Exam I

Question 1

Nucleus

Answer 1

Contains Nucleolus, dense structure composed of RNA. DNA remains in nucleus. Extensive DNA chain at risk for breakage, requires histones.

Question 2

Ribosomes

Answer 2

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

Question 3

Lysosomes

Answer 3

Maintain cellular health by:
efficient removal of toxic cellular components
removal of useless organelles
termination of signal transduction
signals cellular adaptation

Question 4

Metabolic Alkalosis Causes

Answer 4

Vomiting
Nasogastric suctioning
Diuretic therapy
Hypokalemia
Excess NaHCO3 intake
Mineralocorticoid uses

Question 5

Metabolic Alkalosis Pathophysiology

Answer 5

Loss of strong acid or gain of base

Compensatory response is increased CO2 retention by lungs

Question 6

Metabolic Alkalosis Laboratory Findings

Answer 6

Increased plasma pH
PaCO2 normal (uncompensated)
Increased PaCO2 (compensated)
increased HCO3

Question 7

Metabolic Acidosis causes - Increased non-barbonic acids (Elevated Anion GAP)

Answer 7

Increased hydrogen load
Ketoacidosis (DM)
Lactic acidosis (shock)
Ingestions (ethylene glycol, salicylates)

Question 8

Metabolic Acidosis causes - Bicarbonate Loss (Normal Anion GAP)

Answer 8

Diarrhea
Ureterosigmoidoscopy
Renal Failure
Proximal renal tubule acidosis

Question 9

Metabolic Acidosis pathophysiology

Answer 9

Gain of fixed acid, inability to excrete acid or loss of base
Compensatory response is increase CO2 excretion by lungs (Kussmaul respirations)

Question 10

Metabolic Acidosis laboratory findings

Answer 10

Decreased Plasma pH
PaCO2 normal (uncompensated)
decreased PaCo2 (compensated)
decreased HCO3

Question 11

Respiratory Acidosis Causes

Answer 11

COPD
Barbituate or sedative overdose
Chest wall abnormality
Severe pneumonia
Atelectasis
Respiratory muscle weakness
Mechanical hypoventilation
Pulmonary edema

Question 12

Respiratory Acidosis Pathophysiology

Answer 12

Increased CO2 retention from hypoventilation

Compensatory response is increased HCO3 retention by kidney

Question 13

Respiratory Acidosis Laboratory Findings

Answer 13

Decreased plasma pH
Increased PaCO2
HCO3 normal (uncompensated)
Increased HCO3 (compensated)

Question 14

Respiratory Alkalosis Causes

Answer 14

Hyperventilation (fear, anxiety, hypoxia, pain, exercise, fever)

Stimulated respiratory center (septicemia, stroke, meningitis, encephalitis, brain injury, salicylate poisoning)

Liver failure
Mechanical hyperventilation

Question 15

Respiratory Alkalosis Pathophysiology

Answer 15

Increased CO2 excretion from hyperventilation

Compensatory response is increased HCO3 excretion by kidney

Question 16

Respiratory Alkalosis Lab findings

Answer 16

Increased plasma pH
Decreased PaCO2
HCO3 normal (uncompensated)
Decreased HCO3 (compensated)

Question 17

Hypomagnesemia (<1.5mEq/L)

Causes

Answer 17

Malnutrition, malabsorption syndromes, alcoholism, urinary losses (renal tubular dysfunction, loop diuretics)

Question 18

Hypomagnesemia Manifestations

Answer 18

Behavioral Changes, irritability, increased reflexes, muscle cramps, ataxia, nystagmus, tetany, convulsions, tachycardia, hypotension

Question 19

Hypermagnesemia (>3.0)

Causes

Answer 19

Usually renal insufficiency or failure; also excessive intake of magnesium-containing antacids, adrenal insufficiency

Question 20

Hypermagnesemia Manifestations

Answer 20

Lethargy, drowsiness; loss of deep tendon reflexes, nausea and vomiting, muscle weakness, hypotension, bradycardia, respiratory distress, heart block, cardiac arrest

Question 21

Hypocalcemia (<8.5)

Causes

Answer 21

Inadequate intestinal absorption, massive blood administration, decreases in PTH and vitamin D levels, nutritional deficiencies - malnutrion, alkalosis, elevated calcitonin level, pancreatitis, hypoalbuminemia

Question 22

Hypocalcemia

Manifestations

Answer 22

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

Question 23

Hypercalcemia (>10-12)

Causes

Answer 23

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

Question 24

Hypercalcemia

Manifestations

Answer 24

Many nonspecific, fatigue, weakness, lethargy, anorexia, nausea, constipation, impaired renal function, kidney stones, dysrhythmias, bradycardia, cardiac arrest, bone pain, osteoporosis, fractures

Question 25

What influences the reciprocal relationship between Calcium and Phosphorus

Answer 25

PTH, calcitonin, Vitamin D

Question 26

Hypophosphatemia (<2.0)

Causes

Answer 26

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

Question 27

Hypophosphatemia

Manifestations

Answer 27

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

Question 28

Hyperphosphatemia (>4.7)

Causes

Answer 28

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

Question 29

Hyperphosphatemia

Manifestations

Answer 29

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