Vitamins, Mineral & General Principal Flashcards
What electrolytes does the low volume state have?
Increased total Na+ (NET)
Decreased serum Na (dilution effect)
Decreased serum K+
Increased serum pH
What serum pH does the low volume state have?
Alkalotic (due to H+/K+ exchanger)
What serum pH does emesis have?
Alkalotic because you vomit out HCl-
What serum pH does diarrhea have?
Acidosis because stool has bicarb
What is a possible cause if pulse rises more than 10 bpm in repositioning from lying to sitting?
Hypervolemia
What happened if your pulse drops more than 10 bpm on standing?
Autonomic dysfunction
What are the symptoms of a Low Energy State?
CNS: Mental retardation, dementia
CV: heart failure, pericardial effusion
Muscle: weakness, SOB, vasodilation, impotence, urinary retention, constipation
What are the Rapidly Dividing Cells of the Energy State?
Skin: dry Nails: Brittle Hair: Alopecia Low Bone Marrow: Suppressed Vasculature: Endothelium breaks down Lungs: Infection / SOB Kidney: PCT effecfted first GI: N/V/D Bladder: Decreased tone Sperm: Decreased Germ Cells: Predisposed to cancer Breasts: Atrophic Endometrium: Amenorrhea
What are the most common signs of the Low Energy State?
Tachypnea and Dyspnea
What are the most common symptoms of the Low Energy State?
Weakness and SOB
What are the most common infections of the Low Energy State?
UTI and respiratory infections
What is the most common cause of death in the Low Energy State?
Heart Failure
Explain Restrictive Lung Disease:
Restrictive: Interstitial problem that causes trouble breathing in (small stiff lungs)
Pulmonary Function Test’s: FEV1/FVC greater than 0.8, decrease vital capacity
ABG: decreased pH, decreased PO2, decreased PcO2 (increased respiratory rate)
Chest X-Ray: reticulonodular pattern, ground glass appearance
Most common cause of death is Cor-pulmonale
Treatment: PEEP ventilator, increased O2, increased respiratory time
Explain Obstructive Lung Disease:
Obstructive: Airway structure problem that causes trouble breathing out (mucus filled lungs)
PFT’s: FEV/FVC is less tha 0.8, increased RV; Reid index increased (thick airway)
ABD: decreased pH, normal to low PO2, increased PCO2
Most common cause of Death is Bronchiectasis
Treatment: ventilator to increase respiratory rate and expiratory time, increase oxygen only if needed
What symptoms does a “more likely to depolarize” state have?
Brain: Psychosis, seizures, jitteriness
Skeletal Muscle: muscle spasms, tetany
Smooth Muscle: diarrhea, then constipation
Cardiac: tachycardia, arrhythmia
What symptoms does a “less likely to depolarize” state have?
Brain: lethargic, mental status changes, depression
Skeletal Muscle: weakness, SOB
Smooth Muscle: constipation then diarrhea
Cardiac: hypotension, bradycardia
What is the humoral immune response?
B-cells and PMN’s patrol the blood looking for bacteria
What is the cell-mediated immune response?
T-cells and Macrophages patrol the tissues looking for non-bacteria
What are the Macrophages called in areas of the body?
Blood: Monocytes Brain: Microglia Lung: Type 1 Pneumocytes Liver: Kupffer cells Spleen: RES cells Lymph: Dendritic cells Kidney: Mesangial cells Peyer's Patch: M cells Skin: Langerhan cells Bone: Osteoclast cells Connective Tissue: Histiocytes, Giant cells, Epithelioid cells
What is the CBC for every basculitis?
Decreased: RBC and platelets
Increased: WBC, T-Cells, Monocytes, Schistocytes, ESR
What is the time course of the inflammatory response?
1 hour: swelling
Day 1: PMN’s show up
Day 3: PMN’s peak
Day 4: Monocytes/Macrophages and T-cells show up
Day 7: Monocytes/ Macrophages and T-cells peak, Fibroblasts arrive
Day 30: Fibroblasts peak
Month 3-6: Fibroblasts complete scar formation
What state does Estrogen mimic?
The Neuromuscular disease state
Estrogen is a muscle relaxant
What do high GABA levels lead to?
Bradycardia, lethargy, constipation, impotence, memory loss
What determines the prognosis of Cancer?
Depth of invasion, any choice that has to do with depth - the deeper it is= the worse the prognosis
What ion has the least movement at rest?
Chloride
What ion has the greatest movement at rest?
Potassium
How would you know the patient has a Vitamin A (retinoic Acid) Deficiency?
Poor night vision, Hypoparathyroidism, dry skin
How would you know the patient has a Vitamin B1 (Thiamine) Deficiency?
Beriberi, Wernicke’s Encephalopathy, Wenicke-Korsakoff Syndrome
How do i know the patient has a Vitamin B2 (Riboflavin) Deficiency?
Angular Cheilosis
How do I know the patient has a Vitamin B3 (Niacin) Deficiency?
Pellagra (4 D’s: Diarrhea, dermatitis, dementia, death)
How do I know the patient has a Vitamin B4 (Lipoic Acid) Deficiency?
No deficiency state
How do I know the patient has a Vitamin B5 (Pantothenic Acid) Deficiency?
No deficiency state
How do I know the patient has a Vitamin B6 (Pyridozine) Deficiency?
Peripheral Neuropathy
How do I know the patient has a Vitamin B9 (Folate) Deficiency?
Megaloblastic anemia, hypersegmented neutrophils, neural tube defects
How do I know the patient has a Vitamin B12 (Cyanocobalamin) Deficiency?
Megaloblastic anemia, hypersegmented neutrophils, Neuropathy
How do I know the patient has a Vitamin C (Ascorbic Acid) Deficiency?
Scurvy
How do I know the patient has a Vitamin D Deficiency?
Rickets (children), Osteomalacia (adults)
How do I know the patient has a Vitamin E Deficiency?
Increased free radical damage, hemolytic anemia, ataxia gait, impaired position and vibration sense
What happens when there is a biotin Deficiency?
Loss of carboxylase function
How do I know the patienthas a Vitamin K Deficiency?
Bleeding, Loss of gamma-carboxylation
What is seen in Calcium deficiency?
Poor bone and teeth development
What is seen in Magnesium deficiency?
Loss of kinase function, hypoparathyroidism
What is seen in Zinc deficiency?
Dysgeusia, anosmia, Poor wound healing
What is seen in Copper deficiency?
Menky Kinky Hair Syndrome
What is seen in iron deficiency?
Anemia
What disease has a chromium deficiency?
Diabetes
What disease has a Selenium deficiency?
Dialted cardiomyopathy
What is seen with Tin deficiency?
Poor hair growth
What is seen why Molybdenum deficiency?
Lose xanthine oxidase function
What is seen with Manganese deficiency?
Lose xanthine oxidase function
What is seen with Fluoride deficiency?
Poor teeth and bone growth
