Paramedic Pathophysiology Flashcards
When there is a fluid volume deficit, kidneys secrete:
renin
Main function of Renin in fluid volume deficit
stimulation of Angiotensin I secretion
___ converts Angiotensin I to Angiotensin II
Angiotensin converting enzyme
Angiotensin II serves these two purposes purpose
Peripheral vasoconstriction
Increasing secretion of aldosterone from Adrenal glands
Function of Aldosterone:
Stimulating distal convoluted tubule to reabsorb Na+
The compensatory mechanism for fluid volume deficit regulated by the kidneys
Renin-Angiotensin-Aldosterone-system
3 situations when the kidneys secrete renin:
High blood osmolality
Low blood volume
Low BP
Increased systemic hypertonicity triggers the release of ___ to aid in fluid retention
ADH
Pathologic H2O gain or blood protein loss can be referred to as:
Decreased blood osmolality
or
decreased oncotic pressure
SIADH = ___
Syndrome of inappropriate ADH
Explanation of SIADH
Increased/excessive ADH production
SIADH can be a cause of:
Fluid volume overload
SIADH works by:
Abnormally high levels of ADH > decreased urine output > increased vascular fluid volume
Fluid volume overload can also be cause by excessive loss of ___
solutes
Insufficient plasma compartment protein concentration
hypoproteinemia
3 possible otiologies of Hypoproteinemia:
Insufficient protein synthesis (liver cirrhosis) Insufficient protein intake (malnutrition or alcoholism) Kidney disease (glomerulonephritis)
Inflammation of the glomeruli
glomerulonephritis
Concept map of glomerulonephritis:
Inflammation of glomeruli causes diminished protein filtration from blood > protein spills into urine instead of recirculating > reduced blood osmolality/oncotic pressure > fluid shifts from blood to tissues > edema
2 Possible sequela of Hypoproteinemia:
Edema due to fluid shifts into the tissue
Muscular atrophy
A PT with fluid shifts from B>T is in:
fluid volume overload
Primary compensatory mechanism of fluid volume overload:
Natriuretic Pepside system
In the NPS, the __ and __ of the heart secrete __ and __
right atrium, left ventricle; atrial natriuretic peptide, B-type natriuretic peptide
The NPS is triggered by:
stretching of the heart muscle fibers by excess fluid volume
When natriuretic peptides reach the ___ they stimulate ___ to decrease fluid volume
kidneys; increase in urination
Abnormal mass of tissue
Tumor
Another term for abnormal mass of tissue
Neoplasm
“Not cancer”
Benign
“Cancer”
Malignant
Genetic mutation that sets cancer into motion
Oncogene
Cancer stating method
TNM
Benign tumors usually end with this suffix
-oma
Malignant tumors usually have these prefixes/roots
Sarco-, carcino-, blasto-
Malignant tumor of muscle tissue
Myosarcoma
Benign nerve cell tumor
Neuroma
Increase in the size of cells
Hypertrophy
Increase in the number of cells
Hyperplasia
Reversible replacement of cells of one type with another type
Metaplasia
Excessive fluid trapped in body tissues
edema
Most common type of edema
peripheral
Total fluid volume loss of ___% or more can lead to compromised homeostasis
30%
Hypertonic solutions have relatively higher ___ than interstitial fluid
osmotic pressure
Abnormal accumulation of fluid in the peritoneal cavity
ascites
PTs with CHF may present with ___ edema
pulmonary
A decrease in ECF with proportionate losses of NA+ and H2O
isotonic fluid deficit
Decreased urine output
Oliguria
Proportionate gain in both H2O and NA+
isotonic fluid excess
(Increased/Decreased) capillary colloidal osmotic pressure may cause edema
decreased
Normale serum NA+ range:
136-142 mEq/L
___ occurs when there is body water loss without proportionate loss of NA+
hypertonic fluid deficit
Serum NA+ level greater than 143 mEq/L
hypernatremia
NA+ is primarily found __
in blood and ECF
Serum NA+ level less than 135 mEq/L
Hyponatremia
___ fluid deficit occurs when there is NA+ loss in the body without proportionate H2O loss (relative water excess)
hypotonic fluid deficit
The major intracellular cation, crucial to many cellular functions
K+
Normal serum K+ range:
3.5-5.0 mEq/L
Decreased serum K+ level
hypokalemia
Medications that can inhibit K+ excretion:
spironolactone, ACE inhibitors, NSAIDs
Elevated K+ levels can interfere with ___
normal neuromuscular function
Hypoparathyroidism (endocrine disease) can lead to ___
hypocalcemia
Hypocalcemia can lead to ___ of neuromuscular & cardiovascular systems
increased excitation
__ may beg observed in the ECG of a PT with hypocalcemia
prolonged QT interval and dysrhythmias
Decreased serum phosphate
hypophosphatemia
Massive loading of phosphate into the ECF
hyperphosphatemia
Breakdown of muscle fibers that may occur as a result of low serum phosphate level
rhabdomyolysis
Second most abundant intracellular cation:
Magnesium
__ almost always occurs as a result of kidney insufficiency
hypermagnesemia
A ___ imbalance usually manifests itself as a disturbance in excitable tissues (especially the heart)
K+
Disturbances of ___ are associated with disturbances of K+ balance
acid-base imbalance
__ ions shift out of the cell in response to an influx of hydrogen (acidosis)
Ca2+
Ca2+ acts at the ___
neuromuscular junction
Because it works at the neuromuscular junction, __ decreases the rate of neural transmission
hypercalcemia
___ is characterized by hypersensitive neurons & and accelerated rate of neural transmission
hypocalcemia
___ causes increased cell permeability of Na+
hypocalcemia
Signs of hypocalcemia include: (4)
wheezing, stridor, crackles, bradycardia
Fluctuations in the level of bicarbonate cause ___
metabolic alkalosis or acidosis
Low pH caused baby inhibition of normal breathing pattern
respiratory acidosis
ABG findings of respiratory acidosis will usually involve:
low pH & high HCO3
Low pH caused by accumulation of acids
metabolic acidosis
ABG findings of metabolic acidosis will usually involve:
high low pH, low HCO3
State of high pH due to increase in normal breathing pattern
respiratory alkalosis
respiratory alkalosis will usually have ABG findings that reveal:
high pH, normal HCO3
OD of a CNS depressant (i.e. heroin) can cause:
respiratory acidosis
Respiratory acidosis is caused by:
accumulation of acids due to a decrease inn respiratory rate
Respiratory acidosis can cause a release of ___ into blood, which can cause potentially fatal dysrhythmias
K+
Respiratory acidosis is always related to ___
hypoventilation
Respiratory alkalosis is always associated with conditions that result in ___
hyperventilation
___ moves into the ICF to rebalance depleted H+ levels in respiratory alkalosis
Ca2+
Hypocalcemia resulting from respiratory alkalosis causes ___
muscle contractions
Muscle spasms in the fingers and toes causing them to flex in a claylike manner
carpopedal spasms
A classic sign of respiratory alkalosis:
hyperventilation accompanied by carpopedal spasms
___ usually occurs with increased urinary output or decreased gastric acid output
Metabolic alkalosis
Cellular death is followed by:
necrosis
During and after cell death, the cell and its organelles swell and release ___ that destroy intracellular components
enzymes
The earliest and most dangerous mediators produced by cells in response to hypoxia are:
free radicals
Definition of a free radical:
a molecule missing one electron in its outer shell
___ binds to hemoglobin more easily than O2
CO
___ measures the disease-causing ability of a microorganism
Virulence
The ___ of a microorganism is a measure of its ability to reproduce and cause disease within the human body
Pathogenicity
Cells that engulf and consume foreign material
macrophages
Poisonous substances produced inside a cell and released into the surrounding tissues or fluids
exotoxins
Toxins that affect the GI tract
enterotoxins
Toxins that affect the nervous tissue
neurotoxins
Toxins that affect a variety of tissue types:
cytotoxins
Chemicals or proteins released by WBCs that cause fever to develop
pyrogens
