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Spring 2023 > Pathophysiology Exam 1 > Flashcards

Pathophysiology Exam 1 Flashcards

1
Q

ICF

A

intracellular fluid

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2
Q

ECF

A

extracellular fluid

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3
Q

What determines solution concentration?

A

amount of water and solute

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4
Q

Solute =

A

Na+ (there are more, but most important)

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5
Q

Where does water move when the ICF & ECF are at equilibrium?

A

Water doesn’t move; no net water movement/fluid shift

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6
Q

Normal fluid concentration range

A

280-300

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7
Q

Isotonic

A

normal concentration

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8
Q

Hypertonic

A

more concentrated, less dilute

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9
Q

Hypotonic

A

less concentrated, more dilute

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10
Q

Hypertonic caused by:

A

decrease water or increase solute or both

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11
Q

Hypotonic caused by:

A

increase water or decrease solute or both

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12
Q

Most common cause of hypertonic ECF

A

water loss

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13
Q

What happens to the cell when the ICF is isotonic and the ECF is hypertonic?

A

It shrinks

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14
Q

water always moves where?

A

from dilute to concentrated

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15
Q

What happens to the cel when the ICF is isotonic and the ECF is hypotonic?

A

It swells/expands

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16
Q

the total of all the water in the body

A

total body water (TBW)

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17
Q

ICF is what fraction of TBW?

A

2/3

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18
Q

ECF is what fraction of TBW?

A

1/3

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19
Q

ECF two compartments

A

1) Interstitial fluid (btw cells)
2) Plasma (bloodstream)

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20
Q

IF constitutes how much of the ECF?

A

80%

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21
Q

Plasma constitutes how much of the ECF?

A

20%

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22
Q
  • pressure trying to push water out of the bloodstream
  • established by BV
A

Plasma hydrostatic pressure

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23
Q
  • pressure trying to keep or attract water into the bloodstream
  • established by albumin
A

Plasma oncotic pressure

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24
Q

What causes water movement between the ECF compartments?

A

plasma hydrostatic and oncotic pressure

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25
Q

If hydrostatic pressure = oncotic pressure then what?

A

water doesn’t move

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26
Q

Is BV at the arterial and venous ends of the capillary bed remain stable?

A

yes

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27
Q

accumulation of fluid in interstitial space
- distribution problem

A

Edema

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28
Q

4 factors that favor Edema formation

A

1) increase plasma hydrostatic pressure (increase BV)
2) decrease oncotic pressure (decrease albumin)
3) increase capillary permeability (increase leakiness)
4) Lymphatic obstruction

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29
Q

What can cause plasma hydrostatic pressure to increase?

A

anything that increases BV
- CHF; causes fluid retention, which increase BV

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30
Q

What can cause plasma oncotic pressure to decrease?

A

anything that decreases albumin
- liver failure
- protein malnutrition or protein absorption problem

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31
Q

What can cause capillary permeability to increase?

A
  • inflammation: cells pull apart
  • Trauma: direct vessel damage
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32
Q

What can cause lymphatic obstruction

A
  • internal blockage
  • external compression of lymphatic damage
    Both: prevent drainage, leading to fluid accumulation
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33
Q

charged ionized particles

A

electrolytes

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34
Q

Normal blood Na+

A

135-145

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35
Q

Water follows what?

A

Na+

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36
Q
  • emia
A

in blood stream

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37
Q

Hypernatremia

A

Na+ > 145
- 160 = severe

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38
Q

Hyponatremia

A

Na+ < 135
- <125 = severe

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39
Q

Most abundant ECF electrolyte

A

Na+

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40
Q

What do Na+ abnormalities impact?

A

ECF osmolarity & BV/BP

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41
Q

What regulates Na+ homeostasis?

A

GI tract, kidneys & endocrine system (aldosterone)

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42
Q
  • most common in hospitalized patients & elderly
  • almost always caused by decrease in water
  • ECF becomes hypertonic
  • Cells shrink
  • In severe cases: CNS cells are damaged
A

Hypernatremia

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43
Q
  • results from decrease Na + or increase water
  • ECF becomes hypotonic
  • Cells swell
  • In severe cases: brain swells
A

Hyponatremia

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44
Q

What are common causes of hyponatremia?

A
  • diuretic use
  • diarrhea: decrease Na & decrease BV
  • heart failure: increase water & increase BV
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45
Q

How should Hyponatremia be treated?

A

treated slowly: No more than 8 mEg/L of sodium in 24 hours
- rapid treatment could cause severe brain damage

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46
Q

Normal blood K+

A

3.5-5

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47
Q

What 2 hormones regulate K+?

A

1) aldosterone
2) insulin

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48
Q

Aldosterone

A

increase Na+ & decrease K+

49
Q

Insulin

A

shift K+ from blood into ICF

50
Q

K+ plays an important role in what?

A

neuromuscular excitability

51
Q

Most abundant ICF electrolyte

52
Q

K+ homeostasis is regulated by what?

A

GI tract, kidneys & endocrine system (aldosterone & insulin)

53
Q

Hyperkalemia

A

blood K+ > 5

54
Q

Most dangerous electrolyte abnormality. Why?

A

hyperkalemia
- May develop lethal cardiac dysrhythmias: slow conduction velocity in heart. May lead the heart to stop beating (asystole) or cause ventricular fibrillation (Vfib)

55
Q

Common causes of hyperkalemia

A
  • increase K+ retention (ACE inhibitors & ARBs)
  • renal impairment (decrease K+ excretion)
  • Adrenal insufficiency (decrease K+ excretion)
  • disorders causing K+ release from cells: burns, crush injuries, metabolic acidosis, cancer treatment
  • hypoaldosteronism (low aldosterone)
56
Q

Hyperkalemia treatment

A

IV insulin (shift K+ back into cells), glucose & Ca gluconate to protect the heart (Ca restores normal heart conduction velocity)

57
Q

Hypokalemia

A

blood K+ < 3.5

58
Q

Common causes of hypokalemia

A
  • increase K+ loss in urine (diuretic use or hyperaldosteronism)
  • increase K+ loss in GI tract
59
Q

Primary manifestation of hypokalemia

A

decrease in neuromuscular excitability

60
Q

Hypokalemia treatment

A

treat underlying cause

61
Q

What is abundantly stored in bone and teeth?

62
Q

Normal blood Calcium

63
Q

Calcium abnormalities affect what?

A

Neuromuscular excitability

64
Q

Calcium homeostasis is regulated by what?

A

GI tract, kidneys, skeletal system & endocrine system (PTH & VitD)

65
Q

Hypercalemia

A

blood Ca > 10.5

66
Q

Common cause of hypercalcemia

A

hyperparathyroidism and cancer

67
Q

What does hypercalcemia cause?

A
  • decrease NM excitability (moves threshold further from RMP)
  • possible constipation
  • hypercalcuria (increase urinary Ca) with kidney stones
68
Q

Severe cases of hypercalcemia cause

A

skeletal muscle weakness, confusion & coma

69
Q

Hypercalcemia treatment

A

treat underlying cause
- may include a loop diuretic to increase calcium urinary excretion

70
Q

Hypocalcemia

A

blood Ca < 8.5

71
Q

Common cause of hypocalcemia

A
  • hypoparathyroidism
  • Vit D deficiency
  • Renal failure
72
Q

Mild cases of hypocalcemia

A

asymptomatic or muscle cramps

73
Q

Severe cases of hypocalcemia

A
  • tetany (continuous contractions)
  • hyperreflexia (increased reflexes)
  • parathesias (tingling) of the tongue, lips, fingers, feet
  • seizures
74
Q

Treating mild hypocalcemia

A

oral Ca supplements

75
Q

treating severe tetany

A

IV Ca gluconate

76
Q

pH of arterial blood

77
Q

Maintaining acid base balance:

A

1) buffer systems work to resist pH changes
2) kidneys regulate acid/base excretion as needed
3) Lungs regulate CO2 (volatile acid) excretion as needed

78
Q

What is responsible for the metabolic regulation of acid-base balance?

A

buffer systems & kidneys

79
Q

What reflects the function of the metabolic component of acid-base regulation?

A

Bicarbonate ion (HCO3-) levels

80
Q

What is responsible for the respiratory regulation of acid-base balance?

81
Q

what reflects the function of the respiratory component of acid-base regulation?

A

CO2 levels

82
Q

HCO3- is a

83
Q

CO2 is a

84
Q

what does an acid-base disturbance indicate?

A

something is wrong with the buffer systems, kidneys, or lungs (most commonly lungs or kidneys)

85
Q

Hypokalemia NM effects

A

decrease NM excitability: Nervous, smooth, skeletal
Increase NM excitability: cardiac

86
Q

Hyperkalemia NM effects

A

Increase NM excitability: Nervous, skeletal, smooth
Decrease NM excitability: cardiac

87
Q

K+ levels in blood determine what?

A

Resting membrane potential (RMP)

88
Q

Ca 2+ levels in blood determines what?

89
Q

In the case of hyperkalemia, RMP is moved closer to threshold, which does what?

A

increase NM excitability

90
Q
  • Heart protective
  • No impact on K+ levels
  • moves threshold
A

Ca 2+ gluconate

91
Q

Shifts K+ into cells

92
Q
  • Maintains blood sugar
  • prevents hypoglycemia
  • given with insulin to treat hyperkalemia
93
Q

PTH

A

increases blood calcium

94
Q

Increases PTH, which increase calcium levels

A

hyperparathyroidism

95
Q

Can cause bone breakdown, which increases calcium levels

96
Q

Decrease PTH, which decreases blood calcium

A

hypoparathyroidism

97
Q

ABG

A

arterial blood gas

98
Q

What can cause acidosis (in terms of acid and base)?

A

increase acid and/or decrease base

99
Q

What can cause alkalosis (in terms of acid and base)?

A

decrease acid and/or increase base

100
Q

ABG readings
pH = 7.30
CO2 = 53
HCO3- = 25

A

Respiratory acidosis

101
Q

Respiratory acidosis causes

A
  • COPD (chronic obstructive pulmonary disease); traps air
  • Acute asthma attack; can’t exhale CO2 fast enough
  • Opioids; slows down ventilation, increasing CO2
102
Q

AGB readings
pH = 7.3
CO2 = 40
HCO3- = 14

A

Metabolic acidosis

103
Q

pH normal range for ABG

A

7.35 - 7.45

104
Q

CO2 normal range for ABG

105
Q

HCO3- normal range for ABG

106
Q
  • measure negative ions in blood that aren’t normally measured
  • narrows potential causes of metabolic acidosis
A

Anion Gap (AG)

107
Q

Normal AG range

108
Q

Potential causes of metabolic acidosis with a normal AG

A

HCO3- loss
- prolonged diarrhea

109
Q

Elevated AG range

110
Q

Potential causes of metabolic acidosis with an elevated AG

A

accumulation of non-volatile acid; “Mud Piles”
- Uremia
- DKA (diabetic ketoacidosis)
- Lactic acidosis

111
Q

associated with chronic kidney disease

112
Q

acute complication of type 1 diabetes

A

Diabetic Ketoacidosis (DKA)

113
Q

associated with hypoxia (reduced tissue oxygenation)

A

Lactic acidosis

114
Q

ABG readings
pH = 7.28
CO2 = 27
HCO3- = 12

A

Metabolic acidosis w/ respiratory compensation

115
Q

Metabolic acidosis and respiratory compensation formula

A

CO2 = (1.5 x HCO3-) + 8 +/- 2

116
Q

ABG readings
pH = 7.22
CO2 = 27
HCO3- = 8

A

Metabolic acidosis w/o respiratory compensation

117
Q

Anion Gap (AG) calculation

A

AG = blood Na+ - (blood Cl- + HCO3-)

118
Q

ABG readings
pH = 7.53
CO2 = 29
HCO3- = 33

A

Respiratory and metabolic alkalosis

Spring 2023 (10 decks)

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