a fistula

A

An opening between two body parts that do not normally open to each other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is an adhesion

A

Scar tissue in which two body parts are stuck together that normally don’t stick together

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Give 6 things involved with temp regulation

A

Vascular response, skin response, positioning, shivering, epinephrine, and thyroid hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Name the four stages of fever

A

Prodromal, chill, flush, and Defervescence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Describe the prodromal stage

A

A general feeling of unwell but no identifiable specific signs and symptoms that would point to a certain disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Describe fever in the elderly

A

Fever response is diminished so a temp of 99 is similar to for example a 102 in children. Also elderly people can often have errors in measurement with what they’re telling you

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Compare antigen vs antibodies

A

antigen would be like the foreign invader. It’s the thing that antibodies recognize and respond to

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is seroconversion

A

The point in time that you can measure antibodies in a person’s bloodstream to know if they’ve been exposed to whatever you’re looking for. Usually referred to HIV. It’s when you can determine that they do have HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is myalgia

A

General muscle aches and pains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is gammaglobulin

A

Same thing as both immunoglobulin and antibodies. 3 words for the same thing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What is pyrogenic

A

Things that cause fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is autoimmunity

A

When you break down organs in your own body due to an immune response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Name 3 of the skin and mucous membranes

A

Physical barriers, chemical barriers - peptides, and normal flora

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What is the mononuclear phagocyte system

A

Monocytes, macrophages, and dendritic cells destroy or present antigens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is involved with the lymphoid system

A

spleen, lymph nodes, thymus - filters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

How is bone marrow involved in the immune system

A

It creates stem cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What does bone marrow primarily do as a lymphoidal structure

A

cell growth and differentiation. T and B stem cell development and B cell maturation. T cells stay in the thymus while B cells stay in the bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Describe what the 3 granulocytes are involved in

A

Neutrophils - 1st WBCs to appear at injury/infection - phagocytosis. Eosinophils - allergic reactions and parasitic response. Basophils and mast cells - allergic reactions, chronic inflammation and wound healing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What do mast cells release

A

Histamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is the other big job of macrophages besides phagocytic activity

A

The presentation of antigens to T cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What do NK cells do

A

Destroy tumor cells and viruses without prior exposure required. They are pre-programmed to take care of certain abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What do T cells do

A

Direct the immune system’s function. It tells the B cells to turn into certain antibodies. They determine how many neutrophils get released and how many eosinophils get released.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What is the only job of the B cell

A

To become an antibody

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Describe the innate immunity

A

Responds primarily to microbes. Composed of skin, phagocytic cells, NK cells, monocytes - macrophages and cytokines.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What is passive immunity

A

Immunity that is given to an individual through antibodies. It doesn’t last very long. Two main ways are from mother to infant and through antibody injections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Describe the adaptive/active immunity

A

Requires exposure to antigen for development such as vaccines or diseases. Acquired over time. Composed of WBCs and their products. More specific than innate immunity. It has a memory.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What are the two types of adaptive/active immunity

A

Humoral and cell-mediated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What are major histocompatibility complexes (MHC)

A

Proteins that identify self and present antigens to the attacker cells of the immune system. Very important in tissue transplantation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What’s another name for MHC

A

human leukocyte antigens (HLAs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Describe cell mediated immunity

A

Composed of T cells. T cells develop from stem cells in bone marrow and move to thymus gland to mature. T4 cells with CD4+ are helper cells. T8 cells with CD8+ which are cytotoxic cells. Cytokines are also involved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What does IgG antibody do

A

Bacteria, toxins, viruses - second responder to antigens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What does IgM antibody do

A

First responder to an antigen. elevated levels indicate a recent infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Describe primary response of humoral immunity

A

First exposure to an antigen that stimulates the development of antibodies. Vaccines are a great example

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Describe secondary response of humoral immunity

A

Occurs when a person is subsequently exposed to the antigen

79
Q

Describe the development of the immune system

A

Begins at 5-6 in utero
Secondary lymph organs are small at birth
IgG is the only Ig to cross the placenta
The presence of other Ig at birth indicates intrauterine infection
IgA is transferred in breast milk & colostrum

80
Q

Describe a type I hypersensitivity response

A

It’s immediate. IgE receptor stimulation on mast cells and basophils. Causes vasodilation, increased capillary permeability, and smooth and bronchial muscle constriction

81
Q

Describe an anaphylactic reaction

A

They’re life threatening such as hives, bronchoconstriction, tachycardia, and vasodilation

82
Q

Describe a type II cytotoxic Hypersensitivity

A

Antibody mediated (immediate and tissue specific). Activation of IgG and IgM. Respond to antigens on cell surfaces and some drugs and binds to the surface

83
Q

Give type O antigen and antibodies

A

No antigen. Anti-A and anti-B

84
Q

Describe type III hypersensitivity reaction

A

It’s an immune complex reaction. insoluble antigen-antibody complexes deposit in the glomeruli, skin vessels, and joints and activates complement.

85
Q

What can type III hyper-sensitivity lead to

A

Kidney damage - glomerulonephritis. Serum sickness from certain drugs. Systemic lupus erythematosus (SLE)

86
Q

Describe a type IV hypersensitivity reaction and give 6 examples

A

It is delayed and not antibody mediated it’s cell mediated involving T lymphocytes:
TB skin test– delayed result
Fungi
Protoza
Parasites
Contact dermatitis
Pneumonitis

87
Q

How are autoimmune disorders treated and diagnosed

A

Diagnosed via Ig. Treated via Immunosuppression, plasma exchange, and cytokines

88
Q

What are host vs graft transplant immunopathology

A

Hyperacute, acute, chronic, local S&S

89
Q

What is graft versus host transplantation immunopathology

A

Acute, chronic, systemic S&S

90
Q

What happens when you have an inability to pruduce Ig

A

Recurrent pyrogenic infections (extracellular infections)

91
Q

Give two deficiencies involved with antibody specific immunodeficiency disorders

A

IgA deficiency
IgG deficiency

92
Q

Give an example of an all antibody immunodeficiency disorder

A

X Linked Agammaglo

93
Q

What happens when cell-mediated immunity does not function correctly

A

Increases susceptibility to Increases susceptibility to
Fungi
Viruses
Intracellular bacteria
Cancer

94
Q

What is severe combined immunodeficiency disease

A

Lack both humoral and cell-mediated immunity
Severe Combined Immunodeficiency Disease

95
Q

Describe HIV pathophysiology

A

It’s a retrovirus so it carries genetic information in RNA instead of DNA. HIV attaches to CD4+ (T helpers). HIV RNA enters the cells and converts its RNA to DNA in the cell, therefore the body’s cells begin producing the virus. This process kills the CD4+ cells and releases more HIV

96
Q

How do we measure HIV

A

CD4+ count is an indication of the effectiveness of the immune response. Less than 200 cells/uL leads to opportunistic diseases. Viral load is a measure of how much of the virus is in the bloodstream.

97
Q

Give a list of High risk groups for HIV

A

Homosexual males, heterosexual females. History of an STI. IV drug users. Persons who require frequent blood transfusions. Transplant recipients. Those who contact contaminated instruments.

98
Q

Describe primary infection phase of HIV

A

2-4 weeks post exposure
Viral loading
Flu like S&S
Fever and night sweats
Fatigue
Myalgias (muscle pain)
Sore throat
GI disturbances
Rash
HA (headache)
Swollen lymph nodes

99
Q

Describe latency phase of HIV

A

can last for a few to 10-15 years. S&S free except for enlarged nodes. Continued decrease in CD4+ Increasing viral load.

100
Q

Describe overt disease phase of HIV (AIDS phase)

A

By definition, CD4+ count of less than 200 cells/uL and an AIDS defining illness: fever, weight loos and wasting, diarrhea, Generalized lymphadenopathy
Opportunistic infections – lungs, skin
Cancers – Kaposi sarcoma, cervical

101
Q

What are some nervous system infections associated with HIV

A

Retinopathy and ocular malignancies
AIDS dementia
Toxoplasmosis
Cryptococcus
Encephalopathy

102
Q

Name 3 malignancies that are more common with HIV

A

Kaposi sarcoma
Non-Hodgkins lymphoma
Cervical cancer
Pap test every 6 months

103
Q

How do we diagnose HIV

A

Test for antibodies IgG to HIV using EIA, ELISA, and western blot

104
Q

Describe treatment for HIV

A

Antiretroviral therapy: Works to slow replication of the virus. Increase CD4+ count, converted HIV to a chronic disease. Preexpose prophylaxis leading to 92% decrease in transmission

105
Q

Name some childbearing factors of HIV

A

HIV crosses the placenta
HIV antibodies cross the placenta
Blood transmission at birth
HIV is present in breast milk
Infants testing negative for 6 months without opportunistic dz are said to be HIV free
Viral loads <1000copies/mL have decreased chance of being positive

106
Q

Describe children with AIDS

A

Failure to thrive. CNS abnormalities. Developmental delays. PCP in the first 3-6 months of life

107
Q

Give type A antigen and antibodies

A

A antigen, anti-B antibody

108
Q

Give type B antigen and antibodies

A

B antigen, anti-A antibody

109
Q

Give type AB antigen and antibodies

A

A and B antigens, no antibodies

110
Q

Compare positive and negative blood types

A

If you’re positive your blood cells have the Rh protein, if you’re negative your cells lack the Rh protein

111
Q

Name four symptoms of wasting

A

Diarrhea
Chronic weakness
Fever
Lipodystrophies

112
Q

What are microflora

A

harmless, helpful organisms

113
Q

What is a host

A

organism where the pathogen lives

114
Q

What is virulence

A

disease producing capacity

115
Q

What is immunocompetence

A

ability to ward off infection

116
Q

Describe 3 underlying infection premises

A

All living things seek to survive and reproduce.
Must extract from the environment or host everything necessary to live and reproduce.
Humans are constantly exposed to microorganisms some of which are pathogens.

117
Q

List 9 infectious agents in order of descending virulence

A

Prions (most virulent)
Viruses
Bacteria
Spirochetes
Mycoplasmas
Rickettsiae
Chlamydiae
Fungi
Parasites (least virulent)

118
Q

Describe prions

A

Transformed protein structures that are not broken down by proteases and accumulate in neuronal tissue.
Transmitted via injection, transplantation of contaminated tissue, contact with contaminated medical equipment, and ingestion of contaminated food.
Do not elicit an immune response.
Antimicrobials are ineffective

119
Q

Describe viruses

A

Intracellular organisms with no organized cell structure and have either a protein or lipoprotein coat or a genome (DNA or RNA) but not both.
Can only reproduce within a living cell.
Have latent and reactivation periods.
Do not respond to antimicrobials very well.

120
Q

Describe bacteria

A

Largely asexual replicating non nucleated cells with a cell wall.
Gram stain
May be aerobic or anaerobic.
Varying sensitivity to antimicrobials.
May develop resistance.
May be protective or pathogenic
Name = Genus then species

121
Q

Describe fungi

A

Free living eukaryotic (nucleus, DNA & cell wall) saphrophytes (feeds on dead and dying material).
Infections are called mycoses

122
Q

Describe parasites

A

Members of the animal kingdom that cause infection in humans – helminths, protozoa & arthropods.

123
Q

Describe chlamydiae and what are they considered

A

They are considered parasitic. Similar to rickettsiae but are transmitted from vertebrate to vertebrate

124
Q

Describe Rickettsiae and what are they considered

A

Combine characteristics of viruses and bacteria; intracellular, have cell walls, asexual reproduction, have DNA and RNA.
Infect arthropods without causing disease but victims of arthropods develop disease

125
Q

Name the 5 ingredients for infection

A

Source
Portal of entry
Site of Infection
Symptomatology
Exit portal

126
Q

Describe the 5 stages of infection progression

A

Incubation period – replication of the organism without overt S&S
Prodromal stage – vague S&S
Acute stage – Maximum impact and expression of the infection. More severe and specific S&S
Convalescent stage – containment, repair and resolution of S&S.
Resolution –complete recovery

127
Q

Describe factors impacting severity of infection

A

Site
Virulence:
Toxins
Adhesion factors
Invasive factors
Evasive factors

128
Q

Describe four global infection diseases

A

West Nile Virus (WNV) – mosquito vectors and travel
Severe Acute Respiratory Syndrome (SARS) – 29 countries via travel
Ebola – hemorraghic dz – infected blood (animals) and body fluids
Zika – Flu like S&S in adults; microcephaly, visual abnormalities, and joint deformity and muscle deformity

129
Q

What is the intracellular space

A

fluid inside cell

-water can diffuse out and cause cell shrinkage

-water can enter and cause cell swelling (edema)

130
Q

What is the extracellular space

A

fluid outside cells and mostly in vascular space

-bp control

-found in blood vessels containing electrolytes, oxygen, glucose and nutrients to be delivered to cells or waste products for excretion

131
Q

What is the interstitial space

A

fluid surrounding cells outside vascular space

-tissues, between cells and capillaries

-lacks proteins because to large to diffuse out of blood vessels into interstitial space unless theres inflammation

132
Q

What is the third space

A

localization of a large collection of fluid neither intra or extra cellular

133
Q

Describe hydrostatic pressure (movement of fluid and electrolytes)

A

the pressure created by water in the bloodstream against capillaries. Hydrostatic pressure creates a pushing motion of fluid. Anything that increases the amount of water in a container (cell, vascular space) increases the flow of !water out! of the container. Hydrostatic pressure is increased by adding water to the vascular space via IV for example.

-pushes water out of vascular space through capillary membrane pores into interstitial and intracellular compartments

134
Q

Describe colloidal (protein) or oncotic pressures (movement of fluid and electrolytes)

A

-exerted by protein (mainly albumin)

-keeps hydrostatic pressure in by pulling fluid into capillaries

-pulling from ICF into ECF (capillary)

-albumin attracts water and helps keep it inside the blood vessel

135
Q

Describe how capillary permeability works

A

artery and vein meet, fluid leaks out with increased capillary permeability, fluid leaks in with decreased capillary permeability

136
Q

What is isotonic fluid

A

same concentration of sodium particles/tonicity as human blood

137
Q

What is the impact of isotonic fluid on fluid shifts and cell size

A

-does not cause fluid shifts

-does not alter cell size

138
Q

where does isotonic fluid have the prosperity to go/stay

A

no push or pull effects

-stays in vascular space

139
Q

Give two examples of isotonic solutions

A
  • 0.9% normal saline (NS)

-ringers lactate

140
Q

Describe hypotonic fluids

A

have fewer sodium particles/lower tonicity than human blood

-more water than human blood

-dont give if bleeding because it stays in vascular space

141
Q

What is the impact of hypotonic fluid on fluid shifts and cell size

A
  • water is added to bloodstream causing a fluid shift from extracellular fluid to intracellular fluid to deliver water to blood stream

-causes cellular swelling, treats dehydration

142
Q

Where does hypotonic fluid have the prosperity to go/stay

A

it pushes fluid out of vascular space into interstitial and cellular space

-leads to edema if not carefully monitored

143
Q

Give examples of hypotonic fluids

A
  • 0.9% or less means hypotonic solution

-0.45% NS

-0.225% NS

-D5 0.9% NS

-D5 0.45% NS

-D5W

-free water

144
Q

Describe hypertonic fluids

A

higher concentration of sodium particles/tonicity than human blood

-less water than blood

-give for swelling or burns

145
Q

What is the impact of hypertonic fluid on fluid shifts and cell size

A

-solutes are added to bloodstream causing fluids to shift from intracellular fluid to extracellular fluid

-causes cellular shrinkage

-treats edema

146
Q

Where does hypertonic fluid have the prosperity to go/stay

A

pulls fluid into vascular space from interstitial and cellular spaces

-leads to dehydration if not closely monitored

147
Q

Give examples of hypertonic fluids

A

-3% NS

-5% NS

-5% albumin

-25% albumin

-mannitol

148
Q

What do hypertonic fluids cause

A

decreased hydrostatic pressure and increased colloidal pressure

149
Q

Describe 5% and 25% albumin

A

protein

-salt follows water, sucked out of cells into vascular space

150
Q

Describe mannitol

A

osmotic diuretic

-sucks fluid from cells in brain (give for brain swelling)

151
Q

What are some causes of dehydration

A

-low water intake

-diarrhea and vomiting

-diuretics

-burns

-fevers

-uncontrolled diabetes

152
Q

Describe the signs and symptoms of dehydration

A

-hemoconcentrated (increased lab values from blood draw)

-decreased vascular and cell volume

-UOP <30mL

-rapid thready pulse (hard to tell when one pulse ends and starts)

-poor skin turgor

-weight loss

-tachycardia (increased HR, not enough blood volume)

-hypotension

-dark urine

153
Q

Describe what fluids we would give to a dehydrated patient

A

-isotonic: equal parts H2O and Na, slowly corrects, best option

  • hypotonic: more water less sodium, corrects quickly

-never hypertonic (pt basically hypertonic)

154
Q

What are some causes of overload

A

-Increased intake of hypotonic fluid

-Liver failure

-Renal failure (kidneys arent excreting water)

-Heart disease/failure

155
Q

What are signs and symptoms of overload

A

-hemodilution (decreased lab values from blood draw, water is diluting lab values)

-excess vascular volume

-edema

-crackles!: fluid in interstitial space in lung increases hydrostatic pressure, decreased colloidal/oncotic pressure

-full bounding pulse

-weight gain

-bulging eyes

-dyspnea: SOB

-Jugular vein distention

-swollen/puffy

-dilute urine

156
Q

What fluid types should we give to patients with overload

A

-isotonic, works slowly over time

-hypertonic (more sodium less water): sends in more fluid from cells and interstitial fluid, reduces overload quicker

-never hypotonic (pt is almost hypotonic)

157
Q

How does low antidiuretic hormone (ADH) effect fluid balance

A

diabetes insipidus: low ADH leads to large amounts of water loss via urine

158
Q

how does high (excess secretion) of antidiuretic hormone (ADH) effect fluid balance

A

syndrome of inappropriate ADH (SIADH): high ADH leads to water retention

159
Q

What should daily fluid intake be

A

1.5-3L

160
Q

What does 1L of water weight

A

1kg or 2.2 pounds of weight

161
Q

What is obligatory urine output

A

the minimum amount of urine per day needed to excrete toxic waste products

-0.5mL/kg per hour

162
Q

What is the best indicator of fluid balance/volume status

A

daily weights at same time, same scale, same amount of clothing

163
Q

What influences Na movement/levels

A

H2O follows sodium in fluid and electrolyte movement

-sodium follows protein

164
Q

Describe how Na and Cl move

A

together usually

165
Q

What is the sodium normal value range

A

135-145 mEq/L

166
Q

Where is sodium normally reabsorbed

A

kidney tubules under control of the sympathetic nervous system and renin

167
Q

What do angiotensin II and aldosterone cause

A

increased sodium and reabsorption from tubules

168
Q

Describe ADH effects on hypernatremia

A

increased H2O retention (concentration of urine)

169
Q

What is sodium controlled by

A

-thirst regulating H2O intake

-thirst is controlled via hypothalamus in response to dehydration, hypovolemia (low fluid), and angiotensin II

170
Q

Describe the causes of hypernatremia

A

-results from fluid loss or excess sodium

-fever

-vomiting/diarrhea

-concentrated tube feedings

-thirst defect

-strenuous exercise

-excessive diaphoresis (sweating)

171
Q

What is hypernatremia

A

too much sodium in the blood

172
Q

What are the signs and symptoms of hypernatremia

A

Thirst: first

*Superficial: Dry skin, mucous membranes, ↓tears, & saliva

*Vascular space: Weight loss, tachycardia, thready pulse, & hemoconcentration.

*CNS : ↓reflexes, agitation, HA, restlessness, coma &, seizures

-Sodium imbalance: confusion, lethargic, aggrivated

173
Q

What are the causes of hyponatremia

A

-same as volume overload

-ingestion of too much water (low sodium) or hypotonic fluids

-too little aldosterone

-too little cortisol

-too much ADH

-need normal saline or hypertonic saline

174
Q

What are the signs and symptoms of hyponatremia

A

-low sodium (excess water dilutes sodium levels)

-same as volume overload

-superficial: edema, nausea/vomiting, abdominal cramps

-vascular: CHF, full bounding pulse, weight gain, hemodilution

-CNS: lethargy, HA, disorientation, confusion, motor weakness, decreased reflexes, seizures, coma

175
Q

What is potassium controlled by

A

Na+/K+ ATPase pump

176
Q

What is the normal value range of potassium

A

3.5-5 mEq/L

177
Q

Where is potassium excreted

A

-majority: kidneys

-minority: stool and sweat

178
Q

How is potassium controlled

A

-renal excretion

-intracellular-extracellular shifts

179
Q

intracellular-extracellular shifts in potassium: increases H+ causes

A

increased K+ and visa versa

180
Q

intracellular-extracellular shifts in potassium: increased Na+ causes

A

decreased K+ and visa versa

181
Q

intracellular-extracellular shifts in potassium: increased insulin and catecholamines causes

A

increased potassium movement into cells

182
Q

What are some causes of hypokalemia

A

-low potassium intake

-high UOP from diuretics

-vomiting and GI suction

-alkalosis (decreased hydrogen)

-burns

-hyperinsulinemia

183
Q

What results from alkalosis (decreased hydrogen)

A

low potassium, high pH

184
Q

What are some signs and symptoms of hypokalemia

A

-look at heart first with potassium

-renal: increased UOP, thirst, orthostatic hypotension (muscles arent contracting)

-GI: constipation, nausea/vomiting, constipation

-muscular: weakness, fatigue, cramps

-cardiac!!! dysrhythmias (heart conduction is abnormal)

185
Q

What are some causes of hyperkalemia

A

-decreased urinary excretion (renal failure)

-increased ingestion

-intra-extra cellular shifts

-diarrhea: ASSidosis

186
Q

What are some signs and symptoms of hyperkalemia

A

*Paresthesia (burning or prickling sensation)

*Muscle weakness

*Respiratory depression

*Changes in the electrical activity of the heart!!! (bradycardia: slow heart rate, irregular heart rate, cardiac arrest)

187
Q

What would we give with low volume due to blood loss or dehydration

A

normal saline

188
Q

What type of shock causes low fluid volume

A

hypovolemic shock

189
Q

What are some signs and symptoms of low fluid volume

A

-dehydration

  • hypothalamus osmoreceptors activate thirst

-dry mucous membrane

-poor skin turgor (skin stays tented)

-hypotension

-low UOP

-dark color urine

190
Q

What happens with greater hydrostatic pressures

A

fluid will leave capillaries and go into intracellular

191
Q

What happens when oncotic pressure is greater

A

fluid enters capillaries and go into vascular space/ extracellular fluid

192
Q

What condition may result in a “false hyperkalemia”

A

acidosis

193
Q

Reduced sodium concentration accompanied by fluid deficit is also known as

A

hypovolemic hyponatremia.

194
Q

What are hyper and hypokalemia

A

too much or too little potassium in the blood

Patho (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions