midterm

Question 1

intracellular ions

Answer 1

Phosphate (-)
Magnesium
Potassium

Question 2

extracellular ions

Answer 2

sodium
calcium
chloride (-)
bicarb (-)

Question 3

hypokalemia

Answer 3

muscle weakness
v/d
chronic kidney disease

oral if chronic, iv is acute
* mix fluids before spiking

Question 4

hyperkalemia

Answer 4

urethral obstruction
addisons
bradycardia

fluids to dilute

Question 5

hyponatremia

Answer 5

cell swelling (osmotic)
muscle weakness
v/d
kidney disease
overhydrating

Question 6

hypernatremia

Answer 6

cell swelling (concentration gradient)
salt toxicity
cerebral edema, central blindness

Question 7

hypophasphatemia

Answer 7

muscle weakness (eating itself due to ATP lack)
re-feeding injury

Question 8

hypocalcemia

Answer 8

CHRONIC
- body has time to take Ca from stores (osteoporosis)

ACUTE
- milk fever, eclampsia
- HR slow
- CAT (convulsions, arrhythmia, tetany)

Question 9

hypercalcemia

Answer 9

long rest b/w neurons = muscle cramps
cardiac failure

hyperparathyroid
vit D toxicity
hyperadreno/cushing’s
iatrogenic

Question 10

calcium

Answer 10

half albumin bound, half free
stored in bones, parathyroid releases PTH which:
- stimulated release from bones
- stops kidney excretion
- stimulate kidney conversion to calcitriol -> then stimulates more bone release AND gut absorption

Question 11

buffering types

Answer 11

METABOLIC
- 3-5 days to adjust

a) chemical
- K should be high inside cell. if K high outside of cell = acidosis.
- H will move in to buffer

b) urine excretion
- kidneys controlling HCO3

RESPIRATORY
- CO2 high if we aren’t breathing out
- CO2 low if hyperventilating

Question 12

blood gas

Answer 12

PO2 differs in arterial and venous.
- resp. must use arterial.
- meta. can use either

Question 13

A-B equation

Answer 13

CO2 + H20 <=> H2CO3 <=> H + HCO3

carbonic acid (H2CO3) is unstable, will break into:
- acid (H)
- base (HCO3) <- bicarb

this is how resp. buffering works!
- high CO2 (L) results in high H (R)
- high H (R) results in low CO2 (L)

Question 14

meta acidosis

Answer 14

a) bicarb loss (diarrhea)
b) acid gain (ie. ketoacids in diabetes)

• depression, weakness
• hyperkalemia (to much K moving out of cell -> H moving in)

mild: polyionic electrolyte IV
severe (<7.2) : sodium bicarb IV

Question 15

resp acidosis

Answer 15

high CO2 -> high H

hypoventilation
lung disease
anestheisa

• increase ventilation rate
• reduce dead space
• fix lung issues

Question 16

meta. alkalosis

Answer 16

HCO3 excess
H loss (vomit)

0.9% saline IV to dilute bicarb in blood
urination

Question 17

resp. alkalosis

Answer 17

too much CO2 breathed out -> H down

hyperventilation
- decrease RR

Question 18

hyperthermia scale

Answer 18

> 43 = fatal (active core)

41.5 - 43 = heat stroke (active cool)

39.1-41.5 = heat stress (passive cool)

STOP: 39.5

Question 19

hypothermia scale

Answer 19

<28 = fatal (active core)

33-28 = moderate (active warm)

34-37 = mild (passive warm)

STOP: 37
- rewarming shock: warming surface but not core
- after-drop: core too warm

Question 20

healing phases

Answer 20

1. inflammatory
2. proliferation
   a. epithelization
   b. cellular
   c. remodeling
3. maturation