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Patho Units 7-10 > Unit 10 Review > Flashcards

Unit 10 Review Flashcards

1
Q

2/3rds of body’s H2O is in …

A

intracellular fluid

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2
Q

electrolyte most prevalent inside of cells

A

K+ (also Ca++, Mg++, PO4)

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3
Q

4 physiologic mechanisms that contribute to edema formation

A
  1. increased capillary hydrostatic pressure
  2. decreased plasma oncotic pressure
  3. increased capillary membrane permiability
  4. lymphatic obstruction
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4
Q

the ________ pressure between _____________ and _____________ compartments is trying to stay in ____________

A

osmotic
extracellular
intracellular
equilibrium

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5
Q

fluid shifts between intracellular and extracellular compartments r/t osmotic pressure changes cause…

A

third-spacing

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6
Q

lots of Na+ transported into cell, osmotic pressure in cell increases or decreases?

A

increases

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7
Q

When Na+ increases in cell, what happens to H2O?

A

it follows Na+ into cell to balance osmotic pressure and cell swells

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8
Q

abnormal accumulation of fluid in extracellular compartment can be caused by:

A

hypoproteinemia
lyphatic obstruction
increased venous pressure
increased capillary permeability

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9
Q

the ECF volume is divided between the _________ and the ____________ fluid compartments

A

vascular

interstitial

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10
Q

the ICF volume is regulated by ____________ and organic compounds in the ICF and by ____________ that move freely between the ICF and ECF

A

proteins

solutes

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11
Q

the transfer of H2O between the vascular and interstitial compartments happens at what level?

A

cellular

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12
Q

excessive accumulation of fluid within the interstitial spaces

A

edema

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13
Q

edema is a problem of __________ _______________ and does not necessarily indicate a __________ _________.

A

fluid distribution

fluid excess

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14
Q

reasons for increased capillary hydrostatic pressure

A 
venous obstruction
salt or water retention
thrombophlebitis
hepatic obstruction
tight clothing around extremities
prolonged standing
CHF
renal failure
cirrhosis
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15
Q

reasons for decreased plasma oncotic pressure

A 
liver disease
protein malnutrition
glomerular disease
serous drainage from open wounds
hemorrhage
burns 
cirrhosis
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16
Q

reasons for increased capillary membrane permiability

A 
inflammation or immune response
trauma
burns
crush injuries
neoplastic diseases
allergic reactions
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17
Q

reasons for lymphatic obstructions

A

infection

tumor

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18
Q

proteins and fluid accumulating in interstitial spaces

A

lymphedema

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19
Q

the effects of edema are determined largely by _________

A

location

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20
Q

edema to brain, larynx, or lungs would be considered

A

an acute life-threatening condition

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21
Q

treatment of edema…

A 
treat underlying cause
reduce Na+
diuretics
compression stockings
elevate legs
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22
Q

what is the most abundant cation in the body

A

Ca++

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23
Q

positive ions

A

cations

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24
Q

Ca++ ions combine with _____________ ______ to for ___________ _____________ which increases the rigidity and hardness of bones and teeth enamel

A

phosphate ions

calcium phosphate

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25
Q

how does Na+ enter the body

A

consumed in food, drink, medications, etc…

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26
Q

How does Na+ leave the body

A

urine, sweat, tears, primarily

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27
Q

which organ is the main regulator of Na+?

A

kidneys (adrenals are 2nd to kidneys)

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28
Q

total body water varies with __________ and _________ and these differences can be explained by differences in body __________________

A

gender
weight
composition

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29
Q

what are two main physiologic mechanisms that assist in regulating body water?

A

urination and sweating

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30
Q

where is anti-diuretic hormone produced?

A

hypothalamus and secreted by pituitary

31
Q

how does ADH exert its influence in the reabsorption of water

A

ADH acts on the vasopressin 2 receptors in the renal tubular cells to increase permiability which leads to an increase in H2O absorption into the bloodstreams and the production of more concentrated urine

32
Q

insufficiency of ADH resulting in polyurea and polydipsea

A

Diabetes insipidus

33
Q

two forms of DI

A

neurogenic and nephrogenic

34
Q

What is the most common form of DI?

A

neurogenic diabetes insipidus

35
Q

Neurogenic DI results when any lesion on the _____________, ____________ _________, or _________ _________ interferes with the ADH _______, _________, or __________.

A 
hypothalamus
pituitary stalk
posterior pituitary
synthesis
transport 
release
36
Q

insensitivity of the renal collecting tubules to ADH

A

nephrogenic diabetes insipidus

37
Q

6 causes of hyponatremia

A
  1. inadequate intake of Na+
  2. diuretics
  3. vomiting, diarrhea, GI suctioning
  4. burns
  5. renal failure
  6. SIADH
38
Q

inadequate H2O intake, too much hypertonic saline solution & oversecretion of aldosterone cause

A

hypernatremia

39
Q

other causes of hypernatremia

A 
Cushings Syndrome
excessive H2O loss
impaired thirst
water loss due to fever or respiratory infxn
DI or DM
high amounts of sodium in diet (rare)
40
Q

what is the major cation in the ICF

A

K+

41
Q

10 causes of hypokalemia

A

ETOH, anorexia, alkalosis, tx of pernicious anemia with B12, genetic, laxative abuse, diarrhrea, intestinal drainage tubes, vomiting, NG tubes, diuretics, excessive aldosterone drainage from adrenal adenoma, antibiotics

42
Q

treatment for hypokalemia

A

K+ replacement

40-80 meq/day

43
Q

causes of hyperkalemia

A

metabolic acidosis
decreased kidney function
insulin deficiency, hyperglycemia, hyperosmolality
blood transfusion

44
Q

divalent cations

A

Ca++, Phos, and Mag

45
Q

cation missing two electrons compared to a neutral cation

A

divalent

46
Q

positively charged ion with two electrons in outer shell

A

cation

47
Q

three manifestations of hypoparathyroidism

A

muscle spasms
chvostek sign: tap on cheek & the upper lip twitches
Trousseau sign: painful carpal spasm after prolonged inflation of BP cuff
low phosphate

48
Q

where is parathyroid hormone produced

A

parathyroid gland

49
Q

where does parathyroid hormone exert influence

A

acts on kidneys and bones

regulates serum Ca++

50
Q

describe action of parathyroid hormone

A

in kidneys PTH increases Ca++ absorption, decreases phos and bicarb reabsorption,
also stimulates synthesis of biologically active Vit D
(1,25-dihydroxy vitamin D3)
in the bones, PTH mobilizes Ca++ from bones during times of hypCa++

51
Q

importance of ionized Ca++

A

free, active form can move from ECF to ICF in muscle contraction

52
Q

s/sx of hypCa++

A

tetany

53
Q

important fxns of Ca++

A

necessary for metabolic processes
major cation for structure of bone and teeth
enzymatic cofactor for blood clotting
transmission of nerve impulses and contraction of muscles
required for hormone secretion
plasma membrane stability and permeability

54
Q

can cause partial depolarization of nerves and muscles

A

hypoCa++

55
Q

s/sx of partial depolarization of nerves and muscles

A

confusion, paresthesias around mouth, carpopedal spasm, hyperreflexia, convultions and tetany,

56
Q

continuous muscle spasm can interfere with breathing & cause death

A

tetany

57
Q

provides the form of ATP for energy and acts as intra and extracellular buffer in the regulation of acid-base balance

A

phosphate

58
Q

what happens with hypophasphatemia

A

reduced capacity for O2 transport by RBCs
disturbed energy metabolism
decreased release of O2 to tissues causing hypoxia, bradycardia, and heart block

59
Q

common cause of hypophosphatemia

A 
intestinal malabsorption and increased renal excretion of phosphate
vit D deficiency
use of antacids
ETOH abuse (chronic)
respiratory alkalosis
60
Q

which organ is the principal organ of magnesium regulation

A

kidneys (also small intestine)

61
Q

cardiovascular manifestations of hypermagnesemia

A

depress muscle contraction & nerve function
hypotension
bradycardia
N/V, muscle weakness, respiratory depression

62
Q

volatile acide

A

carbonic acid (in the lungs)

63
Q

three ways pH is regulated

A 
short term (w/in seconds) - buffers in blood 
medium (w/in minutes) - lungs or rate/depth of respiration
long term (hours to days) - kidneys - bicarb - uptake and excretion
64
Q

largest buffer systems in body

A

intracellular buffers (inside cells)
extracellular buffers (blood, ISF, CSF, urine)
respiratory (lungs)
renal (kidneys)

65
Q

increase in noncarbonic acids or loss of bicarbonate from extracellular fluid

A

metabolic acidosis

66
Q

increase in bicarbonate usually caused by loss of metabolic acids from conditions like vomiting, diarrhea, GI suctioning, excessive bicarb intake,

A

metabolic alkalosis

67
Q

decrease of alveolar ventilation and increase in levels of CO2 which causes hypercapnea

A

respiratory acidosis

68
Q

occurs with hyperventilation and excessive reduction of CO2 or hypocapnia

A

respiratory alkalosis

69
Q

two common types of metabolic acidosis

A 
lactic acidosis - from poor perfusion, hypoxemia, CA, over exercising, liver failure, hypoglycemia, ETOH, meds like ASA
diabetic acidosis (DKA) - build up of ketone bodies
70
Q

untreated of uncontrolled Type I DM - increased ketones in blood,

A

DKA

71
Q

formed during breakdown of fatty acids in order to transform them into energy

A

ketones

72
Q

DKA is caused by several factors, the most common are:

A

infection, illness, skipping insulin therapy, trauma, stress, drug abuse, ETOH abuse

73
Q

causes of respiratory acidosis

A

brainstem trauma, over sedation, respiratory muscle paralysis, kyposcoliosis, flail chest, pneumonitis, pulmonary edema, emphysema, asthma, bronchitis

74
Q

common cause of respiratory alkalosis

A

hyperventilation (other causes: anxiety, fever, any lung disease that prompts hyperventilation)

Patho Units 7-10 (15 decks)

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