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67 Cards in this Set

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