Test 2 Flashcards
Same concentration as blood
Isotonic
Lower particle concentration than the bloodstream
Hypotonic
More solute than in the blood
Hypertonic solution
Fluid inside the cell
Intercellular fluid
Fluid inside the blood vessels (plasma)
Extracellular fluid
Fluid outside the cell but not in the vascular system
Interstitial fluid
Molecules that pass from a higher concentration to a low one to achieve osmosis
Diffusion
Movement from a lower concentration to a higher one
Osmosis
When fluid needs something to help it get inside the cell
Facilitated transport
The type of transport that requires energy; ATP
Active transport (ex: Na/K pump)
Hydrostatic pressure pulls fluid out from the capillaries into the ICF and ISF, oncotic pressure pulls it back in due to the pressure exerted by solutes in a solution
Sterling’s Law
How does RAAS help maintain homeostasis?
Replenishes blood volume and raises BP by conserving fluid
Dehydration and a diminished level of circulating blood volume
Symptoms include:
- poor skin turgor
- low bp
- high hr
- dry mucous membranes
- low urine output
- thirst center activated in hypothalamus
Hypovolemia
Fluid overload; too much fluid in the blood
Hypervolemia
What is the main cause of hypervolemia?
Heart failure
The main cellular ion that controls the distribution of water
Sodium (Na)
What is the normal value for sodium (Na)?
135-145 meq/L
Involved in nerve impulses to the heart and the skeletal muscles.
Potassium (K)
What is the main cation in cells?
Potassium
What is the normal values for potassium?
3.5-5.2 meq/dL
The major mineral in bones and teeth; regulated by the parathyroid hormone
Calcium
Normal values for calcium
8.7-10 mg/dL
What mineral can lead to diminished neuromuscular function and kidney failure if too high?
Magnesium (Mg)
What mineral he a reciprocal relationship with calcium?
Phosphorous
What condition results if the values are less than 135 meq/L?
Hyponatremia (low sodium)
What condition can result if levels of this mineral are higher than 145 meq/L?
Hypernatremia
What condition can result if levels are less than 3.5 meq/dL?
Hypokalemia
What condition can result if this mineral’s levels are higher than 5.2 meq/dL?
Hyperkalemia
What condition can result if this mineral’s levels are lower than 8.7mg/dL?
Hypocalcemia
What condition can result if this mineral’s levels are higher than 10 mg/dL?
Hypercalcemia
Which condition can be checked using Chvostek’s or Trousseau’s signs?
Hypocalcemia
What’s the normal range for pH?
7.35-7.45 (7.40 is the ultimate normal)
What is the normal range for pCO2?
35-45 mm Hg
What’s the normal range for HCO3?
22-26 meq/L
What is the normal range for pO2?
90-100 mm Hg
What is the normal range for SaO2?
95-100%
What does the acronym ROME mean?
Respiratory Opposite (High pH; low pCO2 = alkalosis) (Low pH; high pCO2 = acidosis)
Metabolic Equal (High pH; high HCO3 = alkalosis) (Low ph; low HCO3 = alkalosis)
If the pH is normal, but other values are abnormal it is considered
Compensated
If the pH is abnormal as well as the lab values it is considered
Uncompensated
What is the first defense to maintain acid/base balance?
Protein/chemical buffers
What is the second defense to maintain acid/base balance?
Respiratory buffers
What is the third defense to maintain acid/base balance?
Renal buffers
What does increased vascular permeability and blow flow enable in inflammation?
The white bloods cells and repair cells to arrive at the site injury
When the body releases chemicals that dispatch the white blood cells and platelets to the site of injury.
Chemotaxis
What is elevated levels of WBCs in the blood called
Leukocytosis
What are the five basic types of white blood cells?
- Lymphocytes
- Neutrophils
- Eosinophils
- Monocytes
- Basophils
Includes swollen lymph nodes, fever, pain, sleepiness, lethargy, anemia, and weight loss.
Systemic response
What is the most common symptom in infection and inflammation?
Fever
Resets the hypothalamic temperature to a high setting
Pyrogens
Normally resolves once an injury or the infection is gone
Acute inflammation
What is a helpful inflammatory response?
Cox 1
What is a harmful inflammatory response?
Cox 2
What types of cells continually divide and replicate?
Labile cells
What type of cells replace injured cells?
Labile cells
What type of cells can be induced to replicate with a strong enough stimulus (found in liver and bone)?
Stable cells
What time of cells cannot regenerate or replace lost or damaged cells?
Permanent cells
What is rubor?
Erythema or redness
What is tumor?
Edema or swelling
What is calor?
Heat
What is dolor?
Pain
What are the four phases to wound healing?
- Hemostasis
- Inflammation
- Proliferation, tissue granulation formation, angiogenesis, epithelialization
- Wound contraction and remodeling
What time of wound helping occurs with clear wound edges with no missing tissue?
Primary intention
What kind of wound healing happens when there is extensive loss of tissue?
Secondary intention
What kind of wound healing is missing a large amount of tissue and often left open?
Tertiary
What type of wound healing may need a skin graft?
Tertiary
What time of wound healing needs granulation and fibrous tissue to heal?
Secondary intention
What kind of wound healing is a surgical incision?
Primary intention
What is the number one cause of delayed wound healing?
Infection
What kind of medication delays wound healing?
Corticosteroids
What disease delays wound healing?
Diabetes
Carried pathogen to a host
Vector
Ability of the immune system to protect against infection
Immunocompetence
Blood stream infection
Septicemia
Common organisms that cause infection due to a weakened immune system
Opportunistic infections
Performs advantageous function in the host
Normal flora
Organisms that can lead to disease
Pathogens
Healthcare acquired infections
Nosocomial (HAI)
- Free living in the environment
- Can be treated with antibiotics
- Can be advantageous
Bacteria
- Depends on the host cell
- Can cause acute or chronic infections
- Antibiotics do not work
Viruses
- Moldlike
- Can cause local or systemic infections
- Most common is yeast
Fungi
- Protozoa worms and insects
- Transmitted by contaminated water, soil, food, or insects
Parasites
- Can change host cell proteins in the brain
- Leads to spongiform encephalopathy
Prions
- Half of the strains are MRSA
- requires strict isolation
Antibiotic-resistant S. Aureus
- invades the lower respiratory tract and causes inflammation
- created exudative fluid that hinders oxygen exchange at the alveoli
- fluid (consolidation) shown on X-ray
Bacterial pneumonia
- inflammation of meningeal layers of the brain/spinal cord
- often caused by a pneumonia, neisseria meningitidis and h influenzae
- diagnosis is done via lumbar puncture
Bacterial meningitis
- commonly caused from undercooked meat or fecal contamination
- infants and elderly are most at risk
- can cause HUS
E Coli
- airborne
- causes diarrhea
- often caused from long term antibiotic usage
C diff
- Most common upper and lower respiratory infection
- contains antigens called hemagglutinin and neuraminidase
Influenza
How does chickenpox (varicella) reactive?
Shingles
What condition is treated with an anti fungal medication for disruption of the normal flora?
Candida
You can get this infection by consuming contaminated food or water by ingesting the cyst form.
Giardiasis
- brain has spongy appearance
- progressive death of brain’s nerve cells
- fatal within weeks or months
Creurzfeldt-Jakob
What is type I hypersensitivity?
Immediate hypersensitivity
What are allergies? (Can include anaphylaxis)
Type I hypersensitivity
What type of hypersensitivity is cytotoxic (incorrect blood transfusion)?
Type II
What kind of hypersensitivity is delayed? (Ex: poison ivy)
Type IV
What kind of hypersensitivity is type III?
Immune complex (ex: autoimmune disorders)
What autoimmune disorder is characterized by a butterfly rash on the face and damage to the kidneys?
Systemic Lupus Erythematous
What autoimmune disorder attacks the synovial fluids in the joints?
Rheumatoid arthritis
What autoimmune disorder is characterized by splayed appearance of fingers?
RA
What autoimmune disorder is known as systemic sclerosis?
scleroderma
What autoimmune disorder can CREST syndrome occur?
Scleroderma
What autoimmune disorder causes abnormal accumulation of fibrous tissue in the skin and organs?
Scleroderma
How many stages does HIV have?
3 (Acute, chronic, aids)
HIV attacks what?
CD4 (Helper T Cells) and macrophages
HIV does what to the immune system?
Slowly depletes it
What is the period in HIV where the antibody goes from negative to positive?
Seroconversion
When does the seroconversion period of HIV take place?
2 weeks to 6 months after exposure
What is the period called from the contraction of the virus to the antibody development?
Window period
What is the period of HIV called where the virus particles increase in the blood and the Helper T Cells decrease?
Latent period
As helper T Cells decrease, patients are more vulnerable to what?
Opportunistic infections
How long can the latent period of HIV take place?
6 months-10 years
What WBC responds due to bacterial infection?
Neutrophils
What WBC responds due to inflammation, chronic infection, malignancy, or autoimmune disorders?
Monocytes
What WBC responds due to an allergic reaction?
Eosinophils
What WBC responds due to parasitic infection or allergic reaction?
Basophils
What responds due to viral infection?
Lymphocytes
What is the normal WBC count?
4100-10900
What is leukopenia?
WBC less than 4100
What is leukocytosis?
WBC count more than 10,900
What is a WBC greater than 50000 not related to leukemia called?
Leukemoid reaction
What is the elevated levels of neutrophils called?
Neutrophilia
What is the deceased levels of neutrophils called?
Neutropenia
Where can hematologic neoplasms be found?
- Blood (leukemia)
- lymph (lymphomas)
- bone marrow
What is a Philadelphia chromosome?
Abnormality in chromosomes 9 and 22 where translocation has occurred
Cancer of developing WBCs in the bone marrow leading to an over proliferation of cells that do not function
Leukemia
Most leukemia symptoms are a result of overproduction of WBCs that do what to other blood cells?
Crowd them out
A leukemia arising from cancerous myeloid WBCs
Myelocytic leukemia
- cause by a proliferation of undifferentiated blast myeloid cells
- normal cell production of other blood cells is reduced
- cells can infiltrate spleen, liver, lungs and skin
- risk includes precious cancer tx and radiation exposure
Acute myelocytic leukemia (AML)
- caused by an overproduction of mature myeloid cells
- arises from oncogene mutation or exposure to radiation
Chronic Myelocytic Leukemia (CML)
What are the three stages of CML?
- Chronic
- Accelerated
- Blast
A leukemia arising from cancerous lymphoid WBCs
Lymphocytic Leukemia
- more common in children
- survival rates better in children
- the stem cell precursors for t and b lymphocytes do not function so cells do not mature past lymphoblastic stage
- lymphoblasts crowd out other cells
Acute lymphocytic leukemia (ALL)
- most common leukemia in the US
- effects mostly B cells
- common in adults and elderly
- looks like mature B cells, but does not function as such
- 80% caused by chromosomal abnormality
Chronic lymphocytic leukemia (CLL)
What is the most common blood cancer in the US?
Lymphomas
- 17% of all lymphoma cases
- most common in young adults
- malignancy of b lymphocytes
- cause unk, 50% have ebv
- presence of Reed Sternberg cells
- solid non painful lymph engorgement
Hodgkin’s lymphoma
- 83% of all lymphomas
- more common in adults
- over 30 subsets
- can be relayed to b, t, or nk cells
- chromosomal abnormality linked to cause
Non-hodgkins lymphoma
What stage of lymphoma is characterized by two or more lymph nodes above and below the diaphragm?
Stage 3
What stage of lymphoma is characterized by a localized disease; single lymph node region or single organ?
Stage 1
What stage of lymphoma is characterized by two or more lymph node regions on the same side of the diaphragm?
Stage 2
What stage of lymphoma is characterized by widespread disease; multiple organs with or without lymph involvement?
Stage 4
- A generalized disorder that leads to bone distraction, bone marrow failure, renal failure, and neurological complications
- Excess of synthesized abnormal immunoglobulin and I G fragments referred to monoclonal proteins or m-proteins
- Lytic lesions on bones may be present
Multiple myeloma
What are the two major categories of red blood cell disorders?
overabundance and Deficiency
Over abundance of red blood cells have how many forms?
2 (primary and secondary polycythemia)
An excess of all blood cell types which is characterized by low erythropoietin
Primary polycythemia
Caused by prolong hypoxia as in chronic obstructive pulmonary disorder, it is characterized by high erythropoietin
Secondary polycythemia
What are the ways anemia can occur?
- Acute/chronic blood loss
- problems with bone marrow RBC production
- lack of erythropoietin or maturation defects of RBC (related to low iron, folate, and B12)
What type of anemia is due to RBC formation not able to keep with RBC breakdown?
Increased Hemolysis
What is an example of increased hemolysis?
Hemoglobinopathies (sickle cell anemia and thalassemia)
Renal failure does what to erythropoietin production?
Deceased it
An increase in RBCs in the body that causes blood to be thicker increasing the risk of clots
Polycythemia
What are the normal values for RBCs for men and women?
Men: 4.5-5.5
Women: 4.0-4.9
What are the normal HGB values of men and women?
Men: 13-18
Women: 12-16
What is the normal HCT for men and women?
Male: 45-55%
Female: 37-48%
The three RBC values typically sit how close with one another?
1/3rd
What is low levels of RBCs called?
Anemia
What can primary polycythemia cause?
Thrombosis formation
Which Polycythemia is more common?
Secondary
What are the normal platelet levels?
150,000-400,000
What is thrombocytosis?
Platelet levels greater than 750,000
Where does primary thrombocytosis occur?
Bone marrow
How does secondary thrombocytosis occur?
- bleeding
- removal of spleen
- trauma
- infections
- hemolysis
How does Increased coagulation activity happen?
- stasis of blood
- coagulation factors
Bleeding disorders happen how many ways?
2 (deceased platelet numbers or defective coagulation)
What is thrombocytopenia?
Platelet levels below 100,000
What is characterized by an abnormality in von Willebrand factor which causes platelet adhesion and results in vascular occlusion?
Thrombotic Thrombocytopenic Purpura (TTP)
What is an X linked disorder in which the clotting cascade is disrupted?
Hemophilia
What lack of factors are involved in hemophilia?
Factors 8 and 9
What typically results in renal failure, hemolysis, and thrombocytopenia (commonly preceded by e coli infection)?
HUS (hemolytic uremic syndrome)
What condition results when fibrin clots are formed rapidly, using up coagulation factors, and increasing risk of bleeding?
Disseminated intravascular coagulation (DIC)
- More than 1500 meds are associated with this
- antibody attack on platelets in the presence of certain drugs
Drug-induced thrombocytopenia
Which medications are most commonly associated with drug-induced thrombocytopenia?
Heparin and aspirin
