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Pathology > Module 2 (Exam 1) > Flashcards

Module 2 (Exam 1) Flashcards

Fluid-Electrolyte, Acid-Base Disorders and Endocrine Function

1
Q

ICF (Intracellular fluid)

A

• 40% of body weight

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2
Q

Interstitial fluid (ISF)

A

ECF; fluid between the cells

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3
Q

Intravascular fluid (IVF)

A

ECF; fluid inside the blood vessels

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4
Q

TSF (transcellular fluid)

A

ECF; CSF, pleural and pericardial cavities, joint spaces

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5
Q

Osmolarity

A

solute concentration (osmosis and diffusion, hydrostatic (BP-push) and osmotic (pull, regulated by albumin) pressures

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6
Q

Tonicity

A

osmotic pressure of two solutions separated by a semipermeable membrane

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7
Q

Hypotonic

A

lower solute concentrations, fluids shift into intracellular space (fat cell)

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8
Q

Hypertonic

A

higher solute concentrations, fluids shift from ICF to IVF, cell shrinkage

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9
Q

Sensible fluid losses

A

urine, feces

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10
Q

Insensible fluid losses

A

sweat, respirations

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11
Q

Thirst mechanism

A

triggered in hypothalamus by decreased blood volume and higher osmolarity

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12
Q

ADH (antidiuretic hormone)

A

released from pituitary, promotes reabsorption of water in kidneys

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13
Q

Aldosterone

A

increases reabsorption of sodium and water in the renal tubules

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14
Q

Atrial natriuretic peptide

A

stimulates renal vasodilation and suppresses aldosterone, which increases urinary output

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15
Q

Edema (fluid excess)

A

interstitial space, issue with distribution (not always fluid excess); BP> osmotic pressure

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16
Q

Anasarca

A

generalized edema

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17
Q

Hypervolemia

A

• excess fluid in the intravascular space
• excessive sodium/water intake and insufficient losses

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18
Q

Water intoxication

A

excess fluid in intracellular space, may lead to lysis

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19
Q

Fluid Excess Causes: Excessive Na/H2O (high sodium…)

A

• high-sodium diet
• polydipsia (excessive thirst)
• hypertonic fluid administration
• free water
• enteral feedings

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20
Q

Fluid Excess Causes: Inadequate H2O/Na Elimination

A

• hyperaldosteronism
• Cushings syndrome
• inappropriate ADH
• renal, liver, heart failure

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21
Q

Fluid Excess Manifestations

A

•edema/anasarca/weight gain
•dyspnea
•bounding pulse, tachycardia, hypertension
•polyuria
•jugular vein distention

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22
Q

Hypovolemia

A

decreased fluid in intravascular space, can occur w/o electrolyte defects

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23
Q

Fluid Deficit

A

can lead to increase of blood solute levels, cell shrinkage, and hypotension

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24
Q

Fluid Deficit Causes: Excessive Fluid/Na Losses

A

• GI issues
• excessive diaphoresis
• prolonged hyperventilation
• hemorrhage
• diabetes
•burns/open wounds
• diuretics

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25
Q

Fluid Deficit Manifestations

A

• thirst
• dry mucous membranes
• decreased skin turgor
• weight loss
• hypotension, tachycardia, weak pulse
• flat jugular
• oliguria

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26
Q

Electrolytes: Sodium (Na) (135-145 mEq/L)

A

ECF; neurological function (sodium potassium pump); regulates fluid volume; reabsorbed by kidneys
• controls serum osmolarity and water balance
• excreted through kidneys and GI

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27
Q

Electrolytes: Potassium (K) (3.5-5 mEq/L)

A

ICF; muscle contraction and cardiac conduction; kidneys and GI ELIMINATE
• CANT FLUCTUATE MUCH W/O CAUSING SERIOUS ISSUES

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28
Q

Electrolytes: Calcium (Ca) (4/5 mEq/L)

A

bone health, neuromuscular and cardiac function, blood clotting, hormone secretion
• inverse relationship with P, synergistic relationship with Mg
• absorbed through GI and excreted in waste
• regulated by vitamin K, parathyroid hormone and calcitonin

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29
Q

Electrolytes: Magnesium (Mg)

A

ICF; bone and cellular functions; alcoholism leads to low levels of

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30
Q

Electrolytes: Chloride (Cl) (98-108 mEq/L)

A

ECF; bound to H2O and Na for fluid distribution, excreted through kidneys

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31
Q

Depolarization

A

Na; increase in membrane potential of cell membrane (cells internal charge becomes more positive)

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32
Q

Repolarization

A

Na; restoration of resting potential (cells internal charge returns to more negative value)

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33
Q

Hypernatremia Causes (serum osmolarity increases

A

• excessive sodium (dietary, IVs, Cushing’s syndrome, corticosteroid use)
• deficient water (insufficient intake, prolonged hyperventilation, diuretic use, diabetes insipidus)

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34
Q

Hypernatremia Manifestations

A

• symptoms of dehydration
• increased thirst and decreased urine output
• restlessness and agitation
• lethargy, weakness, headaches
• BP changes, tachycardia, weak pulse
• edema
• hyperchloremia

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35
Q

Hyponatremia Causes (serum osmolarity decreases)

A

• deficient sodium (diuretic use, GI losses, diaphoresis, insufficient aldosterone)
• excessive water (IVs, hyperglycemia, renal and heart failure, inappropriate ADH)

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36
Q

Hyponatremia Manifestations (anorexia…)

A

• anorexia
• GI upset
• dry mucous membranes
• muscle weakness
• hypocholemia

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37
Q

Hyperkalemia Causes

A

• deficient excretion (renal failure, Addisons disease, Gordon’s syndrome)
• excessive intake (supplements, IVs, increased release from cells like acidosis)

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38
Q

Hyperkalemia Manifestations

A

• paresthesia (pins and needles)
• muscle weakness/ flaccid paralysis
• bradycardia and EKG dysrhythmias (depressed ST segment, long PR interval)
• cardiac arrest
• respiratory depression
• metabolic acidosis
• abdominal cramping and diarrhea
• hypercholemia
• hyponatremia

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39
Q

Hypokalemia Causes

A

• excessive loss (GI loss, Cushing’s syndrome, corticosteroids)
• deficient intake (malnutrition, alcoholism)
• increased shift into the cell (alkalosis and insulin excess)

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40
Q

Hypokalemia Manifestations (hyporeflexia…)

A

• hyporeflexia
• leg cramps
• weak pulse
• hypotension and EKG dysrhythmias
• constipation and ileus
• metabolic alkalosis
• hypocholemia
• hypernatremia

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41
Q

Hypercalcemia Causes

A

•calcium antacids/supplements, cancer, immobilization, corticosteroids, vitamin D DEFICIENCY, hypophosphatemia

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42
Q

Hypercalcemia Manifestations

A

• GI symptoms and constipation
• bone pain
• kidney stones
• polyuria and polydipsia
• fatigue, lethargy, confusion

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43
Q

Hypocalcemia Causes

A

• excessive loss (hypoparathyroidism, renal failure, high phosphate levels, alkalosis, pancreatitis, diarrhea
• deficient intake (alcoholism, hypoalbuminemia)

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44
Q

Hypocalcemia Manifestations

A

• seizures
• tetany
• paresthesias
• ventricular tachycardia
• positive Trousseau/Chvostek sign

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45
Q

Trousseau’s sign (hypocalcemia)

A

occlusion of arterial blood flow elicits carpal spasm

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46
Q

Chvostek sign (hypocalcemia)

A

tapping patients facial nerve prompts facial spasm

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47
Q

Electrolytes: Phosphorus (P) (2.5-4.5 mg/dL)

A

bones; metabolism and membrane formation, excreted through kidneys

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48
Q

pH reflects…

A

hydrogen concentration (the more H, the lower the pH)

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49
Q

What systems work together to maintain acid-base balance?

A

buffers (body fluids), respiratory system, and the renal system

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50
Q

Buffers

A

chemicals that combine with an acid or base to change pH (immediate reaction until compensation is initiated)

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51
Q

What are the 4 major buffer systems?

A

bicarbonate-carbonic (1), phosphate (2), hemoglobin (2), protein (4)

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52
Q

What are the roles of K and H in the acid-base balance?

A

they move interchangeably through cell to balance pH
• with extracellular excess, H moves in of cell for buffering so K moves out
• K imbalance can lead to pH imbalances

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53
Q

Respiratory Regulation

A

• manages pH by altering CO2 excretion (chemoreceptors)
• SPEEDING UP respirations excreted MORE CO2, DECREASING acidity
• SLOWING DOWN respirations excreted LESS CO2, INCREASING acidity
• responds quickly yet short lived

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54
Q

Renal Regulation

A

• alters excretion/retention of H or bicarbonate
• more effective and responds slower, but lasts longer by permanently removing H

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55
Q

The respiratory system compensates by…

A

increasing/decreasing ventilation

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56
Q

PaCO2 (35-45 mmHg)

A

acidic; partial pressure of CO2; indicates the adequacy of pulmonary ventilation

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57
Q

The renal system compensates by…

A

producing acidic or alkaline urine

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58
Q

HCO3 (bicarbonate) (22-26 mEq/L)

A

basic; indicates the activity in kidneys to retain or excrete bicarbonate

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59
Q

Causes of Acidosis

A

• hypoventilation
• diabetic/metabolic ketoacidosis (renal failure, shock, sepsis, severe diarrhea)

60
Q

Causes of Alkalosis

A

• hyperventilation
• metabolic alkalosis (loss of gastric juices, overuse of antacids, K wasting diuretics)

61
Q

Metabolic Acidosis Causes

A

• deficiency of bicarbonate (GI and renal losses)
• excess H (tissue hypoxia, ketoacidosis, drugs, renal retention)

62
Q

Metabolic Acidosis Manifestations

A

• headache
• malaise, weakness, fatigue, lethargy
• warm and flushed skin
• nausea and vomiting
• anorexia
• hypotension and dysrhythmias
• hyperkalemia
• Kussmaul respirations (hyperventilation)

63
Q

Metabolic Alkalosis Causes

A

• excess bicarbonate (excessive antacid use, hypochloremia)
• deficient acid (GI and renal loss, hypokalemia, hypovolemia, hyperaldosteronism)

64
Q

Metabolic Alkalosis Manifestations (confusion…)

A

• confusion
• hyperactive reflexes and tetany
• parasthesia
• seizures and coma
• respiratory depression
• dysrhythmias (tachycardia)

65
Q

Respiratory Acidosis Causes

A

• CO2 retention, which increases carbonic acid (hypoventilation or decreased gas exchange)

66
Q

Respiratory acidosis Manifestations

A

• headache
• tremors and muscle twitching
• vertigo and disorientation
• diaphoresis
• lower BP and dysrhythmias (higher K)

67
Q

Respiratory Alkalosis Causes

A

excess CO2, lower carbonic acid (hyperventilation)

68
Q

Respiratory alkalosis Manifestations

A

• parasthesia
• fainting, dizziness, vertigo
• nausea and vomiting
• tachycardia and dysrhythmias (lower K)
• dry mouth and excessive diaphoresis

69
Q

PaO2

A

partial pressure of oxygen; indicates serum oxygen concentration

70
Q

Hypothalamic Hormones

A

• dopamine
• TRH
• CRH
• Somatostatin
• GHRH
• GnRH

71
Q

Anterior Pituitary Hormones

A

• prolactin (targets boobs)
• TSH (targets thyroid)
• ACTH (targets adrenal)
• GH (targets liver)
• FSH (targets testes and ovaries)
• LH (same as FSH)

72
Q

Thyroid gland Hormones

A

T3, T4

73
Q

Adrenal Cortex Hormones

A

cortisol

74
Q

Liver Hormones

A

IGFs

75
Q

Testes/Ovary Hormones

A

Androgens; estrogen and progesterone

76
Q

Hypopituitarism Causes

A

occur suddenly but develops slowly
• congenital defects
• brain trauma or infection, tumors, hypothalamic dysfunction
• autoimmune conditions
• TB

77
Q

Dwarfism

A

GH hormone (hypopituitarism); short stature

78
Q

Diabetes Insipidus

A

ADH (hypopituitarism); excessive fluid excretion in kidneys
• diluted urine (low urine specific gravity)
• hypernatremia

79
Q

Hypopituitarism Manifestations

A

• hypoglycemia, vomiting (cortisol)
• bradycardia, cold intolerance, constipation (thyroxine)
• amenorrhea and micropenis (sex)
• short stature (GH)
• polyuria, polydipsia, hypernatremia (ADH)

80
Q

Hyperpituitarism Manifestations (headache…)

A

• headache
• vision problems
• diaphoresis
• sleep apnea
• carpal tunnel, join paint and stiffness
• parasthesia and muscle weakness

81
Q

Gigantism (hyperpituitarism)

A

tall stature caused by excessive GH PRIOR to puberty

82
Q

Acromegaly (hyperpituitarism)

A

increased bone size by excessive GH in adulthood

83
Q

Syndrome of Inappropriate Antidiuretic Hormone (SIADH) (hyperpituitarism)

A

increased renal water retention caused by excessive ADH
• sticky and thick urine (high urine specific gravity)
• hyponatremia
• nausea, vomiting

84
Q

Hyperprolactinemia (hyperpituitarism)

A

excessive prolactin that results in menstrual dysfunction and galactorrhea

85
Q

Cushing’s Syndrome (hyperpituitarism)

A

excessive cortisol from increased ACTH levels

86
Q

Hyperthyroidism (hyperpituitarism)

A

hypermetabolic state caused by excessive thyroid hormones from increased TSH

87
Q

Diabetes Mellitus

A

hyperglycemia from defects in insulin production or action, which results in abnormal metabolism because of the glucose transportation issue

88
Q

Diabetes Mellitus Manifestations

A

• hyperglycemia
• glucoseria (glucose in urine)
• polyuria, polydipsia, polyphagia
• weight loss
• blurred vision and fatigue

89
Q

Type 1 Diabetes (insulin dependent, juvenile onset)

A

develops when immune system destroys pancreatic beta cells; children and YA; exact cause unknown
CANNOT BE PREVENTED

90
Q

Prediabetes (pancreas)

A

blood glucose levels higher than normal but not high enough for diagnosis
• cells are insulin resistant by adipokines secreted by adipose cells (also secrete inflammatory substances)
•glucose levels increase which causes pancreas’s to increase insulin production
• hyperglycemia may destroy beta cells
•lifestyle can prevent or delay Type 2

91
Q

Type 2 Diabetes (pancreas) (non insulin dependent, adult onset)

A

• 90-95% of newly diagnosed cases
• pancreas gradually loses ability to produce insulin
•usually managed with oral meds or supplemental insulin

92
Q

Type 2 Diabetes Risk Factors

A

age, obesity, family history, gestational diabetes history, physical inactivity

93
Q

Gestational Diabetes (pancreas)

A

• 2nd-3rd trimester, 40-60% chance of developing diabetes within 5-10 years

94
Q

Metabolic Syndrome (syndrome X, insulin resistance syndrome)

A

cluster of risk factors occurring together
• hyperglycemia
• high BP
• hypercholesterolemia (low HDLs and high triglycerides)

95
Q

Goiter

A

visible enlargement of the thyroid gland; may affect respiratory and GI

96
Q

Goiter Causes

A

• cysts
• thyroiditis
• hyper/hypothyroidism
•iodine deficiency

97
Q

Iodine Deficiency

A

leads to decreased T3 and T4, causes increased TSH production to compensate, which causes thyroid hyperplasia and hypertrophy

98
Q

Hypothyroidism Causes

A

hypometabolic state
• autoimmune thryoiditis (Hashimotos)
• iatrogenic (resulting from medical treatment)

99
Q

Hypothyroidism Manifestations

A

• fatigue and sluggishness, muscle weakness and pain
• cold sensitivity
• facial edema
• unexplained weight gain and hypercholestemia
• hair loss/thinning, brittle nails
• bradycardia and hypotension

100
Q

Myxedema

A

rare and life threatening hypothyroidism usually triggered by infection, trauma, CNS suppressants

101
Q

Myxedema Mainfestations

A

• hypotension
• respiratory depression
• hypothermia
• lethargy and coma

102
Q

Hyperthyroidism Causes

A

hypermetabolic state
• excessive iodine
• Graves’ disease (autoimmune disease that stimulates thyroid hormones)
• thyroid inflammation

103
Q

Hyperthyroidism Manifestations

A

• weight loss
• tachycardia and hypertension
• increased appetite
• sensitivity to heat
• tremors and irritability
• exophthalmos (bulging eyes)

104
Q

Thyrotoxicosis (thyroid storm)

A

sudden worsening of hyperthyroidism symptoms with infection or stress with fever and abdominal pain

105
Q

Hypoparathyroidism Causes

A

•congenital defects
• damage to glands (surgery, radiation, autoimmune)

106
Q

Hypoparathyroidism Manifestations (parasthesia…)

A

• parasthesia
• tetany
• dysrhythmias and hypotension
• abdominal cramping and diarrhea
• hair loss and dry brittle nails

107
Q

Hyperparathyroidism Causes

A

• tumors
• hyperplasia
• chronic hypocalcemia (renal failure)
• vitamin D deficiency

108
Q

Hyperparathyroidism Manifestations

A

• osteoporosis and kidney stones
• polyuria
• constipation and abdominal pain
• weakness and flaccid muscles
• dysrhythmias and hypertension
• nausea and vomiting
• anorexia

109
Q

Pheochromocytoma

A

rare tumor of the adrenal medulla that excretes epinephrine and norepinephrine

110
Q

Pheochromocytoma Manifestations

A

• hypertension, tachycardia, bounding pulse
• diaphoresis
• severe headaches
• anxiety and extreme fright, pallor
• weight loss

111
Q

Cushing Syndrome (hypercorticolism) Mainfestations

A

• trunk obesity and moon face, edema
• muscle weakness and delayed growth
• acne and hursitism
• purple striae
• thin skin and delayed wound healing
• osteoporosis
• insulin resistance
• hypertension and hypokalemia

112
Q

Addisons disease (hypocorticolism) Manifestations

A

• hypotension and weight loss
• hypoglycemia and salt craving, hyperkalemia
• extreme weakness and fatigue
• mouth lesions on inside of cheek
• chronic diarrhea

113
Q

What is the most abundant buffer system?

A

bicarbonate system

114
Q

Uncompensated

A

unpaired result is normal range; one value is normal while the other is not

115
Q

Partially Compensated

A

all 3 values are abnormal

116
Q

If the pH is basic, and the CO2 and HCO3 is acidic, what alkalosis is it?

A

respiratory

117
Q

If the pH is acidic, and the CO2 and HCO3 is acidic, what type of acidosis is this?

A

Metabolic

118
Q

If the pH is acidic, and the CO2 and HCO3 is basic, what type of acidosis is this?

A

respiratory

119
Q

If the pH is basic, and the CO2 and HCO3 is basic, what type of alkalosis is this?

A

metabolic

120
Q

FRIED is for…

A

hypernatremia

121
Q

FRIED stands for…

A

Fatigue
Restlessness
Increased BP and fluid retention
Edema
Dehydration symptoms

122
Q

SALTO is for

A

HYPOnatremia

123
Q

SALTO stands for…

A

Seizures
Abdominal cramping and confusion
Lethargy
Tendon reflexes diminished
Orthostatic hypotension

124
Q

MURDER is for…

A

HYPERkalemia

125
Q

MURDER stands for…

A

Muscle weakness
Urine output little/none
Respiratory failure
Decreased cardiac contractility
Early muscle twitches
Rhythm changes (tall T, prolonged PR)

126
Q

7 L’s is for..

A

HYPOkalemia

127
Q

7 L’s are…

A

Lethargy
Low, shallow breaths
Lethal cardiac dysrhythmias
Lots of urine
Leg cramps
Limp muscles
Low BP

128
Q

“stones, bones, abdominal moans and psychic groans” are for… (2)

A

HYPERcalcemia and HYPERparathyroidism

129
Q

CATs go numb is for…(2)

A

HYPOcalcemia and HYPOparathyroidism

130
Q

CATs go numb stands for

A

Convulsions
Arrhythmias
Tetany

131
Q

WHLK is for…

A

metabolic acidosis

132
Q

WHLK stands for..

A

Weakness and lethargy
Hyperkalemia
Low BP
Kussmaul respirations (hyperventilation)

133
Q

TRHP is for…

A

metabolic alkalosis

134
Q

TRHP stands for…

A

Tetany and muscle weakness
Respiratory depression (hypoventilation)
Hypokalemia
Parasthesia

135
Q

HID is for…

A

respiratory acidosis

136
Q

HID stands for…

A

Hypoxia and hypotension
Increased heart rate
Disorientation and confusion

137
Q

THID is for

A

respiratory alkalosis

138
Q

THID stands for…

A

Tachypnea
Hypocalcemia and hypokalemia
Increased heart rate
Dizziness and fatigue

139
Q

ADISON stands for…

A

Aldosterone deficiency
Dark spots/hyperpigmentation
Irritability
Stomach upset
Orthostatic hypotension
Natremia, hypo and hyperkalemia

140
Q

The 5 P’s are for…

A

pheochromocytoma

141
Q

The 5 P’s stand for

A

Pressure (hypertension)
Pain (headaches)
Perspiration (diaphoresis)
Palpitation (tachycardia)
Pallor

142
Q

SWEATING is for…

A

Hyperthyroidism (think wendy williams, graves’ disease)

143
Q

SWEATING stands for…

A

Sweating
Weight loss
Exophthalmos (bulging eyes)
Appetite increase
Tachycardia and tremors
Intolerance to heat
Nervousness
Goiter/GI issues

144
Q

MOMSOTIRED is for…

A

hypothyroidism

145
Q

MOMSOTIRED stands for…

A

Memory loss
Obesity
Muscle weakness
Slowness
Skin and hair is dry
Onset gradual
Tired
Intolerance to cold

146
Q

SIADH mnemonic

A

SI “yes” ADH!
stop urination
sticky and thick urine
low sodium

147
Q

Diabetes Insipidus mnemonic

A

DIE ADH
DIluted urine
hypernatremia

Pathology (8 decks)

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