Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

From Flashcardlet > Patho 6 - Fluids/Acid Base > Flashcards

Patho 6 - Fluids/Acid Base Flashcards

1
Q

What percentage of our body weight is water?

A

60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What fraction of our body’s water is intra and extracellular?

A

2/3 intracellular

1/3 extracellular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How does the fluid environment in the body change constantly?

A

Water and particles move between various compartments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is necessary for any fluid to flow?

A

Must have pressure acting on the fluid, and resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where is the blood pressure the highest?

A

(Aorta) Left ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where is the blood pressure the lowest?

A

Right atrium - close to zero

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What provides resistance in the blood vessel circuit?

A

Smooth muscle tone in arterioles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the pressure gradient of the vascular system driven by?

A

Mechanical work of the left ventricular myocardial muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the formula for blood pressure?

A

Blow flow rate (cardiac output) X vascular resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is fluid pressure?

A

Physical/mechanical pressure exerted on one object by another

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is hydrostatic pressure?

A

Pressure caused by the weight of fluid - the force exerted by the weight of a column of fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is hydrodynamic pressure?

A

Increment of pressure created by resistance to the flow of fluid in a closed system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What kind of pressure is blood pressure?

A

Blood pressure in the hydrodynamic pressure of moving blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is cardiac output?

A

Determined by heart rate and the volume of blood ejected with each beat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the formula for cardiac output?

A

CO = HR X SV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is stroke volume?

A

Volume of blood ejected with each heart beat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How does blood volume affect cardiac output?

A

Decreased blood volume decreases cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Why does BP tend to increase with age?

A

Because stiff arteries caused by aging can lead to increased resistance, which increases blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why does the kidney know when blood pressure decreases?

A

The kidney filters blood, so it knows blood pressure is decreased when it is less perfused

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does the kidney do when blood pressure is low?

A

Releases renin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does renin do?

A

Rening converts angiotensinogen from the liver into angiotensin I
Angiotensin I is converted to II by ACE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does angiotensin II do?

A

Increases resistance by increasing vasoconstriction, therefore increasing blood pressure
Also stimulates the release of aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What does aldosterone do?

A

Holds Na, causing the holding of water, which increases blood volume therefore increasing cardiac output and blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is vascular resistance governed by?

A

Collective size of small peripheral arteries which constrict to decrease outflow and increase pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which vessels have the highest hydrostatic pressure?

A

Veins - lower extremity veins have large columns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is ACE and where is it made?

A

Acetylcholinesterase, made in the lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Where is aldosterone made?

A

Adrenal cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is osmolarity?

A

Concentration of solute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is JVD?

A

Jugular vein distention, caused by back up of fluid from the atrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Why do veins have valves?

A

To prevent back flow and the pooling of blood, working against gravity and hydrostatic pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What mechanism helps to squeeze venous blood superiorly to return to the heart?

A

Muscle contractions and valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are varicose veins?

A

Pooling or back flowing of blood in the lower extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Why do varicose veins result?

A

Muscle contractions or valves are not working properly to return venous blood back to the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Why do people with varicose veins present with swollen legs as well?

A

Fluid wants to go to an area of high pressure (veins) to an area of low pressure, resulting in edema in the interstitial spaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the treatment of varicose veins?

A

Increasing exercise to increase muscle contractions, compression socks to increase compression and squeezing, weight loss to relieve pressure on the veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is osmosis in terms of water concentration?

A

Flow of water across a semipermeable membrane from an area of high water concentration to an area of low water concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is a semipermeable membrane?

A

Permeable to the solvent but not the solute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is osmosis in terms of osmolarity?

A

Flow of water from and area of low osmolarity to an area of high osmolarity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What substances dictate osmosis?

A

Solutes, porteins, and albumin - alternations in these concentrations cause fluid movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are the two most important substances in the movement of water in osmosis?

A

Sodium and albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is osmotic pressure?

A

Measure of the tendency of water to move by osmosis from an area of high water to an area of low water concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What does low osmotic pressure say about the solute concentration?

A

Dilute solution - low solute concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What does low osmotic pressure say about the movement of water?

A

Loss of water - dilute solution has too much water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

How is osmotic pressure described in terms of hydrostatic pressure?

A

Amount of hydrostatic pressure that must be applied to fluid to prevent water from crossing a membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the average solute concentration in the body?

A

0.9% solution of NaCl in water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is normal saline?

A

0.9% NaCl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Why is maintaining the blood volume so critical?

A

It is the only way to profuse the tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Why is water hazing so bad?

A

Water intoxication - dilution of blood concentration of solutes, so water goes into tissues - movement from vessels to brain tissue causes seizures and swollen brain with no room for the extra pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What cells control the exchange of substances between blood and tissues?

A

Endothelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What are lymphatics, described in terms of pressure and fluid exchange?

A

Low pressure, capillary like system of vessels, collect interstitial fluid from between cells and deliver it into blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Is lymph fluid uni or bi directional?

A

Unidirectional

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What does the presence of large opening between lymphatic endothelium result in?

A

Allows entry of large molecules like protein and bacteria into lymph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What pressures act to cause the flow of fluid from the blood into the interstitial space and into the lymphatic system?

A

Hydrodynamic and osmotic pressure combine to cause the flow of fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What does hydrodynamic pressure cause the drive of fluid to?

A

Drives fluid out of blood vessel and into interstitial space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What does osmotic pressure cause the drive of fluid to?

A

Opposes the drive of fluid out of blood vessel into interstitial space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What structure regulates the thirst center?

A

Hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What triggers the hypothalamus to become thirsty?

A

High osmolarity, low fluid volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What does antidiuretic hormone do to the urine?

A

Causes body to retain water and concentrates the urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is the average cardiac output?

A

5,000 mL/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

How much fluid intake is loss through urine daily?

A

One liter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

If the average fluid intake each day is 2 L, and 1 L is lost in urine output, what happens to the other liter of fluid?

A

Respiratory evaportaion
Sweat
Feces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is the most important fluid compartment, clinically?

A

Intravascular fluids - blood cells and plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What percentage of plasma is water?

A

90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is the remaining 10% of plasma made up of?

A

Albumin (proteins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What chemicals participate in the active process of vasodilation during injury?

A

Bradykinin, prostacyclin, nitric oxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What three substances regulate normal water loss?

A

Antidiuretic hormone
Aldosterone
Atrial natruiretic peptide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What organ secretes ADH?

A

Posterior pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What does aldosterone do to regulate water loss?

A

Retention of Na and water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What does atrial natriuretic peptide do to regulate water loss?

A

Influences kidney to release Na and water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Why is ANP stimulated?

A

High blood pressure causes release of ANP, working to tell kidneys to release water and lower blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What substance inhibits ADH?

A

Alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Why do we pee so much and get dehydrated when we drink alcohol?

A

Alcohol inhibits ADH so you don’t retain water, you pee it all out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Where is atrial natriuretic peptide secreted?

A

Atrial cardiac muscle cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

How much does a liter of water weigh in pounds?

A

2.2 lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What is a red flag in terms of weight gain for a CHF patient?

A

Weight can of 2.2 lbs indicates holding onto 1 L of fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Why is sodium such a huge player in fluid volumes?

A

Water follows solutes, especially sodium, affecting blood volume and blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Is sodium found intra or extracellularly?

A

Extracellular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What hormone is the major player in concentrations of sodium?

A

Aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What is a salt?

A

Substance that separates into ions when dissolved in water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What kind of molecule is an electrolyte?

A

Salt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What kind of charge does a cation have?

A

Positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What kind of charge does an anion have?

A

Negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

How does the body gain salts?

A

Diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What percentage of the body is fluids versus solids?

A

55% fluids

45% solids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What percentage of body fluid is intra versus extracellular?

A

65% intracellular

35% extracellular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

What percentage of extracellular fluids are interstitial versus blood?

A

80% interstitial

20% blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

What percentage of blood is cells versus plasma?

A

45% cells

55% plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What percentage of plasma is water versus protein?

A

90% plasma

10% proteins - mainly albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What is the relationship between sodium and water balance?

A

They are co dependent (direct relationship)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Which cells have semipermeable membranes hat are permeable to both Na and water? Which are just permeable to water?

A

Blood vessel cells are permeable to both (can move between plasma and interstitial fluid)
Tissue cells only permeable to water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What is the relationship between sodium and blood pressure

A

They are codependent (direct relationship)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What is edema?

A

Abnormal accumulation of fluid in a tissue or body cavaity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

What are the types of edema?

A

Inflammatory and noninflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

What is exudate?

A

Inflammatory edema with a high protein content

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

What causes exudate?

A

Increased vascular permeability of inflammation allowing protein to leak through capillary walls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

What is transudate?

A

Low protein edema caused by pressure imbalance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

What causes transudate?

A

Either increased capillary fluid pressure or decreased plasma osmotic pressure - movement of water exceeds lymphatic drainage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What is pitting edema?

A

Diagnostic feature of transudate edema - area is pressed with finger and impression remains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

What is the primary intracellular cation?

A

Potassium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

What is the relationship between calcium and phosphate?

A

Inverse relationship

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Which electrolyte imbalance is very rare?

A

Magnesium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

What electrolyte follows sodium?

A

Chloride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

What are the major cation electrolytes?

A

Sodium
Potassium
Calcium
Magnesium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

What are the major anion electrolytes?

A

Bicarbonate
Chloride
Phosphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

What can cause hyponatremia?

A 
Diarrhea
Vomiting
Excessive sweating
Excessive drinking
Medications - too many diuretics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

What is the affect of hyponatremia on brain cells?

A

Agitation, confusion, delirium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

What is the normal Na range?

A

135-145

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

What happens if hyponatremia is correctly too quickly?

A

Herniation of the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

What does low extracellular sodium cause?

A

Water shifts into cells, causing intracellular edema and cell swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

What does low plasma sodium cause?

A

Waer shifts out of plasma, lowering blood volumena dblood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

What causes hypernatremia?

A

Medications
Dehydration
Excessive ingestion
Watery, low sodium diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

How can we treat hypernatremia?

A

Give patient fluid - 1/2 concentration of blood or free water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

What is the affect on the brain with hypernatremia?

A

Agitation, shakes, tremors, confusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

What cells of the body are extremely sensitive to Na and solute concentrations?

A

Nerve cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

What is the relationship between K+ and aldosterone?

A

Inverse effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

What happens to the K concentration in urine when aldosterone is secreted?

A

K concentration in urine increases because body is retaining Na

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

What diabetic condition is related to hyperkalemia?

A

DKA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

How do we treat hyperkalemia DKA?

A

Give high concentrations of glucose with 10 units of insulin - insulin takes K into cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

What causes hypokalemia?

A 
Fecal loss - diarrhea
Low diet, alcohol use
High levels of cortisol
Aldosterone
Insulin
Diuretics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

What is the main cause of hyperkalemia?

A

Renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

What is the most important effect of hypokalemia?

A

Electrical activity of the heart - electrical instability and arrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

How does hypokalemia effect skeletal muscles?

A

Interferes with contraction, causing weakness and fatigue

123
Q

How does hypokalemia effect nerve function?

A

Interferes with sensory function, promoting tingling sensations (paresthesias)

124
Q

How does hyperkalemia effect the heart?

A

Slows heart rate or causes dariac standstill and death

125
Q

What is the relationship between calcium and phosphate?

A

Inverse

126
Q

What hormone regulates calcium levels?

A

Parathyroid hormone

127
Q

What does parathyroid hormone do?

A

Raises calcium levels by acting on bone to shift calcium into blood, and absorption of dietary calcium in intentness
Reduces urinary calcium excretion

128
Q

How is vitamin D important in calcium metabolism?

A

Promotes intestinal uptake of calcium and movement of calcium from bone into blood

129
Q

What are the causes of hypocalcemia?

A 
Low PTH
High phosphate from renal failure
Vitamin D deficiency
Severe pancreatitis
Prolonged alkalosis
130
Q

What are the causes of hypercalcemia?

A

Increased PTH
Excess vitamin D
Malignancy - dissolve bone metastasis releasing calcium

131
Q

What does hypocalcemia do?

A
  • Increases irritability of nerve cells, causing involuntary contractions of skeletal muscles and increased reflexes (indirect)
  • Cardiac contractions are weaker, irregular, and decreased blood pressure (direct)
132
Q

What does hypercalcemia do?

A
  • Depresses neuromuscular activity and leads to weakness and fatigue
  • Lethargy and depression - brain
  • Kidney stones
  • Cardiac muscle is irritable, arrhythmias
  • Weak bones
133
Q

What is the function of phosphate?

A
  • Storage and release of energy via ATP
  • Bone and tooth mineralization
  • Acid/base buffer
134
Q

What is the function of magnesium?

A
  • Structure of bones

- Enzyme reactions

135
Q

What is an acid?

A

Compound that releases hydrogen ions when dissolved in water

136
Q

Lower the pH, – the hydrogen ions

A

Higher the hydrogen ions

137
Q

What makes HCl a strong base?

A

It completely dissociates in water, releasing all of its H and Cl

138
Q

What is a base?

A

Compound that decreases the number of free H+ ions, usually by releasing OH+ ions, which combine with hydrogen to form water

139
Q

Why is acidosis far more common than alkalosis?

A

Most metabolic processes generate excess acid

140
Q

What is the main task in regulating blood pH?

A

Neutralize and dispose of metabolic acids

141
Q

What is a volatile acid?

A

Acid that can be exhaled

142
Q

What center controls blood pH?

A

Respiratory center of the medulla, responds to increased acidity in the CSF by increasing respiration and exhaling extra CO2

143
Q

What is respiratory acidosis?

A

If lung function is impaired, ventilation cannot adequately rid the body of CO2, so it accumulates in arterial blood and increases acidity

144
Q

What is respiratory alkalosis?

A

If respiration is greater than CO2 production (hyperventilation), reduction in CO2 can raise pH

145
Q

What are fixed acids?

A

Acids that cannot be exhaled

146
Q

What are some examples of fixed acids?

A

Ingested amino acids and ketones produced from fatty acid metabolism

147
Q

What is metabolic acidosis?

A

Reactions that generate and use ATP during intense exercise

148
Q

What is metabolic alkalosis?

A

Much less common - results from loss of acids or gain of bases

149
Q

How can the body loss acids or gain bases and result in metabolic alkalosis?

A

Lose gastric acid in vomiting

Gain bases in medicinal antacids

150
Q

What are the four types of acid-base imbalance?

A

Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis

151
Q

What organ rids the body of fixed acids?

A

Kidney

152
Q

What is a cause of respiratory acidosis?

A

Respiratory depression from drugs or coma
Chronic pulmonary diseases like emphysema
Narcotics and opiates depress the respiratory system, causing retention of CO2

153
Q

What is a cause of respiratory alkalosis?

A

Hyperventilation

154
Q

What is the effect of respiratory acidosis on CO2?

A

Increased blood CO2

155
Q

What is the effect of respiratory alkalosis on CO2?

A

Decreased blood CO2

156
Q

How does the body compensate for respiratory acidosis?

A

Increased renal acid excretion and generation of new blood bicarbonate buffer

157
Q

How does the body compensate for respiratory alkalosis?

A

Kidneys excrete less acid and generate less new blood bicarbonate buffer

158
Q

What is a cause of metabolic acidosis?

A

Shock with poor tissue oxygenation and anaerobic metabolism, which generates fixed acids
DKA
Kidney failure

159
Q

What is a cause of metabolic alkalosis?

A

Excess ingestion of a base or severe vomiting

160
Q

What is the effect of metabolic acidosis on bicarbonate?

A

Decreased blood bicarb

161
Q

What is the effect of metabolic alkalosis on bicarbonate?

A

Increased blood bicarb

162
Q

How does the body compensate for metabolic acidosis?

A

Rapid, deep respirations to blow off acid as CO2

Increased renal secretion of acid

163
Q

How does the body compensate for metabolic alkalosis?

A

Slow, shallow respirations to retain CO2 as acid

Decreased renal secretion of acid

164
Q

What is a buffer?

A

Any substance that quickly acts to destain a change in pH following the addition of an acid or base

165
Q

What is the bicarbonate buffering system?

A

H+ will combine with bicarbonate to generate the weak acid carbonic acid

166
Q

What is required in order to fully correct the pH imbalance?

A

Renal acid excretion

167
Q

What is lactic acidosis?

A

Tissue damage results in excretion of lactic acids

168
Q

What is hyperemia?

A

Increased volume of blood, active process associated with inflammation or increased metabolic acidity of the affect art

169
Q

What is erythema?

A

Arterioles dilate and the site turns red

170
Q

What is congestion?

A

Increased volume of blood, passive process associated with impaired venous outflow

171
Q

What does active hyperemia result from?

A

Increased blood volume to an organ due to increased functional demand or hormonal stimulation

172
Q

What is an example of hyperemia due to hormonal stimulation?

A

Blushing - flushing of blood to the cheeks

173
Q

What does erythemia in the inflammatory state due to?

A

Increased blood flow from vasodilation

174
Q

Which process of increased volume of blood is arterial?

A

Active - hyperemia

175
Q

Which process of increased volume of blood in venous?

A

Passive - congestion

176
Q

What are some examples of congestion?

A

Pulmonary congestion from CHF - pulmonary edema
Ascites
Liver and spleen

177
Q

What does congestion in the liver result from?

A

Chronic right heart failure

178
Q

What is hemostasis?

A

Composite activity of blood vessel endothelium, platelets, and plasma coagulation factors that keep blood in a fluid clot free state and from a clot to stop bleeding a the site of vascular injury

179
Q

What forces does hemostasis balance?

A

Pro and anti clotting forces

180
Q

What is the maintenance of a clot free state?

A

Hemostasis

181
Q

What is the first element of the coagulation process?

A

Endothelial cells

182
Q

How does the endothelium balance pro and anti clotting forces?

A

Platelets have a natural tendency to adhere to endothelium
Antithrombotic and anticoagulant activity of endothelial cells prevent thrombosis and clotting unless stimulated by injury

183
Q

Is intravascular clotting normal?

A

No, it is pathological

184
Q

What do platelets initiate in clotting?

A

Coagulation cascade

185
Q

What is the second element of hemostasis?

A

Platelets

186
Q

How do platelets affect hemostasis?

A

Initially seals vascular defects
Attract more platelets to enlarge plug
Initiate clotting cascade
Fuse together to form cement to hold clot together
Secrete factors that stimulate wound healing in the repair process

187
Q

What is the third element of hemostasis?

A

Coagulation

188
Q

What is the final step of the coagulation cascade?

A

Causes fibrinogen to polymerize into strands of fibrin, which form a gel like solid meshwork that plugs the hole

189
Q

What are the two pathways of the coagulation cascade?

A

Extrinsic and intrinsic

190
Q

What initiates the extrinsic pathway of the coagulation cascade?

A

Factor VII comes into contact with tissue factor in extravascular tissue

191
Q

What initiates the intrinsic pathway of the coagulation cascade?

A

Coagulation factor XII comes into contact with a foreign surface

192
Q

Which pathway operates in most clinical circumstances?

A

Extrinsic

193
Q

What substance do platelets bind with?

A

Von Willebrand factors

194
Q

What other cascade does the coagulation cascade initiate and why?

A

Thrombolytic cascade to slowly dissolve the clot as healing proceeds

195
Q

What are the steps of hemostasis?

A 
Injury occurs
Temporary vasoconstriction
Platelets accumulate 
Further platelet aggregation
Web of fibrin
Hemorrhage stops as fibrin traps red cells and blocks further bleeding
196
Q

What do meostasis function tests measure?

A

How long it takes for a clot to form

197
Q

What test is associated with coumadin?

A

PT

198
Q

What test is associated with heparin?

A

PTT

199
Q

What does coumadin do?

A

Thins the blood

200
Q

What is a normal PT time?

A

1 second

201
Q

What is a normal time for PTT?

A

30-40 seconds

202
Q

What pathway is affected if PT is abnormal?

A

Extrinsic

203
Q

What pathway is affected if PTT is abnormal?

A

Intrinsic

204
Q

What does PT stand for?

A

Prothrombin time

205
Q

What does PTT stand for?

A

Partial thromboplastin time

206
Q

What substance is associated with the extrinsic pathway?

A

Coumadin

207
Q

What substance is associated with the intrinsic pathway?

A

Heparin

208
Q

What is a normal range for platelet counts?

A

150-450

209
Q

What happens to clotting time if a patient has fewer platelets?

A

Longer clotting time

210
Q

What level of platelets does spontaneous bleeding occur?

A

less than 20

211
Q

When do we worry about a patient’s platelet levels?

A

When platelets fall below 100

212
Q

What is prothrombin time?

A

Time it takes for a sample of patient plasma to clot after the addition of tissue factor

213
Q

What is partial thromboplastin time?

A

Time it takes for a sample of patient plasma to clot after addition of silica powder, an artificial surface

214
Q

What is hemophilia A?

A

X linked gene deficiency of factor VIII - Most common serious inherited coagulation disorder

215
Q

Where is hemophilia A inherited from?

A

Mothers

216
Q

What gender typically gets hemophilia A?

A

Males

217
Q

What is hemorrhage?

A

Excape of blood from a vessel

218
Q

How is hemorrhage classified?

A

According to size

219
Q

What are four types of hemorrhage?

A

Petechia
Purpura
Ecchymosis
Hematoma

220
Q

What size is petechiae?

A

Less than 1 mm

221
Q

What size is purpura?

A

Less than 1 cm

222
Q

What size is ecchymosis?

A

Large than 1 cm

223
Q

What does capillary bleeding often result from?

A

Low platelet count

224
Q

What are bleeding disorders due to?

A

Abnormal hemostasis

225
Q

What is hemorrhagic diathesis?

A

Excessive bleeding beyond the expected amount for a certain injury, or bleeding without obvious injury

226
Q

What is excessive bleeding caused by?

A

Fragile small blood vessels
Decreased platelet count or ineffective platelet function
Decreased coagulation factor activity

227
Q

What is thrombocytopenia typically characterized by?

A

Petechial bleeding in skin or mucosa

228
Q

Why might thrombocytopenia occur?

A

Platelet production is low due to primary bone marrow disorder
Toxic effect of drugs or chemical
Ineffectieve platelet production due to folate or B12 deficiency

229
Q

What is von Willebrand disease?

A

Stems from a efficiency of von Willebrand factor, which interferes with normal platelet adhesion to endothelium

230
Q

What is von Willebrand disease characterized by?

A

Spontaneous bleeding from mouth, nose and by excessive wound and menstrual bleeding

231
Q

What is Christmas disease?

A

Hemophilia B, Factor IX deficiency

232
Q

What test would come back abnormal with hemophilia A?

A

PTT would be prolonged because factor VIII is in the intrinsic pathway

233
Q

What is an intravascular thumbs?

A

Collection of the cellular elements of blood that forms only under pathologic conditions

234
Q

What is the difference between a clot and a thrombus?

A

Thrombus - slow, intravascular, pathologic

Clot - rapid, coagulation cascade, extravascular, not pathologic

235
Q

What is the thrombosis triad?

A

Endothelial injury
Abnormal local blood flow
Hypercoaguability

236
Q

What is the most important cause of thrombosis in arteries?

A

Atherosclerosis

237
Q

What are some examples of endothelial injury?

A

Inflammation
Scarring
Deposits of cholesterol

238
Q

What happens when endothelial injury occurs?

A

Platelets adhere to vascular wall and can grow large enough to occlude blood flow

239
Q

What are two conditions that result in hypercoaguability?

A

Cancers, deficiencies

240
Q

What are four options for the evolution of a thrombus?

A

Can grow by adding a clot
May break loose into blood stream (embolus)
Dissolve
Rechannel - occluded vessel may reopen slowly by boring out of thrombus

241
Q

What does DIC stand for?

A

Disseminated intravascular coagulation

242
Q

What is DIC?

A

Condition in which clotting occurs inside the vascular spaces without exposure to tissue

243
Q

Why is DIC called a consumptive coagulopathy?

A

Bleeding can be a consequence because coagulation factors are consumed by the clotting process and non longer exist in high enough concentration in blood to prevent abnormal bleeding

244
Q

What causes DIC?

A

Always secondary to another condition

245
Q

Is DIC severe?

A

Occurs in extremely sick patients and is usually fatal

246
Q

What are some primary conditions that result in secondary DIC?

A 
Shock - spesis, infection, acidosis
Obstetrical complications
Infections
neoplasms
Massive tissue trauma
Snakebite, heat stroke, vasculitis
247
Q

What are some obstetrical complications that lead to DIC?

A

Toxemia, premature separation of the placenta, amniotic fluid embolism, retained dead fetus

248
Q

What is an embolism?

A

Intravascular object that travels in the bloodstream from one place to another

249
Q

What is the main danger of an embolus?

A

Obstruction of blood flow

250
Q

What are four sources of emboli?

A

Thrombi
Marrow fat
Air
Amniotic fluid

251
Q

What drug is given to a patient to help stop clotting, but can be dangerous if DIC develops?

A

Heparin to stop clotting - but if bleeding starts, the body can no longer form a clot because coagulation factors are all preoccupied - you have uncontrolled bleeding

252
Q

What is a pulmonary thromboembolism?

A

Thrombus forms in deep veins of legs or pelvis and fragments break free and carried to the lungs

253
Q

What is a saddle embolus?

A

Large pieces of thrombi lodge in main pulmonary artery and produce instant death

254
Q

What is an air embolism?

A

Air bubbles into arterial tree, usually during cardiac procedures

255
Q

What is an infarct?

A

Area of ischemic necrosis

256
Q

What is a white infarct?

A

Bloodless infarct - when arterial obstruction occurs in dense, solid tissue

257
Q

What are some organs that can have a white infarct?

A

Kidneys, liver, heart

258
Q

What is a red infarct?

A

Hemorrhagic infarct - bloody because venous or arterial obstruction occurs in loose, spongy tissue or in the lungs or liver which have dual blood supplies

259
Q

Why do organs with dual blood supplies have red infarct?

A

One supply causes infarction while the other pumps blood into dead tissue

260
Q

What are four ways in which infarcts develop in predictable fashion?

A

Depending on

  • Whether organ has single or dual vascular supply
  • Rate at which obstruction develops
  • Sensitivity of downstream tissue to oxygen deprivation
  • Oxygen content of blood
261
Q

How does dual vascular supply affect the probability of infarct?

A

Dual vascular supply makes organs resistant to infarction

262
Q

Why is the kidney sensitive to infarction?

A

It is metabolically very active and burns oxygen quick let, arteries have few interconnections with other vessels

263
Q

What is a tissue that becomes infarcted quickly?

A

Brain neurons are very sensitive to hypoxia and die if deprived of oxygen for 3-4 minutes

264
Q

How does blood oxygen content influence infarction?

A

Low blood oxygen content may facilitate transformation of ischemia into infarction

265
Q

What is shock?

A

State of systemic low blood flow when cardiac output is reduced or effective blood volume is decreased

266
Q

What is often the end result of shock?

A

Multiorgan failure and death

267
Q

What are the types of shock?

A 
Hypovolemic
Cardiogenic
Obstructive 
Septic
(Neurogenic)
268
Q

What is another name for shock?

A

Circulatory collapse

269
Q

What factor in shock leads to circulatory collapse?

A

Decreased cardiac output

270
Q

What is hypovolemic shock?

A

Results from under filled vascular space, usually resulting from hemorrhage

271
Q

What is hypovolemic shock caused by?

A
  • Loss of fluid following burns or severe diarrhea, dehydration
  • Vasodilation may expand vascular space so effective blood volume is insufficient to maintain perfusion pressure
272
Q

What is a condition which results in marked vasodilation that can cause hypovolemic shock?

A

Anaphylaxis

273
Q

What is neurogenic shock?

A

Type of hypovolemic shock where a sudden loss of autonomic function from an acute, paralyzing spinal cord injury causes marked vasodilation

274
Q

How does fluid loss lead to hypovolemic shock?

A

Volume drop leads to inability to keep up cardiac output, causing shock

275
Q

How do burns cause hypovolemic shock?

A

Loss of hydration through the skin - can also cause septic shock due to infection

276
Q

How does anaphylaxis result in hypovolemic shock?

A

Swelling from increased permeability of vessels and edema lead to loss of fluid, and therefore inability to maintain cardiac output

277
Q

What is cardiogenic shock?

A

Pump failure and therefore loss of cardiac output, often occurs with myocardial infarction or other myocardial disease

278
Q

What does cardiac muscle lack in cardiogenic shock?

A

Lacks mechanical pumping power needed in order to maintain blood pressure

279
Q

What happens to the pumping power during an acute MI?

A

Left anterior wall is not pumping efficiently with a decreased ejection fraction

280
Q

What is cardiomyopathy?

A

Heart muscle diseases

281
Q

What is septic shock?

A

Associated with systemic microbial infection that induces an overall inflammatory response

282
Q

How does sepsis cause shock?

A

Contributes to a multifactorial component - it can lead to cardiogenic or hypovolemic shock

283
Q

What condition often results from septic shock?

A

DIC

284
Q

What is obstructive shock?

A

Caused by mechanical interference with cardiac output - will lead to cardiogenic shock

285
Q

What is the most common cause of obstructive shock?

A

Fluid accumulation around the pericardium (usually blood) which prevents cardiac filing

286
Q

What condition often results in cardiogenic shock because it results in fluid accumulation around the heart?

A

Cardiac tamponade

287
Q

What are some presentations of DIC?

A 
Decreased blood pressure
Tachycardia
Angiotensin increase
Aldosterone increase
ADH increase
288
Q

How does the body try to compensate for DIC?

A

When blood pressure falls, sympathetic nervous system vasoconstricts and increases the heart rate to try to compensate, the body tries to hold onto water

  • Angiotensin vasoconstricts
  • Aldosterone retains Na+ and water
  • ADH retains water
289
Q

What are the three stages of shock?

A

Nonprogressive, progressive, and irreversible

290
Q

What is non progressive shock characterized by?

A

Body’s reflex actions attempt to reestablish perfusion

291
Q

How does the sympathetic nervous system attempt to reestablish perfusion?

A

Tachycardia increases cardiac output, vasoconstriction increases peripheral resistance, both act to raise blood pressure

292
Q

How does the kidney attempt to reestablish perfusion?

A

Low blood flow to kidney stimulates the renin-angiotensin-aldosterone system:
Induces vasoconstriction
Stimulates kidney to retain sodium and water to increase blood volume

293
Q

What is progressive shock characterized by?

A

More severe hypoperfusion and metabolic imbalances, caused by hypoxia

294
Q

What does the body do during hypoxia in order to continue metabolism?

A

Converts to anaerobic metabolism

295
Q

What happens when the body starts to use anaerobic metabolism?

A

Body produces lactic acid in excess, causing acidosis and vasodilation and pooling of blood in extremities

296
Q

What happens when blood pools in extremities due to lactic acidosis?

A

Brain and abdominal viscera are deprived of oxygen - leads to more hypoxia and acidosis, starting a cycle

297
Q

What does the kidney try to do in response to acidosis?

A

Kidneys secrete bicarb to compensate for excess acids

298
Q

What does the body do overall in response to acidosis?

A

Increase respiration to exhale more CO2

299
Q

How does progressive shock turn into irreversible shock?

A

Without effective intervention, low blood pressure, decreased perfusion, further hypoxia, and more acidosis result, and continue in a vicious cycle

300
Q

What is irreversible shock?

A
  • Progressively severe hypoperfusion, hypertension, and acidosis
  • Decreased myocardial contractility
  • Leakage into blood of inflammatory mediators from dying cells
301
Q

What is the end result of irreversible shock?

A

Multiorgan system failure, death

302
Q

What happens during shock if the kidneys fail?

A

The body loses the ability to secrete bicarb and renin, worsening the condition

303
Q

What happens during shock if the myocardium loses contractility?

A

Worsens hypoperfusion and decreased cardiac output

304
Q

What relationship do the heart and kidneys have, in relation to their organ failure?

A

Direct relationship - if heart fails, kidney soon will too, and vice versa

From Flashcardlet (133 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions