main concept Flashcards
What electrolytes does the low volume state have?
Total Na, serum Na, Ca, Cl, K
high total Na,
low serum Na (dilutional effect)
low Ca2+(bound to Albumin)
low Cl
low K
Low H(alkaline)
What pH does the low volume state have?
Alkalotic (except diarrhea, RTA Type II, and DKA) b/c Aldo dumps H+
What pH do vomiters have?
Alkalotic b/c you vomit out H+;low volume state
What pH does diarrhea have?
Acidosis b/c stool has bicarb from pancreas
What happened if pulse increase >10 on standing
Hypovolemic shock
What happened if pulse increase <5 on standing?
Autonomic dysfunction
What pump stops working in an energy state?
NA/K pump due to loss of ATP and Mitochondria dysfunction
symptoms of a low energy state in the heart?
CV: heart failure, pericardial effusion
symptoms of a low energy state in the Bone marrow?
Bone marrow: suppressed pancytopenia
symptoms of a low energy state in the vessels?
Vascular endothelium: breaks down; vasculitis
symptoms of a low energy state in the Lungs?
Lungs: infection, SOB
symptoms of a low energy state in the Kidney, GI and bladder?
Kidney: PCT stops working (electrolytes imbalance)
GI: N/V/D
Bladder: urinary retention
symptoms of a low energy state in the Sperm count, Breast, endometrium and Germ Cells?
Sperm: decreased
Germ cells: predisposed to cancer
Breasts: atrophic
Endometrium: amenorrhea; atrophic
symptoms of a low energy state in the muscle?
Muscle: weakness, SOB, vasodilation, urinary retention, constipation
symptoms of a low energy state in the skin, hair, nail/cuticles?
Rapidly Dividing Cells:
Skin: dry
Cuticles: brittle nails
Hair: alopecia
What are the most common signs of the low energy state?
Tachypnea and dyspnea
What are the most common symptoms of the low energy state?
Weakness and SOB
What is the most common cause of death in the low energy state
HF
Explain all restrictive lung diseases
Restrictive: interstitial problem (non-bacterial)
Explain all obstructive lung diseases
Obstructive: airway problem (bacterial)
Big mucus-filled lungs (high RV, high Reid)
index = thickness/ airway lumen)
What symptoms does a “more likely to depolarize” state have?
Brain: psychosis, seizures, jitteriness Skeletal muscle: muscle spasms, cramps
SM: diarrhea
Cardiac: tachycardia, arrhythmia
What symptoms does a “less likely to depolarize” state have?
Brain: lethargy, mental status changes, depression Skeletal muscle: weakness, SOB
SM: constipation
Cardiac: hypotension, bradycardia
What is the humoral immune response?
B cells and PMNs patrol the blood looking for bacteria
What is the cell-mediated immune response?
T cells and Macrophages patrol the tissues looking for non-bacteria
What are macrophages called in each area of the body?
Blood = Monocytes
Brain = Microglia
Lung = T1 pneumocytes
Liver = Kupffer cells
Spleen = RES cells
Lymph = Dendritic cells
Kidney = Mesangial cells
Payers patches = M cells
Skin = Langerhans cells
Bone = Osteoclasts CT:
What is the CBC for every vasculitis?
low RBC, platelets,
high WBC, T cells, MP, ESR
schistocytes
What is the time course of the inflammatory response?
1 hr: Swelling
Day 1: PMNs show up at 4
½ hours, predominate at 24 hours
Day 3: PMNs peak
Day 4: MP/T cells shows up
Day 7: MP/T cells peak, Fibroblasts arrive
Day 30: Fibroblasts peak
Month 3-6: Fibroblasts complete fibrosis
What state does estrogen mimic
The neuromuscular dz state (estrogen is a muscle relaxant)
What does high GABA levels lead to?
Bradycardia, lethargy, constipation, impotence, and memory loss
What is Necrosis?
Non-programmed cell death = noisy, inflammation, nucleus destroyed first
What is Apoptosis?
Programmed cell death = quiet, no inflammation, nucleus guides it =>
What is Apoptosis?
Programmed cell death = quiet, no inflammation, nucleus guides it =>
What is Pyknosis?
Nucleus turns into blobs “pink blobs”
What is Pyknosis?
Nucleus turns into blobs “pick blobs”
What is Karyohexxis?
Nucleus fragments
What is Karyolysis?
Nucleus dissolves
patient with dementia, tremor, fatigue….rule out
hyperthyroidism with TSH test
