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67 Cards in this Set
- Front
- Back
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Def of Hypoxia
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Inadequate oxygenation
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MCC of Hypoxia
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Coronary Artery atherosclerosis
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Inc Alveolar PCO2=
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Dec PaO2
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Ventilation defect:
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Perfused but not ventilated, admin of 100% O2 does not inc PaO2, produces intrapulmonary shunting
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Perfusion defect:
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Ventilated but not perfused, admin of 100% O2 inc PaO2
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Anemia
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Normal PaO2 and SaO2
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MetHb (ex. Pt coming out of Rocky mountains giving O2 doesn't correct), Causes: oxidizing agents, def of MetHb reductase
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Heme Fe3+, Tx- IV methylene blue, Vit C
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CO poisoning:
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Normal PaO2, dec SaO2
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Treat CO poisoining w/
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100% O2
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CO and CN inhibit:
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Cytochrome oxidase
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Mitochondrial Toxins:
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Alcohol and salicylates, cause protons to move into mitochon matrix- can lead to hyperthermia comm complication
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Factors causing a L shift in the OBC
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Dec 2,3 BPG, CO, alkalosis, metHb, fetal Hb, hypothermia
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At high altitudes
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Alkalosis act phosphofructokinase ult inc 2,3 BPG
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Most adversely affected cell in tissue hypoxia
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Neurons
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ST segment depression
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Sign of subendocardial ischemia
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Tissue hypoxia leads to swelling because:
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Na goes into cell (b/c impaired Na/K pump) leads to water following
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Lactate
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Decreases intracellular pH and denatures structural and enzymatic proteins
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Cytochrome c
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Activates apoptosis
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Free radicals:
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Damage membranes and DNA
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Glutathione peroxidase
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Present in pentose phosphate pathway
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MCC of drug induced fulminant hepatitis
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Acetaminophen
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Reperfusion injury
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O2 and inc in cytosolic Ca
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SER hyperplasia occurs with:
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Inc drug metabolism
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I Cell Disease
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Absent primary lysosomal enzymes,mannose-6 phosphate marker (no hydrolytic enz needed to degrade compounds)
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Chediak Higashi Syndrome (CHS)
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Leukocyte defects (cant produce phagolysosomes)in chemotaxis, degranulation, killing
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Marker for intermediate filament degradation
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Ubiquitin
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MCC of fatty change
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Alcohol
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Increased G3-P
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Responsible for fatty change, substrate for triglyceride synthesis
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Serum ferritin decreased
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Iron Deficiency Anemia
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Hemosiderin
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Ferritin degradation product
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Dystrophic calcification
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Calcification of necrotic tissue
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Metastatic calcification
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Calcification of normal tissue
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Inc phophate
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Drives Ca into tissues
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Atrophy
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Dec size of tissue or organ
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Defect in spectrin
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RBC spherocytosis
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Causes of Atrophy
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Dec horm stim, dec innervation, dec blood flow, dec nut, inc press, occlusion of secretory ducts
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Hypertrophy
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Inc cell size
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Hyperplasia
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Inc # of cells
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Cell types
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Labile (stim cells bone marr, basal cells in epi), stable (hepatocytes, astrocytes, smooth musc) and permanent (neurons, skel, cardiac musc)
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Erythropoeitin made
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Endothelial cell of peritubular capillary
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All hormone stimulated glands undergo
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Hyperplasia (not hypertrophy)
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Metaplasia
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One cell type replaces another (inc risk of cancer)
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Dysplasia
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Disordered cell growth, may progress to cancer
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Coagulation necrosis
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Preservation of structural outlines
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Cerebral infarct
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Liquefactive not coagulative necrosis
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MCC of caseous necrosis
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Tuberculosis
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Acute pancreatitis
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Enzymatic fat necrosis (pain radiating to back, Ca stains blue-dystrophic tissue, amylase and lipase inc, alcohol is cause)
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Apoptosis
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Programmed cell death
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Caspases
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Group of cysteine proteases, when activated induce apoptosis
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Tumor suppressor gene
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TP53, guardian of the cell
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Apoptosis gene
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BAX
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Antiapoptosis gene
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BCL2
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AST
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Marker of diffue liver cell necrosis, mitochondrial enz perf inc in alc ind liver disease
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ALT
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Marker of diff liver cell necrosis, more spec for liver cell nec than AST
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CKMB
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Isoenzyme inc in acute myocardial infarct or myocarditis
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Amylase and Lipase
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Marker enz for acute pancreatitis, Lipase more specific, Amylast also inc in salivary gland inflamm
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Wet gangrene
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Superimposed anaerobic infection of dead tissue, us diabetics (C. perf) liquefactive necrosis
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Dry gangrene
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Infarction resulting from ischemia, coagulation necrosis
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Lipofuschin (wear and tear pigment)
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Indigestible lipid derived from lipid peroxidation of cell memb, occurs in atophy and free rad dam of tissue
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Bilirubin Accum path:
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Kernicterus: fat soluble unconjugated bilirubin derived from Rh hemolytic dis of newborn, (basal ganglia) causing perm damage
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Cholesterol Accum path:
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Atherosclerosis (chol laden sm musc and macro-foam cells); Xanthelasma (yell plaq on eyelid, chol in macrophages)
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Glycogen Accum path:
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DM: inc glycogen in prox renal tub cells (insens to insulin); Von Gierke's: def of G6PD; excess in hepatocytes and renal tub cells
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Hemosiderin and Ferritin Accum path:
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Iron overload d/o; excess deposition in parenchymal cells, leads to free radical damage and organ dysfunction; inc in serum ferritin
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Melanin Accum path:
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Addison's disease-destruction of adrenal cortex, hypercortisolism inc ACTH excess syn of melanin and diff pigmentation of the skin and muc memb
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Triglyceride Accum path:
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Fatty liver: triglyceride in hepatocytes pushes the nucleus to periphery
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Athracotic pigment: exogenous Accum
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Coal worker's pneumoconiosis: phagocytosis of black anthracotic pigment (coal dust), by alveolar macophages (dust cells)
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Lead
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Lead poisoning: lead deposits in nuc lf prox renal tub cells (acid fast), contributes to nephrotoxic chg in prox tub
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