Intracellular Functions and Disorders

Question 1

CELLULAR-LEVEL FUNCTION ALTERATIONS

Answer 1

Many disorders and diseases processes are caused by cellular-level disruption that eventually leads to a decrease in ATP production. The metabolic pathway is disrupted leading to sever disruption of homeostasis and negative feedback loops trying to compensate for these deficiencies

Include: hypoxia, nutritional problems (decreased glucose and vitamin availability), changes in balance of electrolytes and other solutes (acid/base imbalance), and changes in fluid distribution

Question 2

HYPOXIA

Answer 2

Decrease in amount of oxygen to cells or the ability to use oxygen appropriately.

Since there are more anaerobic conditions than aerobic conditions, glycolysis is “recycled through” over and over instead of continuing down the metabolic pathway. This leads to the production of 2 glucose molecules of ATP per molecule of glucose, but also multiple molecules of pyruvic acid accumulate, resulting in acidosis

Sequale:

1. Deficiency of ATP for cellular functions: Na/K pumps of each cell cannot maintain normal electrical cell membrane status and impulses will be disrupted
2. Altered acid/base balance: especially acidosis from reliance on gluconeogensis can tip the body’s pH out of its normal window
3. damage and death to tissues

Question 3

AEROBIC / ANAEROBIC

Answer 3

Aerobic - oxygen is present (normal situation)

Anaerobic - low or absent oxygen

Question 4

GLUCOSE

Answer 4

A simple sugar formed from carbohydrates, used for energy in the body

Question 5

GLYCOGEN

Answer 5

A store of carbohydrates, made of polysaccharides of glucose. Usually stored in the liver for future energy needs when there isn’t a cellular need for energy

Question 6

GLYCOGENESIS

Answer 6

The formation of glycogen from sugars (glucose)

Question 7

HYPOGLYCEMIA

Answer 7

Low blood sugar

Question 8

COUNTERREGULATORY HORMONES

Answer 8

Hormones produced in a state of hypoglycemia that cause common reactions when hungry.
Epinephrine, cortisol, growth hormone, glucagon

Question 9

GLYCOGENOLYSIS

Answer 9

Conversion of stored glycogen to glucose stimulated by counterregulatory hormones

Question 10

GLUCONEOGENESIS

Answer 10

The breakdown of fats and proteins, and use of any other substance besides carbohydrates for cellular energy. Last resort if glycogenolysis is exhausted

Question 11

KETONE

Answer 11

A breakdown product of fats and proteins.

Good source of energy if glucose is not available.
Bad because they are acids and too much can lead to acidosis (ketoacidosis)

Question 12

TYPE I DIABETES

Answer 12

Gluconeogensis becomes the primary source of energy and sustained, the patient’s body cannot make insulin, depends on ketones

Hyperketonemia occurs from ketone over-accumulation

Question 13

HYPERKETONEMIA

Answer 13

Blood tests show high serum ketones
Blood test showing LOW (<7.35) blood pH - ketoacidosis
Urine test shows ketonuira (ketones spill into urine)
Acetone breath (acetone secretions from the lungs)

Question 14

VITAMINS/MINERALS

Answer 14

Necessary to maximize the creation of ATP, needed in small amounts.
Metabolic pathway utilizes niacin (B3), thiamine (B1), riboflavin (B2), iron (Fe).

Question 15

IRON DEFICIENCY

Answer 15

May develop iron-deficiency anemia, low ATP, low oxygenation, weakness, fatigue, SOB

Question 16

BERIBERI

Answer 16

Thiamine deficiency, includes neuro associated problems. B1 is essential in properly functioning neurological cells

Question 17

WERNICKE-KORSAKOFF SYNDROME

Answer 17

Classically associated with alcoholism
Manifestations include: memory loss, axtaxia (staggering, uncoordinated gait), and paresthesia (numbness, tingling, other unusual sensations) in the legs.

Question 18

POISONS (CYANIDE)

Answer 18

Cyanide toxicity includes headache, agitation, confusion, vomiting, respiratory problems, and even death.

Inhibits cytochrome oxidase

Question 19

PROTEINS

Answer 19

In the plasma as albumin and lipoproteins

Most abundant intracellular anions, help with electrical balance across the cell membrane

Question 20

SODIUM

Answer 20

Electrolyte (Na+)
Most abundant cation in extracellular fluids
Drives water movement
Travels in the blood as sodium chloride (NaCl)

Question 21

CHLORIDE

Answer 21

Electrolyte (Cl-)

Easily forms bonds and travel the bloodstream as sodium chloride (NaCl)

Question 22

POTASSIUM

Answer 22

Electrolyte (K+)
Main cation in the intracellular fluid
Helps balance sodium (Na+) - pumps out 3 Na ions for every 2 K ions that come into the cell

Question 23

CALCIUM

Answer 23

Electrolyte (Ca+)
Important part of muscle contraction.
Used for blood clotting, bone growth, and maintenance

Question 24

PHOSPHORUS

Answer 24

Electrolyte - phosphate (PO4-)
Main intracellular anion
Balances Ca+, generally when one is high the other is low

Question 25

ACID/BASE BALANCE MOLECULES

Answer 25

Acids: Hydrogen (H+), carbon dioxide (CO2) Base: Bicarbonate (HCO3-)

Question 26

NORMAL CELL ELECTRICAL FUNCTION

Answer 26

Resting membrane potential = -90mv | Normal depolarization point = +30mv

Question 27

ELECTROLYTE IMBALANCE

Answer 27

Occurs when there is an imbalance of solute composition in either blood or tissue. This leads to diffusion of solute particles into the next compartment (domino effect). Blood (plasma compartment)--> tissue (interstitial fluid/cells)

Question 28

HYPERKALEMIA

Answer 28

Higher than normal potassium (K) More cations from blood will diffuse into cells - hypopolarization The cell is more sensitive, cell will go to work quicker

Question 29

HYPERNATREMIA

Answer 29

Higher than normal sodium (Na) More cations from blood will diffuse into cells - hypopolarization The cell is more sensitive, cell will go to work quicker

Question 30

HYPERCALCEMIA

Answer 30

Higher than normal calcium (Ca) | Triggers a decrease in permeability of cell membranes to sodium, so less sodium is allowed into cell - hyerpolarization

Question 31

HYPOPOLARIZATION

Answer 31

The resetting of the cells' resting membrane potential (-90mv) to a MORE positive number (increased positivity, decreased negativity, more cations) than normal, will shorten the polar gap status Hyperkalemia, hypernatremia, hypocalcemia Muscles contract with smaller than normal stimulation resulting in muscle tics or spasms. (positive Chvostek's sign), and can lead to severe or unrelenting spasms (tetany)

Question 32

HYPERPOLARIZATION

Answer 32

The resetting of the cells' resting membrane potential (-90mv) to a LESS positive number (decreased positivity, increased negativity, less cations) it will lengthen the polar gap status Hypokalemia, hyponatremia, hypercalcemia Muscles are less sensitive and contract more slowly. Patients experience fatigue, lethargy, and mental slowness

Question 33

HYPOKALEMIA

Answer 33

Lower than normal potassium (K) Cations will diffuse from cells into blood - hyperpolarization The cell is more sensitive, cell will go take longer to go to work, move slowly

Question 34

HYPONATREMIA

Answer 34

Lower than normal sodium (Na) Cations will diffuse from cells into blood - hyperpolarization The cell is more sensitive, cell will go take longer to go to work, move slowly

Question 35

HYPOCALCEMIA

Answer 35

Lower than normal calcium (Ca) | Triggers an increase in permeability of cell membranes to sodium, so more sodium is allowed into cell - hypopolarization

Question 36

ABGs - ATERIAL BLOOD GASES

Answer 36

``` These are the normal limits of human blood gases: pH (acidity): 7.35 - 7.45 HCO3 (bicarbonate): 22 - 26 pCO2 (partial pressure CO2): 35 - 45 pO2 (partial pressure O2): 80 - 100 saO2 (O2 saturation): 97% - 100% ```

Question 37

ACIDOSIS

Answer 37

A state of greater-than-usual concentration of acidic substances in the blood and cells Too much CO2 or H+, not enough HCO3 Blood pH is < 7.35

Question 38

ALKALOSIS

Answer 38

A state of less-than-usual concentration of acidic substances in the blood and cells, more alkaline Not enough C02 or H+, too much HCO3 Blood pH is > 7.45

Question 39

METABOLIC ACIDOSIS

Answer 39

Acid/base imbalance usually in the kidneys. Caused by by a metabolic problem that results in: a. excess accumulation of H+, and other acids b. not enough excretion of H+ in the urine c. not enough HCO3 being made d. too much HCO3 excreted in the urine e. LOW pH, and LOW HCO3

Question 40

RESPIRATORY ACIDOSIS

Answer 40

State of low pH caused by a ventilation problem in lungs, such as diminished effectiveness of breathing or decreased respiratory rate. Results in: a. retention of CO2 (accumulation of acid)

Question 41

METABOLIC ALKALOSIS

Answer 41

A metabolic problem that results in one or more of the following: a. excess accumulation of HCO3 b. not enough excretion of HCO3 in the urine c. too much acid (H+ and others) being excreted in the urine, or metabolism d. not enough acid being made e. HIGH pH / HIGH HCO3

Question 42

RESPIRATORY ALKALOSIS

Answer 42

State of high pH caused by hyperventilation (increased rate of breathing) - leads to blowing off more CO2. With less CO2 in blood, more alkaline.