U world Fuck Ups Flashcards
Altered mental status with acute renal failure in conjunction with oxalate crystals is consistent with?
Ethylene glycol poisoning
eythelene glycol is what
a toxic alcohol that is found in antifreeze, engine coolants and brake fluids
symptoms of ethylene glycol poisoning
initially: ethanol intoxication
next: acute renal failure symptoms (oliguria, flank pain) - 24 to 72 hours from ingestion
ethylene glycol itself is non toxic but it is metabolized to?
glycolic acid and oxalic acid (which leads to toxicity)
how does acute kidney injury occur in ethylene glycol toxicity?
it is metabolized to glycolic acid which causes direct tubular cytotoxicity
the oxalic acid it is metabolized to crystalizes and causes obstruction to the tubules
combined this results in acute tubular necrosis
histologically has does acute tubular necrosis present
cell ballooning and vacuolar degeneration with normal glomeruli
what are the lab findings in eythleneb glycol toxicity
elevated anion gap metabolic acidosis
elevated osmolar gap
what are the lab findings in eythleneb glycol toxicity
elevated anion gap metabolic acidosis
elevated osmolar gap
water deprivation/ dehydration results in _ release from the posterior pituitary gland
ADH (anti diuretic hormone)
anti diuretic hormone (against peeing) is released from the PP and stimulates what receptors?
V2 receptors on the principal cells in the collecting ducts causing aqua-Orin 2 channels to translocate into the apical cell membrane.
Aquaporin 2 spans the _ membrane and enhances?
luminal
water permeability of the principal cells
in the presence of high ADH meaning we dont want to pull out water describe the tubular fluid changes throughout the nephron
the proximal tubule: water is reabsorbed along with electrolytes so the fluid is isotonic with plasma (300)
descending loop of henle: free water is drawn out of the tubules into the intersitium so this makes the tubular fluid hypertonic (>300)
thick and thin ascending loop of henle: primary region go urine dilution and are impermeable to water: electrolytes are passively resorbed in the thin ascending limb and actively reabsorbed in the thick ascending limb, the tubular fluid is hypotonic (less than 300)
the distal convoluted tubule: is impermeable to water so the tubular fluid remains hypotonic and reabsorption of the solutes/electrolytes such as NaCl: most dilute lesson the nephron (100)
collecting duct: highly permeable to water so water leaves the tubular fluid and hypertonic urine is formed (1200)
GTP is synthesized by what reaction in the TCA cycle
succinylcholine CoA to succinate in the TCA cycle
during gluconeogenesis phosphoenolpyruvate carboxykinase uses GTP to synthesize _ from _
phosphoenolpyruvate from oxaloacetate
the majority of ATP used for cellular processes is generated by the oxidation of?
acetate in the TCA cycle
the enzymes of the TCA cycle are located in the ?
mitochondria (and generate NADH and FADH2)
gap junctions are comprised of what proteins
connexions
gap junctions connect neighboring cells)
what is the purpose of gap junctions?
intracellular communication
what proteins are in tight junctions
Claudius and occludins
what is the function of tight junctions
paracellular barriers
what proteins are in adherent junctions
cadherins
what are the proteins of adherens
cadherins
what are the proteins of desmosomes
cadherins
what proteins are in hemidesmosomes
interns
desmosomes connect
epithelial cells intracellularly
hemidesomones connect
cells to the basement membrane
what cell junction is important in labor
gap junctions with connexions which coordinate and synchronize myocetrial cells of the uterus
in preparation for labor increasing _ levels stimulate upregulation of connexion _ and _ receptors
43
oxytocin receptors
oxytocin receptors are coupled to what G protein
Gq (increase Ca+ and increase excitability)
Acting out:
expressing unacceptable feelings through actions (immature dense mechanisms)
denial
behaving as if an aspect of reality does not exist (immature)
displacement
transferring feelings to less threatening person or object (immature)
intellectualization
focusing on nonemotional aspects to avoid distressing feelings
(immature)
passive agression
avoiding conflict by expressing hostility covertly (immature)
projection
attributing ones own feelings to another (immature)
rationalization
transforming unacceptable feelings/impulses into the opposite (immature)
regression
reverting to earlier developmental stage (immature_
splitting
experiencing a person/situation as wither all positive or all negative (immature)
sublimation
channeling impulses into socially acceptable behaviors (mature)
suppression
putting unwanted feelings aside to cope with reality (mature)
