Main Concepts Flashcards
What electrolytes does the low volume state have?
Elevated total Na+
Elevated pH (alkalotic)
Decreased serum Na+ (dilution effect)
Decreased serum Cl-
Decreased serum K+
Decreased Ca++ (bound to Albumin)
What pH does the low volume state have?
Alkalotic b/c Aldosterone dumps H+
(Not diarrhea, RTA Type II, and DKA)
What pH do vomiters have?
Form of low volume state:
Alkalotic
(Since you vomit out H+)
What pH does diarrhea have?
Exception for low volume state:
Acidotic
(b/c stool has bicarbonate from pancreas that has not had adequate time to be reabsorbed)
What is cause if pulse is >10 mmHg on standing?
Hypovolemic shock
What is cause if pulse is <5 mmHg on standing?
Autonomic dysfunction
What are symptoms of a low energy state?
(CNS)
Mental retardation
Dementia
Decreased activity
What are symptoms of a low energy state?
(CV)
Heart failure
Pericardial effusion
What are symptoms of a low energy state?
(Muscle)
Weakness
SOB
Vasodilation
Impotence
Urinary retention
Constipation
What are symptoms of a low energy state?
(Rapidly dividing cells)
Skin = dry
Cuticles = brittle nails
Hair = alopecia
Bone marrow = suppressed
Vascular endothelium = breaks down; vasculitis
Lungs = infection, SOB
Kidney = PCT (first portion affected)
GI = N/V/D
Bladder = urinary retention
Sperm = decreased
Germ cells = predisposed to cancer
Breasts = atrophic
Endometrium = amenorrhea, atrophic
What are most common signs of the low energy state?
Tachypnea
Dyspnea
What are the most common symptoms of the low energy state?
Weakness
SOB
What are the most common infections of the low energy state?
UTI
Respiratory infections
What is the most common cause of death in the low energy state?
Heart failure
Parameters of restrictive lung diseases
interstitial problem (non-bacterial)
Decreased diffusion and perfusion
Decr VC = small stiff lungs
FEV1/FVC >0.8 => trouble breathing in
ABG: decr pO2 => elev RR, decr pCO2, elev pH
CXR: reticulo-nodular pattern, ground-glass appearance
Die of cor pulmonale
Ex: NM diseases (breathing out is passive), drugs, autoimmune dz
Tx: pressure support on ventilator, incr O2, incr RR, incr inspiration time, decr tidal volume
Parameters of obstructive lung diseases
Airway problem (bacterial)
Big, mucus-filled lungs (elev Residual volume, elev Reid index = incr airway thickness/airway lumen)
FEV1/FVC <0.8 => trouble breathing out
ABG: elev pCO2 => elev RR, low pH
Die of bronchiectasis
Ex: COPD
Tx: Manipulate rate on ventilator, incr RR, incr expiratory time, incr O2 only if needed
What symptoms does a “more likely to depolarize” state have?
(Brain)
Psychosis
Seizures
Jitteriness
What symptoms does a “more likely to depolarize” state have?
(Skeletal muscle)
Muscle spasms
Cramps
What symptoms does a “more likely to depolarize” state have?
(smooth muscle)
Diarrhea
What symptoms does a “more likely to depolarize” state have?
(Cardiac)
Tachycardia
Arrhythmias
What symptoms does a “less likely to depolarize” state have?
(Brain)
Lethargy
Mental status changes
Depression
What symptoms does a “less likely to depolarize” state have?
(Skeletal muscle)
Weakness
SOB
What symptoms does a “less likely to depolarize” state have?
(smooth muscle)
Constipation
What symptoms does a “less likely to depolarize” state have?
(Cardiac)
Hypotension
Bradycardia
What is the humoral immune response?
B cells & PMNs patrol the blood looking for bacteria
What is the cell-mediated immune response?
T cells & Macrophages patrol the tissues looking for non-bacteria
What are macrophages called in the brain?
Microglia
What are macrophages called in the blood?
Monocytes
What are macrophages called in the lungs?
T1 pneumocytes
What are macrophages called in the liver?
Kupffer cells
What are macrophages called in the spleen?
RES cells
What are macrophages called in lymph fluid?
Dendritic cells
What are macrophages called in the kidney?
Mesangial cells
What are macrophages called in Peyer’s patches (GI tract)?
M cells
What are macrophages called in the skin?
Langerhans’ cells
What are macrophages called in bone?
Osteoclasts
What are macrophages called in connective tissue?
Histiocytes
Giant cells
Epithelioid cells
What is the CBC for every vasculitis?
Decreased RBC count
Decreased platelets
Elevated WBC count
Elevated T cells
Elevated macrophages
Elevated ESR
Schistocytes
What is the time course of the inflammatory response?
1 hour -> swelling
Day 1 -> PMNs show up at 4.5 hours, predominate at 24 hours
Day 3 -> PMNs peak
Day 4 -> M0/T cells shows up
Day 7 -> M0/T cells peak, fibroblasts arrive
Day 30 -> Fibroblasts peak
Month 3-6 -> Fibroblasts complete fibrosis
What state does estrogen mimic?
The neuromuscular disease state
(Estrogen is a muscle relaxant)
What does high GABA levels lead to?
Bradycardia
Lethargy
Constipation
Impotence
Memory loss
What is Necrosis?
Non-programmed cell death
Noisy
Inflammation
Nucleus destroyed first
What is Apoptosis?
Programmed cell death
Quiet
No inflammation
Nucleus guided
What is Pyknosis?
“Pick blobs”
Nucleus turns into blobs
What is karyohexis?
Nucleus fragments
What is Karyolysis?
Nucleus dissolves
