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Pathophysiology > Unit 1 > Flashcards

Unit 1 Flashcards

1
Q

Cellular Adaptation

A

Cells change to:

  • Adapt to a new environment
  • Escape
  • Protect Themselves
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2
Q

What is Atrophy?

A

Atrophy is a decrease in cell size

  • may even result in the complete loss of cells
  • it is a sign of pathophysiology rather than a sucessful adaptation
  • is not a normal adaptation, is always a sign of a problem
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3
Q

What are the causes of atrophy?

A

It is usually caused by disease or ischemia (an inadequate blood supply to an organ or part of the body)
- reduced blood supply, reduced oxygen and glucose to tissues, cellular shrinkage and death

May also result from:

  • diminished nerve stimulation
  • poor nutrition
  • other diseases (Alzheimer’s disease in brain)
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4
Q

Hypertrophy

A
  • An increase in the mass of the cell, but not in the number of cells
  • An increase in the number of muscle proteins (not fluid) to allow muscle fibers to do more work
  • Common tissues: cardiac muscles, skeletal muscles, and kidneys
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5
Q

Hyperplasia

A
  • An increase in the number of cells of a tissue or organ from an increased rate of cell division
  • The cells involved must have mitotic ability

In any given organ, it’s possible for both hyperplasia and hypertrophy to occur

  • Uterine muscle enlargement during pregnancy (hypertrophy)
  • Hyperplasia of the uterine endometrium during pregnancy (and also during every menstrual cycle
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6
Q

Metaplasia

A

An adaptive substitution to a different, “hardier” cell line
- usually changes to a hypertrophied or hyperplastic tissue

Example: Replacement of ciliated columnar epithelium with stratified squamous epithelium in the respiratory tract of a smoker

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7
Q

Dysplasia

A

A change to an abnormal cell line

  • Dysplastic cells are not normal and not found anywhere in the body
  • This is a precancerous change

Examples include:

  • Cervical dysplasia from human papilloma virus (HPV)
  • Bronchial dysplasia from smoking
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8
Q

What are dysplasia cells characterized by?

A

Atypical changes in the size, shape and appearance, an of the cells (atypical hyperplasia)

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9
Q

What is Dysplasia caused by?

A

Caused by persistent injury or irritation progressing towards neoplasia (new, abnormal proliferation of cells)

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10
Q

Cellular Injury

A

Cells become injured in many ways

  • membrane permeability changes
  • interruption of oxidative metabolism (ATP production)
  • Diminished protein synthesis
  • Leakage of digestive enzymes
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11
Q

Hypoxia

A

Tissue hypoxia is when cells are deprived of oxygen

  • hyp[o]- = low
  • -oxia = oxygen

It is probably the most common cause of non-adaptive cellular injury

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12
Q

What is Hypoxia caused by?

A

Can be caused by:

  • Low levels of oxygen in the air
  • Poor or absent hemoglobin function (hyp[o]- + -ox- + -emia = low oxygen blood
  • Respiratory or cardiovascular diseases
  • Ischemia: reduced supply of blood, which carries oxygen
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13
Q

How does Hypoxia affect the creation of ATP?

A

Because of the reduction of oxidative metabolism, ATP levels decline

  • this causes decreased Na+/K+ pump activity
  • Na+ begins to accumulate in cells
  • Water follows Na+ and also accumulates in cells, which causes the cell to swell
  • Ca++ starts to come inside the cells (gap junctions shut off, other cell notices this one has a problem)
  • Intracellular K+ decreases approaching levels outside cell which results in: decreased protein synthesis, decreased membrane transport (symport and antiport), and increased lipids (lipogenesis)
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14
Q

What does Hypoxia do to the cell once ATP systems decrease in function?

A
  • There is a change in membrane permeability (Ca++ rushes in). This impairs mitochondrial function.
  • Cells accumulate excess water, lipids, and proteins
  • Decreased protein synthesis (as ribosomes are separated from the ER by increased fluid levels)
  • Glycolysis increases (anaerobic metabolism) because of low O2.
  • Lactic acid accumulates and causes low cellular pH (acidosis)
  • Lysosomes swell and dump, chromatin clumps, proteins denature
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15
Q

Free Radicals

A
  • A free radical is an atom or molecules that has an unpaired electron. This radical makes the atom very unstable and active
  • To gain stability, the radical gives up or steals an electron
  • Superoxide ion (O2-)
  • Hydroxyl (OH+)
  • Peroxinitrite ion (ONOO-)
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16
Q

Free Radical Formation

A

Formation of Free Radicals
- Normal metabolism, ionizing radiation, drug metabolism

Mechanisms of Injury

  • Lipid peroxidation: Destruction of unsaturated fatty acids (the ones with kinks in them) by free radicals
  • Protein destruction: fragmentation of polypeptide change and denaturation
  • DNA Alteration: Breakage of DNA strands
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17
Q

Free Radical Inactiviation

A

Antioxidants

  • Block synthesis or inactive free radicals
  • Vitamin E, Vitamin C, albumin, cerulopasmin (carries copper), and transferrin (carries iron)

Enzymes

  • Superoxide dismutase (SOD): This is usually inactivated by the enzyme superoxide dismutase (SOD). SOD converts superoxide to HO
  • Catalase: SOD makes H2O2.
  • Glutathione peroxidase (GPx)
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18
Q

Lead Poisoning

A

Acts like iron, calcium,and zinc

  • Interferes with neurotransmitters in the CNS (may cause wrist, finger, and foot paralysis in the peripheral nervous system.
  • Interferes with hemoglobin synthesis
  • Accounts for a significant number of childhood poisonings (sources include paint, dust and soil, contaminated tap water, dyes, pottery glazes, gasoline
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19
Q

Toxic Chemical Agents

A

Cellular injury by chemical agents can be caused by direct contact of the chemical, with molecular components of the cell, formation of free radicals, or lipid peroxidation

  • For example, carbon monoxide (CO), has a very high affinity for Hgb (would rather have the CO, rather than the O2)
  • It is colorless and odorless
  • CO causes nausea and vomiting, headache, weakness, and tinnitus (ringing in the ears)
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20
Q

Ethanol

A

A form of alcohol found in mood-altering beverages

  • In the liver, ethanol is converted to acetaldehyde which is toxic to the liver (free radical damage)
  • This toxicity leads to a deposition of fat, hepatomegaly, interruption of protein transport, decreased fatty acid oxidation, increased membrane rigidity, and liver cell necrosis
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21
Q

Trauma

A
  • Blunt force injuries are mechanical injuries resulting in tearing, shearing, or crushing of tissues
  • The most common blunt injuries are caused by falls and auto accidents
  • Contusion: Bleeding into the skin or underlying tissue
  • Hematoma: A collection of blood in an enclosed space (subdural and epidural hematomas in the skull)
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22
Q

What are 5 types of trauma wounds?

A
  1. Abrasion: Removal of superficial layers of the skin
  2. Laceration: A rip or tear in the skin or tissue
  3. Incised Wound: A cut that is longer than it is deep
  4. Stab Wound: A cut that is deeper than it is long
  5. Gunshot Wound (GSW):Can be penetrating (bullet remains in the body), or perforating (bullet exits the body)
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23
Q

Asphyxia as a means to Hypoxia

A

Asphyxia is lack of oxygen to the lungs. Asphyxial injuries can occur because of a failure of airflow (oxygen) to the lungs

  • Suffocation
  • Strangulation
  • Chemical
  • Drowning
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24
Q

Nutritional Imbalances

A

For adequate cellular function and integrity, adequate amounts of proteins, lipids & carbohydrates are required.

  • Low levels of plasma proteins, like albumin, encourages movement of water into the tissues, thereby causing edema
  • Hyperglycemia and hypoglycemia
  • Vitamin deficiencies
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25
Q

Name 5 Physical Agents

A
  1. Extreme Temperatures
  2. Atmospheric Pressure
  3. Water Pressure
  4. Ionizing Radiation
  5. Noise
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26
Q

Extreme Temperatures

A

Hypothermia

  • Vasoconstriction
  • Ice crystal formation causing cellular swelling

Hyperthermia
- Loss of fluids and plasma proteins

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27
Q

Atmospheric Pressure

A

Blast Injuries

  • Compressed waves of air
  • Thorax collapses; organs hemorrhage and rupture
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28
Q

Water Pressure

A
  • Causes nitrogen to dissolve in blood

- When pressure removed, nitrogen released and forms gas emboli

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29
Q

Ionizing Radiation

A

When we form ions we strip electrons

  • Electron removal from active cells
  • DNA is the most vulnerable target (during mitosis)
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30
Q

Noise

A

Acute sound noise or cumulative effect

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31
Q

What are 8 Cellular Accumulations?

A
  1. Water
  2. Lipids
  3. Carbohydrates
  4. Glycogen
  5. Protein
  6. Pigments
  7. Calcium
  8. Urate
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32
Q

What are 5 Types of Necrosis?

A

Necrosis is local cell death and is irreversible. It involves the process of self/auto digestion and lysis

  1. Coagulative
  2. Liquefactive
  3. Caseoous
  4. Fat necrosis
  5. Gangrenous
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33
Q

Coagulative Necrosis

A
  • Common is kidneys, heart, and adrenal glands
  • Coagulation is caused by protein denaturation (these cells have large amounts of proteolytic enzymes (proteases))
  • Albumin is changed from a gelatinous, transparent state to a firm, opaque state.
  • It is suspected that high levels of intracellular calcium play a role in coagulative necrosis
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34
Q

Liquefactive Necrosis

A

Occurs in neurons and glial cells of the CNS
- Brain cells have a large amount of digestive enzymes (hydrolases). These enzymes cause the neural tissue to become soft and liquefy

Liquefactive necrosis can also occur with certain infections (pus)
- Hydrolytic enzymes are released from neutrophils to fight an invading pathogen

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35
Q

Caseous Necrosis

A

Combination of coagulative and liquefactive necrosis

  • Results from pulmonary infection with Mycobaterium tuberculosis (TB)
  • The tissue is destroyed, but it is not completely digested
  • The remaining tissue resembles clumped cheese
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36
Q

Fat Necrosis

A

Occurs in the breast, pancreas, and abdominal tissues

  • Caused by lipases, which are found in very high levels in “lipo” (fat) tissues
  • Lipases break down triglycerides, releasing free fatty acids
  • The fatty acids combine with calcium, magnesium, and sodium to form soaps.
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37
Q

Gangrenous Necrosis

A

Refers to the wide-spread death of tissue or tissues due to hypoxia

  • Wet (liquefactive)
  • Dry (coagulative)
  • Gas Gangrene: Infection caused by many species of Clostridium bacteria (anaerobic). The enzymes and toxins released by these bacteria cause bubble of gas to form and spread very quickly
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38
Q

Cellular Death

A

Apoptosis

  • Cell death involved in normal & pathologic conditions
  • Apoptosis depends on cellular signals
  • These signals cause protein cleavage (proteases) within the cell, causing cell death
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39
Q

How is Apoptosis different from Necrosis?

A

It is an active process (we recycle parts of cells in apoptosis to be re-used)

  • Apoptosis: the cell is a “suicide victim” (a normal death)
  • Necrosis: the cell is a “homicide victim”

It affects scattered, individual cells

  • Apoptosis: gene activation in “chosen” cells
  • Necrosis: death is widespread

It results in cell shrinkage, not lysis and swelling

  • Apoptosis: cells shrink
  • Necrosis: cells swell and lyse
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40
Q

Aging and Cellular Death

A

Theories:

  • Aging is caused by accumulations of injurious events (environment)
  • Aging is the result of a genetically-controlled developmental program

Mechanisms:

  • Genetic, environmental, and bahavioral
  • Changes in regulatory mechanisms
  • Degenerative alterations
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41
Q

Somatic Death

A

Is the death of an entire organism

  • Cessation or respiration and circulation
    1. Algor Mortis
    2. Livor Mortis
    3. Rigor Mortis
    4. Potmortem Autolysis
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42
Q

Algor Mortis

A

Skin becomes pale and the body temperature falls

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43
Q

Livor Mortis

A

Purplish discoloration in peripheral tissues

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44
Q

Rigor Mortis

A
  • Depletion of ATP keeps contractile proteins from detaching causing muscle stiffening
  • Within 12-14 hours, rigor mortis gradually diminishes
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45
Q

Postmortem Autolysis

A

Breaks down muscle and other tissues

46
Q

The Cross-Bridge Cycle - Rigor Mortis

A

What happens if ATP is absent?

  • Myosin remains permanently bound to actin, muscles cannot move
  • Muscles are stuck between step 5 and step 1
  • Rigor mortis results
  • Eventually, enzymes and microbes destroy muscle structure and corpse becomes loose again.
47
Q

What is the distribution of body fluids in males and females?

A

Female:

  • 45 % solids
  • 55% fluids

Male

  • 40% solids
  • 60 % fluids

Intracelluar vs. Extracellular

  • 2/3 Intracellular Fluid (ICF)
  • 1/3 Extracellular Fluid (ECF)
  • The fluid content is not equal, but the concentration is equal
48
Q

What are 3 types of Osmotic Forces?

A
  1. Isosmotic
  2. Hyperosmotic
  3. Hyposmostic
49
Q

Isosmotic

A

Concentrations (not volumes) of two fluids separated by a membrane are equal

50
Q

Hyperosmotic

A

The concentration of the ECF is higher than the ICF. The net movement of water is from the ICF to the ECF

  • The ECT has a high (hyper) concentration
  • We can only measure the ECT concentration
  • Cells undergo crenation (crenated cell - shriveled)
51
Q

Hyposmotic

A

The concentration of the ICF is higher than the ECF. The net movement of water is from the ECF to the ICF.

  • The ECT has a low (hypo) concentration
  • We can only measure the ECT concentration
  • Cells undergo hemolysis (enlarged cell)
52
Q

How much water to we gain and lose everyday?

A

We gain about 2500 mL (2.5 liters) everyday, and we lose about 2500 mL (2.5 liters) everyday. They must be equal.

53
Q

Capillaries

A

Capillaries join arterioles (smallest arteries) and venules (smallest veins)

  • This is the only place where the exchange of “stuff” takes place
  • Capillaries occur as capillary beds of interconnected vessels
  • Capillaries small enough that RBCs must fold to pass through
  • Precapillary sphincters are smooth muscle cuffs that regulate flow of blood through the capillary bed
54
Q

Capillary Exchange

A

Capillaries are specialized for exchange of materials (they are a single layer thick, have a semipermeable membrane that works kind of like a filter)

  • Oxygen, glucose, and other nutrients must be delivered to cells (filtration)
  • Carbon dioxide, acid, urea, and other wastes must be carried away to be excreted (reabsorption)
55
Q

Starling’s Law of the Capillary - Hydrostatic Pressure

A

The pressure from the “pump” that pushes blood around (like water pressure in pipes)

Hydrostatic Pressure = Blood Pressure

56
Q

Starling’s Law of the Capillary - Osmotic Pressure

A

The concentration force of water trying to dilute out a higher concentration of solutes in blood (net osmotic pressure)
- This forces water from the tissues (lower solute concentration) toward the bloodstream (higher solute concentration)

57
Q

Dehydration

A

Occurs when reabsorption exceeds filtration

  • Water loss exceeds gains
  • Decreases blood pressure
  • Increases blood osmolarity
58
Q

Edema

A

Occurs when filtration exceeds reabsorption

59
Q

Starling’s Law of the Capillary - Permeability

A

This is how many holes are in the capillaries, and how large those holes are.
- Disease conditions can increase the size and number of holes in the capilliaries (e.g. inflammation, burns, allergies)

60
Q

What are the 3 factors of Starling’s Law of the Capillary

A
  1. Hydrostatic Pressure
  2. Osmotic (oncotic) Pressure
  3. Permeability
  • The balance between these forces is called the Starling Forces and the equation which relates them is called Starling’s Law of the Capillary
  • Interstitial fluid osmotic pressure about the same throughout the capillary, but hydrostatic pressure drops
  • This means the capillary delivers nutrients on the arteriole side, and picks up wastes on the venule side.
61
Q

Pathology: Hypertension - Starling’s Law of the Capillary

A

High blood pressure

- The blood hydrostatic pressure is increased, favoring filtration, and inadequate reabsorption, which leads to edema

62
Q

Pathology: Decreased Plasma Protein - Starling’s Law of the Capillary

A

The blood would be less concentrated with decreased plasma proteins.
- The blood osmotic pressure is decreased, favoring filtration, and inadequate reabsorption, which leads to severe edema.

63
Q

Pathology: Increased Vascular Permeability

A

In the case of inflammation and burns, we need increased permeability so that the substances we need that are in the blood (white blood cells, platelets, and proteins) can move into the tissue to help the problem.

64
Q

Regulation of Daily Water Gain

A

The thirst center is located in the hypothalamus. It detects increases in the blood osmolarity (concentration)

  • Dehydration
  • Other receptors for dehydration include the kidneys, baroreceptors in the arteries, and neurons in the mouth that detect dryness
65
Q

Hypovolemic

A

Not enough volume of blood. If water losses exceed gains, that decrease blood volume, so there is less liquid in the same about of space. Blood osmolarity increases and this decreases blood pressure

66
Q

Water Movement

A

Changes in osmolarity (concentration). Kidneys can excrete water at a rate of 15 ml/min

Excessive Water Consumption

  • A decrease in plasma and interstitial osmolarity causes water to move into the intracellular environment, resulting in cellular swelling
  • Water Intoxication
67
Q

What is an Electrolyte

A

A substance that dissociates into ions in aqueous solutions and conductions

Common electrolytes are:

  • Cations: Na+,K+, Ca++, Mg++
  • Anions: Cl-, HCO3-, PO4-3

Functions: Volume and osmotic regulation, myocardial function, enzyme cofactors, and acid-base balance

68
Q

Molarity

A

Molarity = moles (mol) per liter

A 1 molar (1M) solution = 1 mole of a solute in 1 liter of solution

69
Q

Equivalent Weight

A
  • 1 mole is Avogrado’s number (6.023 x 10^23) of something (molecules, atoms, ions
  • The term “equivalent” is only used for ionic compounds: acids, bases, and salts (Equivalent = # of charges)
  • In water, these compounds ionize into cations and anions
  • An equivalent weight of something is the amount of that compound that will liberate one mole of charge as cations or anions.
70
Q

Equivalent and Millequivalents

A

In the body, there are very small amounts (by weight) of ions, so they are listed on mOsm/L or mEq/L
- Simply move the decimal like you do for liters and milliliters

Examples:

  • Na+ = 0.14 M = 0.14 moles/L = 140 mmoles/L = 136 - 146 mEq/L
  • K+ = 3.4 - 5.0 mEq/L
71
Q

Sodium

A

The plasma concentration of sodium is kept within a very narrow range (136 - 146 mEq/L)

The body’s sodium concentration is maintained primarily by the kidney
1 - glomerular filtration
2 - renin-antiotensin-aldosterone system

Aided by hormones produced by the heart, brain, and kidney that also influence sodium reabsorption/excretion
3 - natriuretic peptides

72
Q

As Goes Sodium

A
  • Sodium accounts for 90% of the ECF cations
  • Sodium together with chloride (Cl-) and the bicarbonate ion regulates osmotic forces and therefore regulates water balance
  • In ECF: As sodium goes, so goes water
  • Sodium also works with potassium to maintain (neuromuscular “irritability” for conduction of nerve impulses and muscle contraction
73
Q

What are 2 abnormal levels of Sodium?

A
  1. Hypernatremia

2. Hyponatremia

74
Q

Hypernatremia

A

Sodium (>146 mEq/L)

  • Cellular shrinking
  • Hypertension
  • Thirst
  • Oliguria and Anuria
75
Q

Potassium

A
  • Potassium has a major influence on ICF osmolality and maintenance of electroneutrality in relation to Na+ and H+
  • Potassium is required for maintaining the resting membrane potential, transmission and conduction of nerve impulses, maintaining normal cardiac rhythms, and muscle contraction
  • The kidney plays the largest role in maintaining potassium levels
  • Normal plasma potassium: 3.4 - 5.0 mEq/L
76
Q

What are the 2 types of abnormal levels of potassium?

A
  1. Hyperkalemia

2. Hypokalemia

77
Q

Hyperkalemia

A

Potassium (>5.5 mEq/L)

  • Altered conductivity in the heart
  • Cell membrane is depolarized (more positive than normal). Mild attacks (muscular irritability). Severe (muscle weakness)
  • Can be caused by blood transfusions
  • Associated with metabolic acidosis (K+ for H+)
  • Lethal injections (big dose of potassium)
78
Q

How does Hypokalemia affect the ECG?

A

Hypokalemia causes a reversal of the cardia action potential (completely upsidedown)

79
Q

How does Hyperkalemia affect the ECG?

A

Hyperkalemia (depolarization) slows, and even stops, the heart

80
Q

Calcium

A

Calcium (8.6 -10.5 mg/dl) is necessary in many metabolic processes

  • Main cation in bones and teeth
  • Cofactor in the clotting pathways
  • KEY: Calcium blocks sodium channels

The concentration of calcium and phosphate are inversely related; if one increases, the other decreases
- The renal system maintains these levels

81
Q

Phosphate

A

Phosphate (2.5 - 4.5 mg/dl) is found throughout the body

  • Bone (calcium phosphate = hydroxyapatite)
  • Phospholipids
  • Creatine phosphate (brain and muscle energy source)
  • ATP (energy currency)

The concentration of calcium and phosphate are inversely related; if one increases, the other decreases
- The renal system maintains these levels

82
Q

What 3 hormones are involved in the hormonal control of blood?

A
  1. Calcitonin
  2. Parathyroid Hormone (PTH)
  3. Calcitriol (active vitamin D)
83
Q

What does Calcitonin do in the hormonal blood control process?

A

Calcitonin: comes from the thyroid gland

  • Inhibits osteoclasts
  • stimulates osteoblasts
  • decreases blood (Ca+)
  • increases bone formation
84
Q

What does the Parathyroid Hormone (PTH) do in the hormonal blood control process?

A

The Parathyroid Hormone:

  • stimulates osteoclasts
  • inhibits osteoblasts
  • increases blood (Ca++)
  • decreases bone formation
85
Q

What does Calcitriol do in the hormonal blood control process?

A

Calcitriol (Active Vitamin D)

  • Not directly involved with bone
  • However, PTH stimulates kidneys to release calcitriol, which increases absorption of Ca++ from foods
  • Vitamin D is also important in intestinal absorption of Ca++
86
Q

What happens in the absence of Vitamin D?

A

In the absence of vitamin D, blood Ca++ levels drop and bones become soft and flexible (bones are mostly collagen because the mineral portion is lacking.
- In children, rickets result

87
Q

What are 2 abnormal levels of Calcium?

A
  1. Hypercalcemia
    - Hypophosphatemia
  2. Hypocalcemia
    - Hyperphosphatemia
88
Q

Hypercalcemia

A

Hypercalcemia (> 12.0 mg/dl) (Hypophosphatemia)

  • Decreased neuromuscular excitability (hyperpolarization)
  • Increased bone fractures
  • Kidney stones
89
Q

How does abnormal calcium (Hyper or Hypocalcemia) affect the ECG?

A

Abnormal calcium has an effect on the ECG, but it is much more subtle than the effects of abnormal potassium

90
Q

Magnesium

A
  • An intracellular cation
  • Plasma concentration 1.8 - 2.4 mEq/L
  • Acts as a cofactor in cellular reactions (important for protein &nucleic acid synthesis
  • Required for ATPase activity
  • KEY: decreased acetylcholine release at the neuromuscular junction (NMJ)
  • Example: given in pre-eclampsia
91
Q

What are the 2 abnormal levels of Magnesium?

A
  1. Hypermagnesemia

2. Hypomagnesemia

92
Q

Hypermagnesemia

A

Hypermagnesemia (> 2.5 mEq/L)

  • Skeletal muscle depression
  • Bradycardia
  • Muscle weakness
93
Q

pH Levels

A

pH is measuring the Hydrogen Ion Concentration

- pH 7.0 is alkaline/basic (more OH- than H+)

94
Q

What does a buffer do in the body?

A

A buffer acts as an H+ and/or OH- “sponge” so that pH is kept relatively constant

The most important buffer system in human biology is the carbonic acid-bicarbonate buffer system

95
Q

What are the 2 organ systems that regulate the acid/base balance?

A
  1. Lungs (respiratory): retain or excrete CO2
    - first part of carbonic-acid-bicarbonate buffer system
  2. Kidneys (metabolic): retain or excrete HCO3-
    - second part of carbonic-acid-bicarbonate buffer system
96
Q

Maintaining Acidosis and Alkalosis

A

The respiratory system and renal system must work together to maintain an appropriate pH for the body

  • The respiratory system affects pH by changing the PCO2 level (PCO2 is the same as carbonic acid H2CO3)
  • The kidneys affect pH by retaining or dumping HCO3-
97
Q

What are the 4 categories of Acid/Base Imbalance?

A

Respiratory:

  • Acidosis: elevation of PCO2
  • Alkalosis: depression of PCO2

Metabolic:

  • Acidosis: depression of HCO3-
  • Alkalosis: elevation of HCO3-
98
Q

Respiratory Acidosis

A
  • Hypoventilation
  • Asthma, Emphysema
  • Pneumonia
  • Coma
  • Snickers stuck in throat

The kidneys will compensate (over a period of hours) by conserving HCO3- and excreting H+ ions

99
Q

Respiratory Alkalosis

A
  • Hyperventilation
  • Drugs
  • Excitement
  • Anxiety

The kidneys will compensate (over a period of hours) by retaining H+ and excreting HCO3- ions

100
Q

Metabolic Acidosis

A
  • Renal failure
  • Shock
  • Ketoacidosis
  • Lactic acidosis
  • salicylate overdose

The lungs will immediately begin to compensate by “wasting” CO2 (hyperventilation)

101
Q

Metabolic Alkalosis

A
  • Ingestion of bicarbonate
  • Vomiting (losing gastric juice high in H+ ions)
  • Chloride depletion
  • Diuretic therapy

The lungs will immediately begin to compensate by holding on to CO2 (hypoventilation)

102
Q

Normal pH Level

A

7.35 - 7.45

103
Q

Normal PO2 Level

A

68 - 72 mmHg

104
Q

Normal PCO2 Level

A

35 - 45 mmHg

105
Q

Normal HCO3- Level

A

22 - 36 mEq/L

106
Q

In general, in determining whether something is more acidic or more basic….?

A
  • Anything above 7.40 is alkalotic

- Anything below 7.40 is acidotic

107
Q

How to determine if the compensation is full or partial

A

Fully Compensated:

  • pH within normal 7.35 - 7.45 range
  • Never goes beyond 7.40

Partially Compensated:
- pH is not back into the normal range

108
Q

Hypocalcemia

A

Calcium (> 4.5 mg/dl) (hyperphosphatemia)

  • increased neuromuscular excitability (partial depolarization)
  • muscle cramps
109
Q

Hypomagneseima

A

Magnesium (

110
Q

Hyponatremia

A

Sodium (

111
Q

Hypokalemia

A

Potassium (

Pathophysiology (2 decks)

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