Exam I Flashcards
Nucleus
Contains Nucleolus, dense structure composed of RNA. DNA remains in nucleus. Extensive DNA chain at risk for breakage, requires histones.
Ribosomes
RNA-protein complexes (nucleoproteins) synthesized in the nucleolus, secreted into the cytoplasm through nuclear pore complexes in the nuclear envelope. Main function, cellular protein synthesis
Lysosomes
Maintain cellular health by: efficient removal of toxic cellular components removal of useless organelles termination of signal transduction signals cellular adaptation
Metabolic Alkalosis Causes
Vomiting Nasogastric suctioning Diuretic therapy Hypokalemia Excess NaHCO3 intake Mineralocorticoid uses
Metabolic Alkalosis Pathophysiology
Loss of strong acid or gain of base
Compensatory response is increased CO2 retention by lungs
Metabolic Alkalosis Laboratory Findings
Increased plasma pH
PaCO2 normal (uncompensated)
Increased PaCO2 (compensated)
increased HCO3
Metabolic Acidosis causes - Increased non-barbonic acids (Elevated Anion GAP)
Increased hydrogen load
Ketoacidosis (DM)
Lactic acidosis (shock)
Ingestions (ethylene glycol, salicylates)
Metabolic Acidosis causes - Bicarbonate Loss (Normal Anion GAP)
Diarrhea
Ureterosigmoidoscopy
Renal Failure
Proximal renal tubule acidosis
Metabolic Acidosis pathophysiology
Gain of fixed acid, inability to excrete acid or loss of base
Compensatory response is increase CO2 excretion by lungs (Kussmaul respirations)
Metabolic Acidosis laboratory findings
Decreased Plasma pH
PaCO2 normal (uncompensated)
decreased PaCo2 (compensated)
decreased HCO3
Respiratory Acidosis Causes
COPD Barbituate or sedative overdose Chest wall abnormality Severe pneumonia Atelectasis Respiratory muscle weakness Mechanical hypoventilation Pulmonary edema
Respiratory Acidosis Pathophysiology
Increased CO2 retention from hypoventilation
Compensatory response is increased HCO3 retention by kidney
Respiratory Acidosis Laboratory Findings
Decreased plasma pH
Increased PaCO2
HCO3 normal (uncompensated)
Increased HCO3 (compensated)
Respiratory Alkalosis Causes
Hyperventilation (fear, anxiety, hypoxia, pain, exercise, fever)
Stimulated respiratory center (septicemia, stroke, meningitis, encephalitis, brain injury, salicylate poisoning)
Liver failure
Mechanical hyperventilation
Respiratory Alkalosis Pathophysiology
Increased CO2 excretion from hyperventilation
Compensatory response is increased HCO3 excretion by kidney
Respiratory Alkalosis Lab findings
Increased plasma pH
Decreased PaCO2
HCO3 normal (uncompensated)
Decreased HCO3 (compensated)
Hypomagnesemia (<1.5mEq/L)
Causes
Malnutrition, malabsorption syndromes, alcoholism, urinary losses (renal tubular dysfunction, loop diuretics)
Hypomagnesemia Manifestations
Behavioral Changes, irritability, increased reflexes, muscle cramps, ataxia, nystagmus, tetany, convulsions, tachycardia, hypotension
Hypermagnesemia (>3.0)
Causes
Usually renal insufficiency or failure; also excessive intake of magnesium-containing antacids, adrenal insufficiency
Hypermagnesemia Manifestations
Lethargy, drowsiness; loss of deep tendon reflexes, nausea and vomiting, muscle weakness, hypotension, bradycardia, respiratory distress, heart block, cardiac arrest
Hypocalcemia (<8.5)
Causes
Inadequate intestinal absorption, massive blood administration, decreases in PTH and vitamin D levels, nutritional deficiencies - malnutrion, alkalosis, elevated calcitonin level, pancreatitis, hypoalbuminemia
Hypocalcemia
Manifestations
Increased neuromuscular excitability, tingling, muscle spasms (hands, feet, facial muscles), intestinal cramping, hyperactive bowel sounds, osteoporosis and fractures, severe cases include convulsions, tetany, prolonged QT interval, cardiac arrest
Hypercalcemia (>10-12)
Causes
Hyperparathyroidism, bone metastases with calcium resorption from breast, prostate, renal, and cervical cancer, sarcoidosis, excess vitamin D, many tumors that produce PTH, calcium-containing antacids
Hypercalcemia
Manifestations
Many nonspecific, fatigue, weakness, lethargy, anorexia, nausea, constipation, impaired renal function, kidney stones, dysrhythmias, bradycardia, cardiac arrest, bone pain, osteoporosis, fractures
What influences the reciprocal relationship between Calcium and Phosphorus
PTH, calcitonin, Vitamin D
Hypophosphatemia (<2.0)
Causes
Intestinal malabsorption related to Vitamin D deficiency, use of magnesium and aluminum containg antacids, long-term alcohol abuse, malabsorption syndromes, respiratory alkalosis, increased renal excretion of phosphate associated with hyperparathyroidism
Hypophosphatemia
Manifestations
Conditions related to reduced capacity for oxygen transport by red blood cells and distrubed energy metabolism, leukocyte and platelet dysfunction, deranged nerve and muscle function, in severe cases, irritatability, confusion, numbness, coma, convulsions, possibly respiratory failure due to muscle weakness, cardiomyopathies, bone resorption resulting in rickets or osteomalacia
Hyperphosphatemia (>4.7)
Causes
Acute or chronic renal failure with significant loss of glomerular filtration, treatment of metastatic tumors with chemotherapy that releases large amounts of phosphate into serum, long-term use of laxatives or enemas containing phosphates, hypoparathyroidism
Hyperphosphatemia
Manifestations
Symptoms primarily related to low serum calcium levels (caused by high phosphate levels) similar to symptoms of hypocalcemia, when prolonged calcification of soft tissues in lungs kidneys, joints
