Pathophysiology Flashcards
Describe Primary adrenal insufficiency
-Otherwise known as Addisons disease.
-Occurs when adrenal cortical hormones are deficient, and adrenocorticotropic hormones are elevated.
What are common symptoms associated with Addisons disease?
Addisons disease patients often present with hyperpigmentation, GI upset/issues, weight loss, postural hypotension, hypoglycaemia, weakness, low serum Na+, hyperkalemia.
They often end up in renal failure.
What is Cushing syndrome?
Secondary adrenal insufficiency. Occurs when there is increased glucocorticosteroid use.
What are three classic findings of Cushing syndrome?
Moon face, fragile skin, diabetes.
Describe an addasonian crisis?
-Acute worsening of Adrenal insufficiency symptoms, occurs in 25% of pt with Hx.
Tx with steroids (hydrocortisone, dexamethasone), large volumes of fluid, treat hypoglycaemia.
What is the pancreases responsible for?
Secretion of insurin and glucagon from the islets of langerhans resulting in the regulation of glucose levels.
What cells are in charge of glucagon and insulin production?
Glucagon is created by alpha cells
Insulin is created by beta cells.
What are the three P’s associated with diabetes
Polyuria (frequent urination), polydipsia (excessive thirst) and polyphasic (excessive hunger)
Define Tpe 1 diabetes
Destruction of beta cells resulting in decreased insulin production.
Define Type 2 diabetes
Insulin is readily available, however metabolic abnormalities create insulin resistance.
Describe DKA
-Occurs when ketone production exceeds cellular use and excretion causing acid buildup.
-Often what leads to IDDM diagnosis
Describe Hyperglycemic hyperosmolar syndrome
Not DKA, occurs mostly with NIDDM.
-Excessive blood glucose levels lead to severe dehydration
-Presents with dehydration, DLOC, seizures, stroke like symptoms, polydipsia.
What effect dose hypercapnia on the brain, lungs and vessels?
Brain=Increased ICP secondary to vasodilation and increased cerebral blood flow.
Lungs=Pulmonary vasoconstriction
Vessels=Vasodilation
What effect does hypocapnia have on brain, vessels?
Brain= vasoconstriction causing decreased cerebral blood flow, decreased ICP.
Vessels=vasoconstriction
What effect does hypoxemia have on the brain and vessels?
Hypoxemia causes vasodilation, resulting in increased CBF and ICP.
If a post arrest presents with SVT immediately, what should the paramedics course of action be?
Wait 5 minutes to cardiovert SVT as per post arrest checklist CPG.
What is a narrow PEA suggestive of?
Mechanical, or RV problem
-Tamponade
-Tension pnx
-mechanical hyperinflation
-PE
-Acute MI or cardiac rupture
What is a wide PEA suggestive of?
Metabolic, or LV problem
-Severe HyperK
-Sodium channel blocker too
-Acute MI
What is the definition of Hyperkalemia?
HyperK is defined by a serum potassium greater than 5.5mmol/L
Other than blood work, what other findings would suggest HyperK?
-Hx of renal impairment/failure
-Dialysis patient, missed apt.
-Potassium sparing diuretics’ (Med Hx)
-Decreased urine output
-Recent Infection
-ECG findings (bradycardia, wide QRS)
-Metabolic acidosis
What are 5 classic causes of hyperK?
-Rhabdomyolysis
-Extensive burns
-Renal failure (decreased excretion)
-Metabolic acidosis
-Toxidrome (Betablockade, TCA, CCB, Digoxin, ASA etc)
Define Systemic inflammatory response syndrome Criteria
RR over 30
HR over 100
Fever greater than 38 or less than 36
MAP less than 65
