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74 Cards in this Set

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Clinical significance of hypotonic and hypertonic solutions.
Hypotonic gets h20 to cells, hypertonic gets h20 to blood.
How is osmolarity regulated?
By maintaining approximately equal numbers of particles on both sides of the membrane.
Clinical significance of the osmotic diuretic, Mannitol?
Helps us deal with water intoxication (cerebral edema, delirium, unconsciousness, hyperosmolar coma, death).
What causes Diabetes Insipidus?
ADH deficiency (too much pee)
What can yield imperfect information regarding a person's ability to maintain a normal fluid balance status?
Osmolarity.
What does urine osmolarity tell us?
Renal Function.
What does serum osmolality tell us?
Sodium, BUN, and blood glucose levels.
How is osmolarity different than molarity?
It measures moles of solute particles rather than moles of solute (some solutions can dissassociate in solution, others cannot).

Ex: 1M NaCl=2 Osmolar Solution (Na+ and Cl-)
Osmoles of solute per kilogram of H20?
Osmolality
D5W
5% glucose=5 grams of glucose/100mL=5 grams/dL
Concentration expression
%=100mL=1dL=0.1L and it's g/%

Ex: 10%=10grams/100mL
Hypo, Eu, and Hyper
Hypo= Not enough
Hyper= Too much
Eu/Iso= Just right
Cation
Anion
ion/electrolyte with positive charge

ion/electrolyte with negative charge
Anion Gap Formula
(Na+K) - (HCO3+Cl)
Bicarb loss, mystery anions.
Metabolic Acidosis
Range of Anion Gap
normal 10-12
What are mystery anions?
Anions that cannot be measured through blood tests.
(ex/ lactate, phosphate, sulfate, ketoacids, albumin)
Why does the anion gap appear?
When there are losses in bicarb without subsequently increasing Chloride, other anions step up to maintain electroneutrality.
Decreased Bicarbonate related to?
Acidosis
Bicarb decreases, Chloride Increases
Normal Anion Gap
Hypoalbuminemia: Bicarb/Cl decreases in a....
Low Anion Gap
The charge that many solutes in the body has refers to?
Equivalents (E) or Milliequivalents (mEq)
The tendency of an ion to gain or loss an electron is formulated by...?
mEq-mMol x valency
The measure of the acidity or alkalinity of a solution (measured by a log scale)
pH
Formula to measure acidity or alkalinity of a solution is?
pH= -log [H+]

ex/ pH of 0.1 M HCl=1
What is the relationship of bicarb and CO2 to the maintenance of pH?
Acts as a buffer. Any substance that tries to make pH (HCO3/CO2) has to maintain a pH plasma between 7.35 and 7.45.
What determines the impact of buffer pairs on pH?
(equation)
Henderson-Hasselback

pH of HCO3/CO2=6.1 + log (24/1.2)
=6.1 + 1.3
=7.4
Alterations in pH are described as?
Metabolic (HCO3) or Respiratory (CO2)
Metabolic Alkalosis (HCO3 increase) due to...
Vomiting
Metabolic Acidosis (HCO3 decrease) due to...
Running hard (lactate-->metabolic acidosis)
Diabetes with Ketoacidosis (IDDM)
Respiratory Acidosis (CO2 decrease) due to...
Hyperventilation
Respiratory Acidosis (CO2 increase) due to...
Hypoventilation
Alterations in pH effect which electrolytes?
Hydrogen and Potassium
Hyperglycemia resulting from metabolic acidosis results in what electron loss?
Hypokalemia
What treats Hypokalemia during metabolic acidosis?
Insulin (by pulling K+ back into the cells)
X-rays, UV therapy, Visible light, Radiation Therapy.
Electro Magnetic Radiation (EMR)

*different types of EMR=different physiological effects
What are Carbohydrates?
Chains of hydrated carbon.
What are important Carbohydrates?
Glucose (monosaccharide)
Fructose (Monosaccharide)
Sucrose (table sugar glucose/fructose) disaccharide
Lactose (milk sugar) Galactose + glucose disaccharide
Carbohydrate Functions?
Excess glucose stored as glycogen.
Balances storing excess glucose and breaking down glycogen
Hormonal controls: insulin, epinepherine, glucagon
What is glycogenesis?
Glycogen formation. Excess glucose is stored as glycogen.
What is Glycogenolysis?
Glycogen splitting. Glycogen break down into glucose to satisfy metabolic needs.
Fuel reserves beyond 1-2 days worth of glycogen converts to?
Fatty acids and stored in adipose tissue.
Long term elevation of glucose (can have adverse effects)
glucose toxicity
What is glycosolation/glycatation?
When glucose sticks to proteins and changes their function-this is bad because proteins have several other jobs to do!
What is the HbA1C test?
Glycosylated hemoglobin Measures the elevation over baselining diabets and can give average blood glucose level covering 90-120 days (based on RBC lifespan).
Relation of amino acids to proteins?
Amino Acids are the building blocks to make proteins.
20 are naturally made.
How are amino acids classified?
Essential (from diet)
Non-essential (made by the body)
Gluconeogenic can be metabolized into?
Glucose
Ketoneogenic can be metabolized into?
Ketones (ex/ Atkins diet)
Protein molecules that catalyze chemical reactions are?
Enzymes
Enzymes increase or reduce the energy for a reaction to take place?
Reduce (many rxns have a certain amount of energy that must be put in before it can proceed-even if it ends in released energy. ex/ glycolysis)
Enzymes that can be found in cells. This presence indicates damage to the cell.
CPK, CK-MD, Troponin (all indicate MI)
Microsomal enzymes are primarily produced in the?
Liver (can be regulated by drugs, hormones, nutrition)
Increases the rate of steroidal breakdown
Cytochrome p450
(induced by smoking, meds, metabolizes many drugs
ex/smoking and BC
Makes DNA from RNA
Reverse Transcriptase
(ex/ HIV)
Fuels, Enzymes catalyzed chemical reactions, Hormes, Hormone receptors generate second messengers, Antigens, Antibodies, Clotting factors, Structural proteins (actin, myosin, tropomyosin, troponin), carries (albumin, TPG, SHBG, transferrin, hemoglobin)
The multiple roles played by proteins
What are lipids?
Lipds are water insoluble organic compounds (fatty acids, triaglyceroles/triglycerides, phospholipids, lipoproteins, cholesterol. steroid hormones, vitamin k, prostaglandins)
What are fatty acids?
An important fuel force; saturated or unsaturated; spare proteins during fasting.
What are triglycerides?
Fatty acids + glycerol backbone; major energy storage form; key to circulating plasma lipoproteins like VLDL or chylomicrons.
What are phospholipids?
major component of the cell membrane. similiar to TG's, glycerol + 2 fatty acids + phosphate group +copound; their hydrolysis/breakdown is in many cases coupled to receptors for hormones or neurotransmitters & their breakdown generates second messengers.
What are lipoproteins?
VLDL, LDL, HDL, chylomicrons, related to CVD/atherosclerosis
Principally in nucleus, some in mitochondria and organelles capable of self-reproduction, exists in DOUBLE helix, transmits genetic info.
DNA
In nucleus & cytoplasm (ribosomes), nucleolus and chromosomes; single strand; underlies synthesis of all proteins
RNA
What are the important functions of the cell membrane?
Contact inhibition, transduction, immune surveillance, transport.
cellular growth, division, motility is LIMITED when cells are in CLOSE CONTACT with one another; failure of this process can result in inappropriate cell growth and CA.
Contact Inhibition
Turns extracellular signals to intracellular ones, occurs after interaction of a hormone/neurotransmitter w/ its specific receptor on the membrane
Transduction
How can the Number of receptors change during transduction?
may go up or down regulate, may become more or less numerous and change cells response to a given level of hormone.
What are examples of the number of receptor changes during transduction?
Insulin resistance in diabetes
Type II NIDDM & denervation hypersensitivity, myasthenia gravis (autoimmune weakness)
Endogenously produced antibodies binds to and impairs which receptor during transduction
Acetylcholine
Transduction or stimulus-response coupling results in?
generation of Second Messangers a cAMP, prostaglandins (inflammation), inostitiol phosphates (cell growth, migration, differentiation, apoptosis), Ca++ or diacylglycerol
Generated by hydrolysis or breakdown of membrane phospholipids mediated by phospholipases such as phospholipase C or D?
Second Messengers
What is Immune Surveillance?
membranes contain class I or class II antigens which recognize and activate immune cells, detect new antigens on tumor cells, allow cells to distinguish between self and invader.
Effective diffiusion barrier=
Transport
Lipid soluble molecules easily transverse (O2, CO2, N2, lipid anesthetics) and 40% of energy consumed is used to operate the Na/K ATPase (The Pump) during?
Transport