PP Main Concepts

Question 0

What pH does the los volume state have?

Answer 0

Alkalotic ( expect diarrhea, RTA Type II and DKA ) b/c Aldo dumps H

Question 1

What electrolytes does the low volume state have?

Answer 1

Increase total Na
Decrease serum Na ( dilutional affect)
Decrease Cl and K

Question 2

What pH do vomiters have?

Answer 2

Alkalotic b/c you vomit out H

Question 3

What pH does diarrhea have?

Answer 3

Acidosis b/c stool has bicarb

Question 4

What happened if pulse icrease >10 on standing?

Answer 4

Hypovolemic shock

Question 5

What happened in pulse decrease <15 on standing?

Answer 5

Autonomic dysfunction

Question 6

What are the symptom of low energy state?

Answer 6

CNS: mental retardation, dementia
CV: heart failure, pericardial effusion
Muscles: weakness, SOB, vasodilation, impotence, urinary retention,      
                constipation
Rapidly Dividing Cells:
- skin: dry
- cuticles: brittle
-  hair: alopecia
- bone marrow: suppressed
- vascular endothelium: breaks down
- lungs: infection, SOB
- kidney: PCT will feel the effect first
- GI: N/V/D
- Bladder: oliguria
- sperm: decreased
- germ cell: predisposed to cancer
- breast: atrophic
- endometrium: amenorrhea

Question 7

What are the most common sings of the low volume energy state?

Answer 7

Tachypnes an dysnea

Question 8

What are the most common symptoms of the low energy state?

Answer 8

Weakness and SOB

Question 9

What are the most common infections of the low energy state?

Answer 9

UTI and respiratory infections

Question 10

What is the most common cause of death in the low energy state?

Answer 10

Heart failure

Question 11

Explain all restrictive lung disease:

Answer 11

Restrictive: interstitial problem ( non bacteria)

• small stiff lungs ( decrease VC )
• trouble breathing in => FEV1/ FVC : > 0.8
• ABG: decrease pO2 => increase RR, decrease pO2, increase pH
• CXR: reticulo-nodular pattern, ground glass appearance
• die of cor pulmonale
• Ex: NM disease ( breathing out is passive ), drugs, autoimmune dz
• Tx: pressure support on ventilator, increase O2, increase RR and increase inspiratory time

Question 12

Explain all obstructive lung disease:

Answer 12

Obstructive: airway problem ( bacterial )

• big mucus-filled lung ( increase RV, increase Reid index = increase airway thickness/ airway lumen)
• trouble breathing out=> FEV1/FVC: < 0.8
• ABG: increase pCO2 => increase RR, decrease pH
• die of bronchiectasis
• Ex: COPD
• Tx: manipulate rate on ventilator, increase RR, increase expiratory time, increase O2 only if needed

Question 13

What symptoms does a “ more likely to depolarize” state have?

Answer 13

Brain: psychosis, seizures, jitteriness
Skeletal muscle: muscle spasms, tetany
SM: diarrhea then constipation
Cardiac: tachycardia, arrhythmias

Question 14

What is the humoral immune respond?

Answer 14

B cells and PMNs patrol the blood looking for bacteria

Question 15

What symptoms does a “ less likely to depolarize” state have?

Answer 15

Brain: lethargy, mental status changes, depression
Skeletal muscle: weakness and SOB
SM: constipation then diarrhea
Cardiac: hypotension, bradycardia

Question 16

What is the cell-mediated immune response?

Answer 16

T cells and Macrophages patrol the tissue looking for non-bacteria

Question 17

What are the macrophages called in each area of the body?

Answer 17

Blood - monocytes
Brain - microglia
Lung - T1 pneumocytes
Liver - kupffer cells
Spleen - RES cells
Lymph - dendritic cells
Kidney - mesangial cell
Payers patches - M cells 
Skin - langerhans
Bone - osteoclasts 
CT: 
- histocytes
- giant cells
- epitheloid cells

Question 18

What is the CBC for every vasculitis?

Answer 18

Decrease RBC
Decrease platelets
Increase WBC
Increase T cells
Increase MP
Schistocytes
Increase ESR

Question 19

What is the time course of the inflammatory response?

Answer 19

1h : swelling
Day 1: PMNs show up
Day 3: PMNs peak
Day 4: MP/T cells show up
Day 7: MP/T cells peak, fibroblas arrive
Day 30: fibroblas peak
Month 3-6: fibroblast leave

Question 20

What state estrogen mimic?

Answer 20

The neuromuscular disease state ( estrogen is a muscle relaxant)

Question 21

What does high GABA levels lead to?

Answer 21

Bradycardia
Lethargy
Constipation
Impotence
Memory loss