Flashcards in Main Concepts Deck (22)
What electrolytes does the low volume state have?
HIGH total Na, LOW serum Na (dilutional affect), LOW Cl, LOW K
What pH does thenlow volume state have?
Alkalotic (except diarrhea, RTA Type II and DKA) b/c Aldo dumps H+
What pH does vomiters have?
Alkalotic b/c you vomit out H+
What pH does diarrhea have?
Acidosis b/c stool has bicarb
What happened if pulse increased more than 10 on standing?
What happened if pulse decreases to less than 5 on standing?
What are the symptoms of a low energy state?
CNS: mental retardation
CV: heart failure, pericardial effusion
Muscle: weakness, SOB, vasodilation, impotence, urinary retention, constipation
Rapidly dividing cells:
-bone marrow: suppressed
-vascular endothelium: breaks down
-lungs: infection, SOB
-kidney: PCT will feel the effect first
-GI: nausea, vomit, diarrhea
-germ cells: predisposed to cancer
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?
Explain all restrictive lung diseases:
Restrictive: intersticial problem (non bacterial)
-small stiff lungs (low VC)
-trouble breathing in => FEV1/FVC : >0.8
-ABG: low pO2 => increases RR, low pCO2, high pH
-CXR: reticulo-nodular pattern, ground glass apperance
-Die of cor pulmonale
-Ex: NM diseases (breathing out is passive), drugs, autoimmune dz
- Tx: Pressure support on ventilator, ^ O2 ^RR, ^inspiratory time
Explain all obstructive lung diseases:
Obstructive: airway problem (bacterial)
-Big mucus-filled lungs (^RV, ^Reid index = ^airway thickness/airway lumen)
-Trouble breathing out => FEV1/FVC: ^RR, v pH
-Die of bronchhiectasis
-Tx: Manipulate rate on ventilator, ^RR, ^ expiratory time, ^O2 only if needed
What symptoms does a "more likely to depolarize" state have?
Brain: psychosis, seizures, jitteriness
Skeletal Muscle: muscle spasm, tetany
SM: diarrhea, then constipation
Cardiac: tachycardia, arrhytmias
What symptoms does a "less likely to depolarize" state have?
Brain: lethargy, mental status changes, depression
Skeletal Muscle: weakness, SOB
SM: constipation, then diarrhea
Cardiac: hypotension, bradycardia
What is humoral immune response?
B cells and PMNs patrol the blood looking bacteria
What is the cell-mediated immune response?
T cells and macrophages patrol the tissues looking for non-bacteria
What are macrophages called in each area of the body?
Lung: T1 pneumocytes
Liver: Kupffer cells
Spleen: RES cells
Lymph: Dendritic cells
kidney: Mesangial cells
Payers patches: M cells
What is the CBC for every vasculitis?
v RBC, v platelets, ^WBC, ^T cells, ^ MP and schistocytes, ^ESR
What is the time course of the inflammatory response?
1 hr: swelling
day 1: PMNs show up
day 3: PMNs peak
day 4: MP/T cells show up
day 7: MP/T cells peak, fibroblast arrive
day 30: fibroblast peak
Month 3-6: Fibroblast leave
What state does estrogen mimic?
The neuromuscular disease state (estrogen is a muscle relaxant)