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Patho > Patho Exam 2 > Flashcards

Patho Exam 2 Flashcards

1
Q

Metabolic Acidosis

A 
Addition of large amounts of fixed acids to body fluids or loss of HC03.
EG Fasting/starvation
DKA
Lactic Acidosis
Alcoholic KA
Salicylate (aspirin) poisoning

ph below 7.35
HCo3 below 24

Comp: Kussmaul breathing
Decreased Pco2
Acid Rain (Urine)
Increased Rain (Urine) ammonia

Lethargy

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2
Q

Respiratory Alkalosis

A 
Hyperventilation
Over ventilated (respirator)
Response to acidosis

Increased excitability of nervous

+Chvostek’s, Trousseau’s

Increase P02, rebreath expired air

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3
Q

Metabolic Alkalosis

A 
Retention of base or removal of acid
Gain bicarbonate, ingestion HC03 (antacid)
Vomiting
Gastric drainage
K+ depletion (diuretics)
Burns
Excessive NaHco3 admin

Increased Excitability

Comp: Decreased rate/depth respirations
Ass. Disorders: Hypokalemia & Fluid volume def

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4
Q

Respiratory Acidosis

A

Impaired Ventilation: Depr. central nervous syst
O.D. or Head injury
Disease of airways/lungs
Disorders of Chest wall, resp. muscles

Increased C02 inhalation

Comp: Incr. loss of H+ in the urine

Improve ventilation, mechanically ventilate

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5
Q

Potassium (K+)

A

Most abundant cation - Intracellular

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6
Q

Phosphate (P04)-

A

Most abundant anion - Intracellular

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7
Q

Sodium (Na+)

A

Most abundant cation - Extracellular

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8
Q

Chloride (CL-)

A

Most abundant anion - Extracellular

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9
Q

Hypovolemia

A

Fluid Loss: diarrhea, vomiting, kidney disease, excercise
Treat: IV, PO fluids
Reduce NG suction

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10
Q

Hypervolemia

A

First seen in intravascular- hypertension, fast pulse
Moves interstitial- lung crackles, edema
Moves into cells- swelling, affects metabolism

Water retention –> incr. hydrostatic pressure
kidney failure, CHF, increased ADH secretion, incr aldosterone
Over admin IV
Lymphatic obstruction

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11
Q

Edema

A 
Diminished plasma proteins:
Malnutrition
Cirrhosis
Hemorrhage
Increased Capillary permeability- protein leak:
Buns
Inflammation

Pleural Effusion
Ascites
Ankle Edema
Hydrothorax

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12
Q

Edema: Treatment

A 
Diuretics
Fluid restriction
I&O
Measure puffy bits
Skin Care
Hose
No dependent positions
ROM
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13
Q

Isotonic

A

Goldilocks “Just Right”
NS (0.9% NaCL)
D5W, LR

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14
Q

Hypertonic

A

Too Little Water
D10W
3% NaCL
Draws fluid from the cells

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15
Q

Hypotonic

A

Too Much Water
1/2 NS (0.45% NaCL)
Replaces cellular fluid

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16
Q

Hypernatremia

A 
Inadequate H20 Intake
Profuse Sweating
Diarrhea
Causes cellular dehydration
>147 mEq/L & elevated HCT

Convulsions
Pulmonary Edema
Hypovolemia

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17
Q

Hyponatremia

A 
Sodium loss (more than water)
Diuretics
GI Losses
Burns
Water Excess
Cellular swelling
<135 mEq/L & low HCT
Lethargy
Headache
Confusion
Seizures
Coma, Nausea, Weakness
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18
Q

Hyperkalemia

A

Excess intake - salt substitutes
Decreased loss - renal failure, trauma, insulin deficiency
Shift of K+ into cells - metab. acidosis
S/S: Muscle fatigue/weakness/parlysis
CNS- numbness, tingling
Cardiac effects: Increased depolarization and irritablily

Treat: Underlying cause
Calcium gluconate - changes resting membrane potential/ reduces irritability
Glucose w/ insulin IV

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19
Q

Hypokalemia

A 
Vomiting
Suctioning
Diarrhea
Diuretics
Following acidosis
S/S:  Fatigue/weakness/anorexia
Constipation
Reduced insulin secretion
Arrythmias
Cardiac effects: Hypoexcitable, repol. delayed

Treat: IV replacement (20 mEq/hr)
Oral replacement
Correct acid/base imbalances

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20
Q

Hypercalcemia

A 
Ca++ > 12 mg/dl
99% in bone
50% bound to plasma proteins
40% ionized form - most important
8.6 - 10.5 mg/dl
S/S: reduced muscle excitability
fatigue, weakness, lethargy, anorexia
Cardiac effects: Bradycardia
Varying Heart block

Treat w/ phosphate
Underlying cause

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21
Q

Hypocalcemia

A 
Ca++ < 8.5 mg/dl
Causes: Hypoparathyroidism
Osteoperosis
Blood transfusions
Poor diet
S/S: Increased muscle excitability
Chvostek, Trousseau
Confusion
Convulsions
Tetany
Smooth Muscle: Cramping, hyperactive bowel
Cardiac Muscle: Prolonged ventr. depol.

Treat w/ Calcium Gluconate
Oral Calcium
Decrease phosphate

22
Q

Hypermagnesemia

A

Mg++ > 2.5 mg/dl
Causes: renal failure, excessive antacids
Symptoms: N/V, weakness, hypotension
Treat: Dialysis, avoid ingestion

23
Q

Hypomagnesemia

A

Mg++ < 1.5 mg/dl
Causes: impaired absorption, increased loss, malnutrition
S/S: Depression, weakness, tetany, convulsions
Treat: IV or IM

24
Q

Hypoventilation

A

Respiratory Acidosis

25
Q

Hyperventilation

A

Respiratory Alkalosis

26
Q

Acute Renal Failure

A

Metabolic Alkalosis (bicarb retention, K+ loss, fluid loss)

27
Q

DKA

A

Metabolic Acidosis

28
Q

pH and C02, pH and HC03

A

pH: concentration of H+, byproduct of metab.

C02: acts as acid by contrib. H+; mixes with H20–>H+ and HCO3 formed

HC03: acts as base by accepting H+; reacts with H+–> creates water and C02

C02 + H2O –> H2C03 –> H+ + HCO3
<–

29
Q

Intracellular

A

K+ and PO4- most abundant cation/anion. 2/3 total body water, supports organelles

30
Q

Extracellular

A

Na+ and CL- most abundant cation/anion. 20% fluid body weight

31
Q

Interstitial Space

A

2/3 of fluid, very few proteins. Located between tissues and blood vessels

32
Q

Intravascular

A

1/3 of fluid, contains plasma proteins. Hydrostatic pressure pushes water out

33
Q

Hypothalamus

A

Osmoreceptors respond to increase in osmolality (decrease in fluid) stimulating release of ADH by posterior pituitary, activates kidneys to retain water

34
Q

Hyper Medulla Function

A

Increase release of catecholamines

S/S: increased BP, diaphoresis (sweat) tremor, nervousness

35
Q

Hypo Medulla Function

A

Decrease catecholamines

S/S: Weakness, lethargy, decreased BP

36
Q

Hyper Cortex Function

A

“Cushing’s Syndrome”, excessive ACTH

S/S: Central trunk obesity, moon face, mood swings, fragile skin

37
Q

Hypo Cortex Function

A

“Addisons”, deficiency of cortical hormones

S/S: Hyperpigmentation, anorexia, N/V, abd pain, diarrhea, trembling, fluid/electrol. imbalance

38
Q

PNS Stimulation

A

HR and BP subside, Breed and Feed, stimulates GI/Bladder

39
Q

SNS Stimulation

A

HR and BP increase, dry mouth, sweaty hands, GI decrease

40
Q

Metaplasia

A

Replacement of one cell by another

41
Q

Hyperplasia

A

Increased number of cells

42
Q

Dysplasia

A

Abnormal changes shape, size, org.

43
Q

Atrophy

A

Decrease cell size

44
Q

Hyperkalemia: Electrical Implications

A 
Increased depolarization/irritability
Decreases repolarization-->arrest
Decreased R wave amplitude
Tall peaked T wave
Depressed ST segment
45
Q

Hypokalemia: Electrical Implications

A 
Hypoexcitability
Ventricular repolarization delayed
AV blocks
Depressed ST segment
Prominent U waves
46
Q

Norm. Electrolyte Lab Values

A 
K= 3.5-5.5 mEq/L
Na= 135-147 mEq/L
Ca= 8.6-10.5 mg/dl
Mg= 1.5-2.5 mg/dl
P04= 2.5-4.5 mg/dl
47
Q

Primary Wound Healing

A

Surgical “clean” incision

48
Q

Secondary Wound Healing

A

Infected wound, healed by granulation

49
Q

Tertiary Wound Healing

A

Delay between injury and wound closure, gross infection

50
Q

DKA Lab Imbalances

A

Metabolic acidosis= pH below 7.35, CO2 below 35, HCO3 below 22.

Insulin not available to control BG levels, body starts using fatty acids which creates ketones, who lower pH. Bicarb buffer depletes quickly, resp compensation (Kussmaul breathing)

Excess glucose spills into urine, osmotic diuresis

Patho (3 decks)

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