EMS lectures 15,16,17,18 Flashcards Preview

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Flashcards in EMS lectures 15,16,17,18 Deck (31):
1

What is the total amount of CO2 produced a day?

25mol/day

2

What amount of unmetabolised acids are produced in a day

50mmol/day

3

What amount of plasma H+ is produced in a day

40nmol/L

4

What is normal pH

7.45-7.35
[H+] = 35-45nmol/l

5

What is the prinicple of the henderson hasselbalch equation

[H+] homeostatis needs balance of H+ production and regeneration of HCO3-

6

Sites of acid base metabolism

lungs, kidneys, gi tract, liver

7

what enters/exits cell during tissue gas exchange

O2 in
Co2 out
Cl- in and out

8

what causes a right shift on the O2, Hb dissociation curve

Increased
2,3diPG, H+, Temperature

9

what type of acid base metabolism occurs in the liver

lactate metabolism
UREA synthesis (only site)

10

what occurs in severe liver failure

NH4+ toxicity
Metabolic alkalosis
lack of urea and H+ produced

11

What are the compensatory mechanisms for acidosis/alkalosis

Respiratory
Renal bicarb regeneration
hepatic ship between urea syntheis and ammonia excretion

12

What is metabolic acidosis

Increase H+ formation (acid ingestion)
Decrease renal H+ excretion
decrease bicarb

H+ up pO2 up
pCo2 Down

13

What is metabolic alkalosis
what are the consequences of metabolica alkalosis
causes?

Generation bicarb by gastric mucosa
Renal generation HCO3- in HYPOKALAEMIA

H+ down, pO2 down
pCO2 up

K+ in cells and urine
PO4 in cells
respiratory suppression

Vomiting, ectopic ACTH

14

what is respiratory Acidosis

Co2 retention
- poor ventilation, perfusion, lungdisease

H+ up, pCO2 up
pO2 DOWN

15

What is respiratory alkalosis

inc CO2 excretion
excessive ventilatoin

H+ down PCO2 down
pO2 UP

16

Causes of increased H+ formation

Ketoacidosis (diabetes, alcoholism)
Lactic acidosis
poisoning
inheritied organic acidosis

17

What is diabetic ketoacidosis

hyperglycaemia - osmotic diuresis
causes hyperketonemia - increased FFA

18

what is alcoholic ketoacidosis

NAD+ depletion (thiamine)
- thiamine deficiency
- increased glycolyisis for ATP
- keto-acids inc to counter hormones

VOMIT ALOT

19

define adaption

reversible change in cellular features due to environmental changes

20

What are the types of adaptive response

increased cellular activity
decreased cellular activity
change of morphological features

21

what is adaptive response to an increase of demand

hypertrophy
hyperplasia

22

what is the effect of subcellular hypertrophy/hyperplasia

increased drug metabolism due to increased organelles

23

What is atrophy

reduction of organ/tissue size due to decrease in cell size or number

24

What are the mechanisms for atrophy

decrease of individual cell volume

death of individual cell via apoptosis

25

What is INVOLUTION

death of indiviudal cells via apoptosis as a mechanism for adaption

26

define
agenesis

failure to form embryonic cell mass

27

define aplasia

failure to differnetiate into organ specific tissue

28

define dysplasia

failure to organise into tissues of organ

29

define hypoplasia

failure to grow to full size organ

30

what is meta plasia

transformation form one cell type to another
epithelium or mesenchymal tissue
physiological or pathological

31

What is dysplasia

earliest stage of neoplasia
irreversible
non invasive in situ disease
cytology of malignancy