Patho Unit 1 Flashcards
Understand: - Altered Cellular and Tissue Biology (Ch 3) - Fluids and Electrolytes, Acids and Bases (Ch 4)
0
Q
Ischemia
A
Reduced supply of blood
1
Q
Cellular Adaptation
A
- Cells change to adapt to a new environment, escape, or protect themselves
- Can be a pathological or functional respose
2
Q
Atrophy
A
Decrease in cell size
- Usually caused by ischemia
- May also result from diminished nerve stimulation, poor nutrition, or other diseases
3
Q
Hypertrophy
A
Increase in the MASS of the cell
- “-trophy” = size
(Body builders win trophies)
4
Q
Hyperplasia
A
Increase in the NUMBER of cells
- “-plasia” = number
5
Q
Metaplasia
A
An adaptive substitution to a different “hardier” (but still normal) cell line
6
Q
Dysplasia
A
A change to an abnormal cell line
- Precancerous
- Caused by persistent injury or irritation progressing toward neoplasia
7
Q
Neoplasia
A
New, abnormal proliferation of cells
- Tumors
8
Q
Hypoxia
A
When the CELLS are deprived of O2
- Probably the most common cause of non-adaptive cell injury
- Caused by low O2 in the air, poor hemoglobin function, resp. or cardio. disease, and ischemia
9
Q
Free Radicals
A
An atom that has an unpaired electron, which makes it very unstable and active
- Formed by normal metabolism, ionizing radiation, drug metabolism
- To gain stability it gives up or steals an electron
10
Q
Antioxidants
A
Block synthesis or inactivate free radicals
- Vitamin E, C, albumin, ceruloplasmin, and transferrin
11
Q
Lead Poisoning
A
- Acts like iron, calcium, and zinc
- Interferes with neurotransmitters in the CNS and hemoglobin synthesis
- Accounts for a significant number of childhood poisonings
12
Q
Ethanol
A
- The form of alcohol found in beverages
- In the liver, ethanol is converted to acetaldehyde, which is toxic to the liver
13
Q
Blunt Force Trauma
A
Mechanical injuries resulting in tearing, shearing, or crushing of tissues
14
Q
Contusion
A
Bleeding into the skin or underlying tissue
15
Q
Hematoma
A
A collection of blood in an enclosed space
16
Q
Abrasion
A
Removal of superficial layers of the skin
17
Q
Laceration
A
A rip or tear when the elasticity of the skin or tissue will not hold up to the pressure applied
18
Q
Incised Wound
A
A cut that is longer than it is deep
19
Q
Stab Wound
A
A cut that is deeper than it is long
20
Q
Penetrating Gunshot Wound
A
Bullet remains in the body
21
Q
Perforating Gunshot Wound
A
Bullet exits the body
22
Q
Asphyxia
A
Occurs because of a failure of airflow to the LUNGS
- Suffocation, strangulation, chemical, or drowning
- Leads to hypoxia
23
Q
Hypothermia
A
- Caused by extreme cold
- Vasoconstriction
- Ice crystals form causing cellular swelling
24
Hyperthermia
- Caused by extreme heat
| - Loss of fluids and plasma proteins
25
Blast Injuries
Compressed waves of air collapse thorax, organs hemorrhage and rupture
26
Water Pressure
Causes nitrogen to dissolve in blood
| - When pressure is removed, nitrogen is released and forms gas emboli
27
Thrombis
Stationary
28
Embolis
Moves
29
Cellular Accumulations
Too much stuff
- Loss of surface area
- Crowds Lysosomes into other organelles
- Water, lipids, carbohydrates, glycogen, protein, pigments, calcium, urate
30
Necrosis
Local, irreversible cell death
- Caused by self digestion and lysis
- "Homicide"
31
5 types of Necrosis
- Coagulative
- Liquefactive
- Caseous
- Fat Necrosis
- Gangrenous
32
Coagulative Necrosis
- Common in kidneys, heart, and adrenal gland
- Coagulation is caused by protein denaturation
- Albumin changes from clear and gelatinous to opaque and firm
33
Liquefactive Necrosis
- Occurs in neurons and glial cells of CNS
- Digestive enzymes (hydrolases) cause neural tissue to become soft and liquify
- Can also occur with certain infections
(What do zombies drink? Liquid brains!)
34
Caseous Necrosis
- Combination of coagulative and liquefactive necrosis
- Results from pulmonary infection with Mycobacterium tuberculosis
- Tissue is destroyed but not completely digested
- Remaining tissue resembles clumped cheese
35
Fat Necrosis
- Occurs in breast, pancreas, and abdominal tissues
- Caused by lipases (found in fat tissues) that break down triglycerides, releasing free fatty acids
- Fatty acids combine with Ca, Mg, and Na to form soaps
36
Aging
The result of genetics and a lifetime accumulation of injuries
37
Apoptosis
Cell death involved in normal or pathologic conditions
- Depends on cellular signals that cause protein cleavage resulting in death
- Cells shrink
- "Suicide"
38
Somatic Deah
Death of an entire organism
| - Includes Algor, Livor, and Rigor mortis, and Postmortem Autolysis
39
Algor Mortis
Skin becomes pale and temperature falls
40
Livor Mortis
Purplish discoloration in peripheral tissue
41
Rigor Mortis
Depletion of ATP keeps contractile proteins from detaching causing muscle stiffening
- Gradually diminishes over 12-14 hours
42
Distribution of Body Fluids
2/3 Intracellular
1/3 Extracellular
- 80% Interstitial
- 20% Plasma
43
Isosmotic
Concentrations of 2 fluids separated by a membrane are equal
44
Hyperosmotic
The concentration of ECF is higher than the ICF
| - Water moves to the ECF
45
Hyposmotic
Concentration of the ICF is higher than the ECF
| - Water moves to the ICF
46
Filtration
Oxygen, glucose, and other nutrients delivered to cells
47
Reabsorption
Carbon dioxide, acid, and other wastes are carried away to be excreted
48
Hydrostatic Pressure
Pressure from the pump (heart) that PUSHES blood
| - Hydrostatic pressure = Blood pressure
49
Osmotic Pressure
PULLING force of water
51
Dehydration
- Water loss exceeds gains
- Decreased blood pressure
- Increases blood osmolarity (detected by hypothalamus)
52
Excessive Water Consuption
- Decrease in plasma and interstitial osmolarity
- Water moves into the intracellular environment, resulting in cellular swelling
- Water intoxication
53
Electrolytes
Dissociate into ions in aqueous solution
- Control volume and osmotic regulation, myocardial function, enzyme cofactors, acid-base balance
- Cations: Na+, K+, Ca++, Mg++
- Anions: Cl-, HCO3-, PO4-3
54
Sodium
Range: 136 - 146 mEq/L
- Body's concentration is maintained primarily by kidneys
- Accounts for 90% of the ECF CATIONS
- Cl- levels always follow Na+ levels
- "AS GOES SODIUM, SO GOES WATER!"
55
Hypernatremia
>146 mEq/L
- Cellular shrinkage
- Hypertension
- Thirst
- Oliguria (low urine output)
- Anuria (no urine)
56
Hyponatremia
<135 mEq/L
- Cellular swelling
- Edema
- Hypotension
57
Potassium
Range: 3.4 - 5 mEq/L
- REQUIRED FOR MAINTAINING THE RESTING MEMBRANE POTENTIAL, nerve impulses, normal cardiac rhythems, and muscle contraction
- Major influence on ICF OSMOLALITY and maintenance of electroneutrality
- Kidney maintains potassium levels
58
Hyperkalemia
> 5.5 mEq/L
- Cell membrane depolarized (more +)
- Altered conductivity in the heart
- Muscular irritability
- Can be caused by blood transfusions
- Lethal injections
59
Hypokalemia
<3.5 mEq/L
- Cell membrane is hyperpolarized (more -)
- Muscle weakness
- Dysrhythmias
- Polyuria leads to K+ loss in the urine
60
Calcium
Range: 8.6 - 10.5 mg/dl
- BLOCKS SODIUM CHANNELS, (inhibits depolarization)
- Main cation in bones and teeth
- Cofactor in clotting
- Maintained by renal system
- Inversely related to Phosphate
61
Hypercalcemia / Hypophosphatemia
>12.0 mg/dl / <2 mg/dl
- Decreased neuromuscular excitability (hyperpolarization)
- Increased bone fractures
- Kidney stones
62
Hypocalcemia / Hyperphosphatemia
4. 5 mg/dl
- Increased neuromuscular excitability (partial depolarization)
- Muscle cramps
63
Phosphate
Range: 2.5 - 4.5 mg/dl
- Bone (calcium phosphate = hydroxyapatite)
- Phospholipids
- Creatine phosphate (brain and muscle energy source)
- ATP
- Inversely related to Ca+
64
Magnesium
Range: 1.8 - 2.4 mEq/L
- DECREASED ACETYLCHOLINE RELEASE AT NEUROMUSCULAR JUNCTION
- Acts as a cofactor in cll reactions
- Required for ATPase activity
65
Hypermagnesemia
>2.5 mEq/L
- Skeletal muscle depression
- Bradycardia (heart rate <60)
- Muscle weakness
66
Hypomagnesemia
<1.5 mEq/L
- Neuromuscular irritability
- Hyperactive reflexes
67
Buffers
Acts as a H+ and/or OH- "sponge" so that pH is kept relatively constant
- The most important buffer system in the body is the Carbonic Acid - Bicarbonate system
68
What 2 systems maintain pH?
| How?
RESPIRATORY SYSTEM:
- Affects pH by changing the PCO2 level (carbonic acid)
RENAL SYSTEM:
- Affect pH by retaining or dumping HCO3- (bicarbonate)
69
Respiratory Acidosis
```
ELEVATION OF PCO2, kidneys will compensate slowly, (excrete H+ and conserve HCO3-)
Causes:
- Hypoventilation
- Asthma, emphysema
- Pneumonia
- Coma
- Choking
```
70
Respiratory Alkalosis
```
DEPRESSION OF PCO2, kidneys will compensate slowly, (retain H+ and excrete HCO3-)
Causes:
- Hyperventilation
- Drugs
- Excitement
- Anxiety
```
71
Metabolic Acidosis
```
DEPRESSION OF HCO3-, lungs will compensate immediately, (hyperventilation)
Causes:
- Renal failure
- Shock
- Ketoacidosis
- Lactic acidosis
- Salicylate overdose
```
72
Metabolic Alkalosis
```
ELEVATION OF HCO3-, lungs will compensate immediately, (hypoventilation)
Causes:
- Ingestion of bicarbonate
- Vomiting
- Chloride depletion
- Diuretic therapy
```
73
Normal Body pH?
7.35 - 7.45
74
Uncompensated Acidosis/Alkalosis
The system that is NOT responsible for the pH imbalance is still within normal range (not trying to fix the problem)
75
Partially Compensated Acidosis/Alkalosis
- Both systems are outside normal limits
| - pH is NOT back within normal range
75
Fully Compensated Acidosis/Alkalosis
- Both systems are outside normal limits
- pH IS back withing normal range
- Acidosis will remain slightly acidic
- Alkalosis will remain slightly alkaline
76
```
Acidosis/Alkalosis Practice -
Patient A: Normal:
pH - 7.55 pH - 7.35-7.45
PO2 - 70 PO2 - 68-72
PCO2 - 40 PCO2 - 35-45
HCO3 - 36 HCO3 - 22-26
```
Uncompensated Metabolic Alkalosis
77
```
Acidosis/Alkalosis Practice -
Patient B: Normal:
pH - 7.28 pH - 7.35-7.45
PO2 - 50 PO2 - 68-72
PCO2 - 60 PCO2 - 35-45
HCO3 - 25 HCO3 - 22-26
```
Uncompensated Respiratory Acidosis
78
```
Acidosis/Alkalosis Practice
Patient C: Normal:
pH - 7.22 pH - 7.35-7.45
PO2 - 70 PO2 - 68-72
PCO2 - 40 PCO2 - 35-45
HCO3 - 14 HCO3 - 22-26
```
Uncompensated Metabolic Acidosis
79
```
Acidosis/Alkalosis Practice
Patient D: Normal:
pH - 7.44 pH - 7.35-7.45
PO2 - 60 PO2 - 68-72
PCO2 - 55 PCO2 - 35-45
HCO3 - 36 HCO3 - 22-26
```
Fully Compensated Metabolic Alkalosis
80
```
Acidosis/Alkalosis Practice -
Patient E: Normal:
pH - 7.36 pH - 7.35-7.45
PO2 - 50 PO2 - 68-72
PCO2 - 60 PCO2 - 35-45
HCO3 - 34 HCO3 - 22-26
```
Fully Compensated Respiratory Acidosis
81
```
Acidosis/Alkalosis Practice-
Patient F: Normal:
pH - 7.3 pH - 7.35-7.45
PO2 - 80 PO2 - 68-72
PCO2 - 20 PCO2 - 35-45
HCO3 - 14 HCO3 - 22-26
```
Partially Compensated Metabolic Acidosis
82
Depolarization
- Sodium channels open allowing Na+ IN
| - Voltage goes up
83
Repolarization
- Potassium channels open allowing K+ OUT
| - Voltage goes back down
84
Free Radical Injury
Lipid Peroxidation
- Destruction of unsaturated fatty acids
Protein Destruction
- Fragmentation of polypeptide chains and denaturation
DNA Alteration
- Breakage of DNA strands
85
CO Poisoning
Carbon Monoxide has a high affinity for Hgb, blocks Oxygen
