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 (volume overload; plasma volume too high)
Too much Na+ in the body (salt)
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(rapid breathing) and Dyspnea(labored breathing)
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 (polymorphonuclear neutrophils) 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 vasculitis?
Decreased: RBC and platelets
Increased: WBC, T-Cells, Monocytes, Schistocytes, ESR (erythrocyte sedimentation rate)
What is the time course of the inflammatory response?
1 hour: swelling
Day 1: PMN’s show up (polymorphonuclear neutrophils)
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 (nyctalopia), Hypoparathyroidism, dry scaly skin (xerosis cutis)
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 (red, swollen patches in corners of mouth where lips meet)
How do I know the patient has a Vitamin B3 (Niacin) Deficiency?
Pellagra (4 D's: Diarrhea, dermatitis, dementia, death) Hartnup disease (deficiency of neutral amino acid Tryptophan)
How do I know the patient has a Vitamin B4 (Lipoic Acid) Deficiency?
There is no B4 vitamin
How do I know the patient has a Vitamin B5 (Pantothenic Acid) Deficiency?
Dermatitis, enteritis, alopecia, adrenal insufficiency
How do I know the patient has a Vitamin B6 (Pyridozine) Deficiency?
Peripheral Neuropathy (can be induced by Isoniazid and oral contraceptives) Convulsions, hyperirritability, and sideroblastic anemias (impared hemoglobin synthesis and iron excess)
How do I know the patient has a Vitamin B9 (Folate) Deficiency?
Megaloblastic anemia, hypersegmented neutrophils, neural tube defects
Deficiency can be caused by phenytoin, sulfonamides, methotrexate
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 (loss of taste), anosmia (loss of smell), 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
In which biochemical step is vitamin B1 important?
Thiamine "Think ATP" alpha-ketogluterate dehydrogenase Transketolase Pyruvate dehydrogenase
In which biochemical step is vitamin B2 important?
Riboflavin
FAD and FMN are derived from riboFlavin (b2=2ATP)
FMN= riboflavin-5-phosphate or flavin mononucleotide
In which biochemical step is vitamin B3 important?
Niacin (b3= 3ATP)
NAD+ and NADP+ used in redoc reactions, derived from Tryptophan
Lowers levels of VLDL and raises levels of HDL
In which biochemical step is vitamin B5 important?
Pantothenic Acid
Essential component of coenzyme A (CoA, a cofactor for acyl transfers) and fatty acid synthase
In which biochemical step is vitamin B6 important?
Pyridoxine
Important for synthesis of cystathionine, heme, niacin, histamine, and neurotransmitters:
including serotonin, epinephrine, norpinephrine (NE), dopamine, and GABA.
In which biochemical step is vitamin B7 important?
Biotin
Cofactor for carboxylation enzymes (which add 1-carbon group)
Example:
pyruvate carboxylase: pyruvate (3C)-> oxaloacetate (4C)
Acetyl-CoA carboxylase: acetyl-CoA (2C)-> malonyl-CoA (3C)
Propionyl-CoA carboxylase: propionyl-CoA (3C)->methylmalonyl-CoA (4C0
In which biochemical step is vitamin B9 important?
Folate
Converted to tetrahydrofolic acid (THF) used for 1-carbon transfer/methylation reactions
Important in synthesis of nitrogenous bases in DNA/RNA