Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/310

Click to flip

310 Cards in this Set

  • Front
  • Back
erythrocyte sedimentation rate in old age indicates
a disease process
enhancement of liver cytochrome P450 system
increased synthesis of GGT...excellent marker for alcoholic liver disease
what is an excellent marker for alcoholic liver disease?
enhancement of cytochrome P450 system
increased production of NADH causes
lactic acidosis-pyruvate --> lactate
fasting hypoglycemia
pyruvate is not available for gluconeogenesis
hypertriglyceridemia
1,3 biphosphoglycerate-->dihydroxyacetone phosphate-->glycerol 3-phosphate-->triglycerides
lab test alterations in alcoholics
enhancement of liver cytochrome p450 system, increased production of NADH causes lactic acidosis and fasting hypoglycemia and hypertriglycceridemia...also causes increase in ketoacid synthesis and increase in fatty acid synthesis and hyperuricemia and increased anion gap metabolic acidosis
acidosis or alkalosis with alcoholics?
anion gab metabolic acidosis because of lactate
lab test alterations in smokers
respiratory acidosis, hypoxemia, increased CO, secondary polycythemia, absolute neutrophilic leukocytosis
acidosis or alkalosis in smokers?
respiratory acidosis
plasma/serum turbidity due to
increase in triglycerides, NOT cholesterol
triglycerides are carried by
lipoproteins (85% chylomicrons) and 55% VLDL
triglycerides are falsely increased after
eating
chylomicrons are __- dense than VLDL
less dense
chylomicrons form a ___ in plasma
wsupranate
VLDL forms a ___ in plasma
supranate (more protein, so it doesn't float on surface of plasma)
increased turbidity inteferes with
measuring enzymes and serum Na, so it's falsey low values
albumin binds
40% of total calcium in blood
how much calcium is free, ionized calcium and metabolically active?
47%
low serum albumin ___ calcium bound to albumin
decreases, so it's hypocalcemia...PTH is normal
normal females have __ Barr bodies. Males have __ Barr bodies
females = 1 ; males = 0
Klinefelter syndrome has __ Barr body
1
Turner syndrome has __ Barr body
0
cystic fibrosis = deletion of
3 nucleotides coding for phenylanine
cystic fibrosis on chromosome
7
Cystic fibrosis transmembrane regulator is defective and
degraded before reaching the cell membrane after it leaves the Golgi apparatus
Tay sachs is
4 base insertion produces a frame shift
tay sachs codes for defective
hexosaminiadase
sickle cell disease/trait is what type of mutation?
point mutation involving thymidine replaceed by adenine
sickle cell codes for __ instead of ___
valine instead of glutamic acid in 6th position of B globin chain
B thalassemia major is what type of mutation?
point mutation produces a stop codon leading to termination of DNA transcription of B globin chain
trinucleotide repeat disorders gets progressively worse in future generations. This is called
anticipation
Huntington's is wat type?
autosomal dominant
Fragile X syndroms is
SXR, female carriers with trinucleotide repeats eventually become symptomatic
Friederich's taxia is
autosomal dominant
myotonic dystrophy is
autosomal dominant
nondisjunction is due to
unequal separation of chromosomes in first phase of meiosis
mosaicism is
nondisjunction nof chromosomes in mitotic division in the early embryonic period. 2 chromosomally different cell lines are derived from a single fertilized egg
mosaicism usually involves
sex chromosomes such as gonadal dysgenesis with XO/XX, XO/XY
Translocation
1 part of a chromosome is transferred to a non-homologous or homologous chromosome
what is balanced translocation?
if the translocated fragment is functional
What is Robertstonian translocation?
in Down's syndrome, the balanced translocation with a translocation between 2 acrocentric chomosomes (chroms 14 and 21 produce 1 long chromosome)
In Down's, all of the #___ are functioning
all #21s are functional. Get 1 #21 from father, 1 14-21 and 1 normal 21 from affected mother
cri-du-chat is
deletion of short arm of chromosome 5. mental retardation, cries like a cat
microdeletion syndromes
loss a small part of 1 chromosome. You can only identify it with high resolution
Prader-Willi syndrome
microdeletion of chromosome 15
chromsome 15 deletion is of what origin?
paternal
Prader Willi syndrome involves
obesity, hypogonadism, mental retardation
microdeletion of chromosome 15 can also cause
Angelman syndrome
What is Angelman sydrome?
child always happy/laughing, but can't talk.
What diseases are genomic imprinting?
Angelman and Prader Willi
genetic disorders in Jews
factor 12 deficiency, Gaucher's disease, tay sachs
genetic disorders in Northern Europeans
cystic fibrosis, MC genetic disease interfering with ability to reproduce
genetic disorders in Mediterranean
GP6D, sickle cell, B thalassemia
genetic disorders in african americans
sickle cell, B/alpha thalassemia, G6PD, hereditary persisitence of HgbF
genetic disorder in southeast asians
alpha thalassemia
genetic syndrome associated with advanced maternal age
21
Down's syndrome folds
epicanthal with upward slanting
Down's reproductive
all males are sterile, and females have 50% chance of having a child with Down's
Trisomy 18
Edward's syndrome = severe mental retardation, clenched hands with overlapping 2nd and 5th fingers. rocker bottom feet
Trisomy 13
Patau's syndrome = cleft/lip palate, severe mental retardation, polydactyly, cystic kidneys
disorders in dexcending order of frequency
AD>AR>sex linked recessive>sex linked dominant
Sex linked recessive
affected males transmit disease to both daughters, but no sons. daughters are asymptomatic carriers.

Female carrier transmits to 50% of boys and 25% of females
sex linked dominant
males and heterozygous females both express disease
what is the most common autosomal dominant disease?
von williebrand's
familial hypocholesterolemia is
autosomal dominant
most autosomal recessive are
enzyme deficiencies
most autosomal dominant disorders are
strucutural defects in proteins and receptors
inborn errors of metabolism are
autosomal recessive
acute intermittent porphyria is
autosomal dominant
C1 esterase inhibitor deficiency is
autosomal dominant
G6PD is
Sex linked recessive
lesch-nyhan is
sex linked recessive
cystic fibrosis is
autosomal recessive
sickle cell trait/disease is
autosomal recessive
hemochromatosis is
autosomal recessive
wilson's disease is
autosomal recessive
the most common sex linked recessive disorder is
fragile X
SCID is
sex linked recessive
Wiskott-aldrich syndrome is
sex linked recessive
esticular feminization is
sex linked recessive
chronic granulomatous disease of childhood is
sex linked recessive
Bruton's agammagloulinemia is
sex linked recessive
fragile X is a
MC mendelian disorder associated with mental retardation and macroorchidism at puberty
what is the repeat in Fragile X?
CGG
Lesch nyhan symdrome
deficiency of HGPRT = no inhibition of PRPP in purine metabolism. there is hyperuricemia, mental retardiation, and self mutilation
sex linked dominant disorders. affected women transmit symptomatic disease to
50% of her daughters and 50% of her sons
sex linked dominant disorders. affected males transmit symptomatic disease to
all daughters and no sons
what are sex linked dominant disorders?
familial hypophosphaternia (defect in proximal reabsorption of phosphate and conversion of 25(OH)D3 to 1,25 OH-D3... and alport's syndrome
multifactorial polygenic inheritance are
multiple small mutations plus the effect of the environment.
what are examples of multifactorial polygenic inheritance?
cleft lip or palate, congenital heart disease, coronary artery disease, gout, type 2 diabetes, essential hypertension, open neural defects, congenital pyloric stenosis
mitochondrial DNA disorders - women transmit symptomatic abnormal allele to
all the children
mitochondrial DNA disorders - men transmit symptomatic abnormal allele to
none of the children
Leber's hereditary optic neuropathy
mitochondrial DNA disorder. myoclonic epilepsy. lactic acid with stroke
cystic fibrosis prevalence is
1/2500
the number of couples at risk for cystic fibrosis
1/25 x 1/25 = 1/625
what is the carrier rate of cystic fibrosis?
1/25
deformations occur in
the last 2 trimesters after organs have developed
oligohydramnios produces
facial and limb abnormalities (called Potter's facies)
What is a malformation?
distrubance (drugs, infection) that occurs in morphogenesis of an organ
what is hypospadias?
faulty closure of urethral folds
what is epispadias?
a defect in geital tubercle
when does the neural tube normally close?
days 23-28
what do teratogens do?
interfere with formation of mitotic spindle, interfere with production of ATP, interfere with gene production
what does cocaine do on the mother?
hypertension and abruptio placenta
hemochromatosis is
autosomal recessive
wilson's disease is
autosomal recessive
the most common sex linked recessive disorder is
fragile X
SCID is
sex linked recessive
Wiskott-aldrich syndrome is
sex linked recessive
esticular feminization is
sex linked recessive
chronic granulomatous disease of childhood is
sex linked recessive
Bruton's agammagloulinemia is
sex linked recessive
fragile X is a
MC mendelian disorder associated with mental retardation and macroorchidism at puberty
what is the repeat in Fragile X?
CGG
Lesch nyhan symdrome
deficiency of HGPRT = no inhibition of PRPP in purine metabolism. there is hyperuricemia, mental retardiation, and self mutilation
sex linked dominant disorders. affected women transmit symptomatic disease to
50% of her daughters and 50% of her sons
sex linked dominant disorders. affected males transmit symptomatic disease to
all daughters and no sons
what are sex linked dominant disorders?
familial hypophosphaternia (defect in proximal reabsorption of phosphate and conversion of 25(OH)D3 to 1,25 OH-D3... and alport's syndrome
multifactorial polygenic inheritance are
multiple small mutations plus the effect of the environment.
In addition to increased birthweight and hyperinsulinism in diabetes, what are other effects of diabetes?
open neural tube defects, cleft lip/palate, respiratory distress syndrome (because less surfactant production)
What does DES do?
interferes with mullerian structures in female fetus causing abnormalities in tubes, uterus, cervix, upper 1/3 of vagina, clear cell adenocarcinoma of vagina/cervix, fertility problems and implantation problems with problems in uterus and fallopain tubes
what is the most common teratogen in the US?
alcohol
what does alcohol do during pregnancy?
mental retardation, intrauterine growth retardation, maxillary hypoplasia, microcephaly, atrial septal defects, hypoglycemia
what does heroin do in pregnancy?
small for gestational age, irritability/hyperactivity, high pitched cry with excessive hunger, salivation, sweating, tremors, fist sucking. temperature instability, seizures
what does isotretinoin do?
3Cs:
craniofacial abnormalities = small ears, micrognathia, cleft palate

cardiac defects

CNS malformations - hydrocephalus, microcephaly
What does phenytoin do during pregnancy
nail hypoplasia, CNS abnormalities, cleft lip/palate, congenital heart disease
what does smoking do during prengnacy?
placental ischemia, increased risk for thrombosis in placental vessels, low birth weight
what happens during pregnancy with mothers with lupus?
complete heart block
What does thalidomide do during pregnancy?
limb abnormalities, absent limbs (amelia) and phocomelia (seal like limbs)
what is amelia?
absent limbs
what is phocomelia?
seal like limbs
What does valproate do during pregnancy?
open neural tube defects
what does warfarin do during pregnancy?
CNS defects and nasal hypoplasia
what are congenital infections?
toxoplasmosis, other (HBV, AIDS< parvovirus, syphilis), Rubella, CMV, herpes TORCH
what infections can be transmitted by breast feeding?
HIV, HBV, CMV
what infections can be transmitted by cervical infection?
HSV2, chlamydia
what infection can be transmitted during delivery?
HBV
what is the most common in utero viral infection?
CMV
what is the most common complication from CMV?
bilateral sensorineural hearing loss
what does CMV do to fetuses?
bilateral sensorineural hearing loss
periventricular calcification
hepatosplenomegaly
chorioretinitis-->blindness
what does urine culture reveal in newborns born with CMV?
large, basophilic intranuclear inclusions (owl eyes) in renal tubular cells
how do you treat newborns with CMV?
gancliclovir. if that doesn't work, then foscarnet
how is rubella transmitted to the fetus
transplacental
when is the highest incidence of congential abnormalities in fetuses with mothers with rubella?
first 8 weeks
what does rubella do to fetus?
interveres with protein synthesis and produces vasculitis. it causes sensorineural deafness, cataracts, and patent ductus arteriosus
what does rubella do to fetuses heart?
patent ductus arteriosus
how is toxoplasmosis transmitted to a fetus?
transplacental
when does toxoplasmosis most commonly get transmitted?
later in pregnancy
what does toxoplasmosis do to fetus?
chorioretinitis-->blindness
calcifications in basal ganglia
how do you identify toxoplasmosis in fetus?
Sabin Feldman dye test that uses live organisms
How is HSV2 transmitted to fetus?
through birth control in women actively shedding the virus. so they should deliver via c section
what does HSV2 do to newborn?
local or systemic disease: encephalitis, skin infections
how is HSV2 treated in newborns?
acyclovir
how is syphilis transmitted to the fetus?
transplacental
when is syphilis transmitted to fetus?
usually NOT during the first 5 months because anatomical barriers prevent access to the fetal circulation
what is the most common sign of syphilis in a newborn?
hepatomegaly
what are signs of syphilis in newborns?
osteochondritis, hepatomegaly, mucocutaneous lesions, pneumonia alba (lobar pneumona) sniffles,
what are common signs of late neonatal syphilis (more than 2 years)
frontal bossing is most common. also saber shins, rhagades (perioral linear scars), Hutchinson's triad-teeth (notched upper central incisors called Hutchinson's teeth and malformed molars called mulberry molars...interstitial keratitis (blindness), sensorineural hearing loss
how do you treat syphilis in children?
penicillin
What does congenital chicken pox cause?
chorioretinitis = potential for blindness
limb hypoplasia
cortical atrophy in the brain
vesicular skin lesions
when you get old, what happens to immune system?
decreased T cell function, loss of isohemagglutinins to blood antigens (may not develop hemolytic transfusion if blood is mismatched)
what is a common skin change in old people?
senile purpura over the dorsum of hands and lower legs where bumping into objects occurs, decreased sweating
what is common in the GI tract when you get old?
decreased gastric acidity, decreased colonic motility (constipation-->diverticulosis), decreased activity of hepatic cytochrome P450 (danger of drug toxicities)
what is common renal problems when you get old?
decreased GFR with reduction in creatinine clearance (risk of drug toxicity due to slow clearance of drugs)
what is the usual cause of pneumonia in old people?
strep pneumonia
what is the most common type of stroke in old people?
aterhosclerotic type
what is the most common cause of lbindness in the elderly?
macular degeneration
what is the precursor to squamous skin cancer?
actinic (solar) keratosis
what are the top 5 causes of death in males and females?
heart disease, cancer, stroke, COPD, motor vehicle
what are the 3 top causes of death in children 1-14?
accidents (motor vehicle, falls, burns); cancer; congenital anomalies
what are the 3 top risk factors for morbidity and mortality in the US?
cigarette smoking, dietary factors/activity patterns, high saturated fat/lack of exercise/alcohol abuse
when drowning, what is destroyed in the lungs?
surfactant --> leads to atelectasis with intrapulmonary shunting --> diffuse alveolar damage and initiates spasm in bronchioles.
what is immediate COD in drowning?
cardiac arrhythmia
third degree burns are
painless
second degree burns involve
entire epidermis
third degree burns include
extensive necrosis of epidermis/adnexa
3rd degree burns can cause what type of cancer
squamous cell
how do you identify toxoplasmosis in fetus?
Sabin Feldman dye test that uses live organisms
How is HSV2 transmitted to fetus?
through birth control in women actively shedding the virus. so they should deliver via c section
what does HSV2 do to newborn?
local or systemic disease: encephalitis, skin infections
how is HSV2 treated in newborns?
acyclovir
how is syphilis transmitted to the fetus?
transplacental
when is syphilis transmitted to fetus?
usually NOT during the first 5 months because anatomical barriers prevent access to the fetal circulation
what is the most common sign of syphilis in a newborn?
hepatomegaly
what are signs of syphilis in newborns?
osteochondritis, hepatomegaly, mucocutaneous lesions, pneumonia alba (lobar pneumona) sniffles,
what are common signs of late neonatal syphilis (more than 2 years)
frontal bossing is most common. also saber shins, rhagades (perioral linear scars), Hutchinson's triad-teeth (notched upper central incisors called Hutchinson's teeth and malformed molars called mulberry molars...interstitial keratitis (blindness), sensorineural hearing loss
how do you treat syphilis in children?
penicillin
What does congenital chicken pox cause?
chorioretinitis = potential for blindness
limb hypoplasia
cortical atrophy in the brain
vesicular skin lesions
when you get old, what happens to immune system?
decreased T cell function, loss of isohemagglutinins to blood antigens (may not develop hemolytic transfusion if blood is mismatched)
what is a common skin change in old people?
senile purpura over the dorsum of hands and lower legs where bumping into objects occurs, decreased sweating
what is common in the GI tract when you get old?
decreased gastric acidity, decreased colonic motility (constipation-->diverticulosis), decreased activity of hepatic cytochrome P450 (danger of drug toxicities)
what is common renal problems when you get old?
decreased GFR with reduction in creatinine clearance (risk of drug toxicity due to slow clearance of drugs)
malignant hyperthermia results from
defective Calcium channels in the muscle sarcoplasmic reticulum
how do you treat malignant hyperthermia?
dantrolene
what is destroyed in lungs during drowning?
surfactant
what is the peak sensitivity to ionizing radiation?
G2 and M phase
What is G2?
synthesis of tubulin for mitotic spindle
What is M phase?
assembly and disassembly of mitotic spindle
What tissues are highest radiosensitivty?
hematopoietic cells lymphocytes>granulocytes>platelets>mature RBCs
what is the tissue with the lowest radiosensitivity?
brain
what is the earliest change from total body irradiation?
lymphopenia>thrombocytopenia>bone marrow hypoplasia
what does UVB do to the skin?
mutagen - thymidine dimers
what is the most common skin cancer?
basal cell carcinoma
what is the precursor to squamous carcinoma?
actinic/solar keratosis
__ventilation is essential at high altitude
hyperventilation
what type of acidosis/alkalosis is present in high altitude?
respiratory alkalosis
what drug prevents acute mountain sickness?
acetazolamide, a carbonic anhydrase inhibitor that produces metabolic acidosis - compensates for the respiratory alkalosis that you normally see
what causes rigor mortis?
decrease in ATP in muscle
where is ethanol reabsorbed?
small intestine (75%), stomach (5%)
what aprtially metabolizes alcohol?
alcohol dehydrogenase
what is the liver metabolism of alcohol?
alcohol --> acetaldehyde + NADH --> acetate + NADH --> acetyl CoA
what enzymes are involved in liver metabolism of alcohol?
alcohol to acetaldhyde is done by alcohol dehydrogenase

then aldehyde dehydrogenase converts it to acetate and then to acetyl coA
what blocks aldehyde dehydrogenase?
disulfiram
what is legally drunk?
100mg/dL
what level of alcohol will cause stupor or coma?
300-350 mg/dL
what level of alcohol will cause death?
500 mg/dL
when does delirium tremens occur?
3-5 days after complete withdrawal
what is delirium tremens?
tremulousness, disorientation, visual hallucinations, agitation
what is treatment for delirium tremens?
IV diazepam and thiamine
what is Mallory Weiss syndrome?
tear of the distal esophagus/proximal stomach from retching
What is Boerhave's syndrome?
rupture of distal esophagus/proximal stomach from retching
what is esophageal varicies?
effect of portal vein hypertension due to alcoholic cirrhosis
how does alcohol cause hemosiderosis?
alcohol increases reabsorption of iron
what type of hyperlipidemia does alcohol cause?
type IV. increases synthesis of VLDL
what type of pneumonia is caused by alcohol
Klebsiella pneumonia
what type of cancer can be caused by alcohol?
squamous: oropharynx, midesophagus, larynx,

adenocarcinoma:pancreas, liver
what type of cerebellar degeneration occurs in CNS/PNS?
Hu and Yo antibodies
how do you measure nicotine intake?
measure plasma/urine levels of cotinine
what is the most common genetic defect in smoking-induced cancer?
nicotine inactivates p53 suppressor gene by a point mutation on chromosome 17
what drugs cause interstitial pulmonary fibrosis?
amiodarone, bleomycin, busulfan, cyclophosphamide, nitrofurantoin, nitrosourea, methysergide, methotrexate, procarbazine
what does methysergide cause?
pulmonary fibrosis, retroperitoneal fibrosis, Raynauds
what do meat packers get exposed to?
polyvinyl chloride. increased risk of hepatic angiosarcoma
what do dry cleaners get exposed to?
CCl4 with liver necrosis due to free radicals
what do rubber/chemical industry get expossed to?
benzene = aplastic anemia, leukemia
what do painters get exposed to?
methylene chloridde = converted into carbon monoxide
what do petroleum industry people get exposed to?
benzene, polycyclic hydrocarbons =lung cancer
what do sewer workers get exposed to?
hydrogen sulfide gas: sulfhemoglobinemia
if you overdose on rubbing alcohol
metabolic end product in the liver is acetone. there is no metabolic acidosis (unlike other alcohols)...deep coma with hyporeflexia
what if you overdose on methyl alcohol (wood's alcohol)
increased anion gap meabolic acidosis...optic neuritis and potential for blindness.
what is wood's alcohol converted to
formic acid
what is treatment for wood's alcohol/methyl alcohol poisoning?
IV ethanol is the competitive antagonist
what is antifreeze (ethylene glycol) converted into?
oxalic acid
if you overdose on rubbing alcohol
metabolic end product in the liver is acetone. there is no metabolic acidosis (unlike other alcohols)...deep coma with hyporeflexia
what if you overdose on methyl alcohol (wood's alcohol)
increased anion gap meabolic acidosis...optic neuritis and potential for blindness.
what is wood's alcohol converted to
formic acid
what is treatment for wood's alcohol/methyl alcohol poisoning?
IV ethanol is the competitive antagonist
what is antifreeze (ethylene glycol) converted into?
oxalic acid
why does antifreeze cause renal fialure?
calcium oxalate crystals obstruct the lumens
how do you treat antifreeze poisoning?
ethanol IV. it's a competitive antagonist of methyl alcohl for alcohol dehydrogenase
what does mercury poisoning cause?
ATN involving proximal tubules
how do you treat mercury poisoning?
dimercaprol
arsenic poisoning smells like
garlic odor
arsenic poisoning causes what type of diarrhea?
rice water, similar to cholera
what does the skin look like after arsenic poisoning?
gray skin with dark macules
arsenic poisoning causes what to the kidneys?
ATN involving proximal tubules
what is the treatment for arsenic poisoning?
dimercaprol
what does mushroom poisoning inhibit?
inhibits RNA polymerase
what are symptoms of mushroom poisoning?
abdominal pain/vomiting, bloody diarrhea, jaundice, extensive fatty change
what are symptoms of petroleum product disorders?
euphoria (drunk acting) when inhaled or ingested. toxic doses cause convulsions, tinnitus, pulmonary edema
what is strychnine poisoning?
CNA stimulant that blocks postynaptic inhibition. it's similar to tetanus. it causes convulsions, opishotonus, risus sardonicus, death
perfusion defect
pulmonary embolus
no perfusion, only ventilation
increase in dead space
if give 100% Oxygen, get the PO2 up
ventilation defect
give 100% oxygen, PO2 doesn't go up.
then you have a shunt
diffusion defect
something in interface like fibrosis/sarcoidosis/pulmonary edema/fluid in heart failure
oxygen can't get through.
active J(jerk) receptor
get dyspnea. can't take full breath because you have fluid in interstitium of lung, irritating J receptor
what produces hypoxemia?
ventilation defect, perfusion defect, diffusion defect, J receptor activation
what is hypoxemia?
decreased PO2
what is anemia
PO2 is normal. Oxygen saturation is normal. What is decreased? hemoglobin. still have normal respiration.
both carbon monoxide and cyanide poisoning occur in
house fire
carbon monoxide poisoning
oxygen saturation decreased. treat with 100% oxygen
cyanosis
a decrease in oxygen saturation
carbon monoxide poisoning symptom
headache
methemoglobin poisoning
Fe+3. oxygen can't bind. oxygen saturation decreased.
methemoglobin blood drawn looks like
chocolate
dude coming out of rocky mountains, he was cyanotic, given 100% oxygen, still cyanotic
drinking water in rocky mountains, loaded with nitrates/nitrates (oxidizing agents) --> oxidize hemoglobin so that it's Fe+3 instead of +2. oxygen didn't correct cyanosis. so it was probably methemoglobin
how to treat methemoglobin
IV methylene blue + vitamin C (reducing agent)
datsone is used for
leprosy
sulfa and nitro drugs do 2 things
1. produce methemoglobin
2. have potential of GP6D and hemolysis
oxidizing agents cause increase in peroxide, which destroys RBC.
methemoglobinemia in HIV. why?
because they're on sulfa drugs
what type of oxygen curve do you want?
right shifted, so that it reduces oxygen to tissue
what happens in high altitude?
you have to hyperventilate, and right shift curve. that's how you get oxygen up there
CO causes decreased oxygen saturation and
left shifted oxygen dissociation curve
cytochrome oxidase
last enzyme before transferring electron to oxygen
cytochrome oxidase, cyanide, carbon monoxide
inhibit cytochrome oxidase
methemoglobin causes what shift?
left
what does CO block besides oxygen?
blocks cytochrome oxidase. no electron goes to the oxygen. the whole system shuts down
uncoupling
ability of inner mitochondrial membrane to synthesize ATP.
what is dinitrylphenol?
uncoupling agent so that protons go right through membrane
what are uncoupling agents that let protons go right through the mitochondrial membrane? (not cool...draining off all of the protons without much ATP.)
salicylates, dinitrylphenol (preserves wood), alcohol,
what happens from draining protons caused by uncoupling agents?
any reactiont hat makes NADH and FADH gets revved up to make more protons. if you increase the rate of the chemical reaction, temperature goes up --> hyperthermia
salicylate toxicity
hyperthermia because it's an uncoupling agent
alcoholic on a hot day
develops heat stroke. very susceptible because mitochondria are already screwed up
what produces tissue hypoxia?
ischemia, hypoxemia, hemoglobin related things, uncoupling agents. absolute key things on boards
respiratory acidosis. what happens to hemoglobin?
nothing.
oxygen saturation = decrease it because PO2 is decreased.
partial pressure of oxygen = decrease it
anemia
hemoglobin is affected, but nothing else
methemoglobin
oxygen saturation affected
PO2 = no effect
what happens when you have decrease in ATP?
hypoxemia
anaerobic glycolysis-->lactic acid
what cells can do anaerobic glycosis?
any cell, including RBCs.
if no oxygen at end of electron transport system, then you get 2 ATP from anerobic glycolysis, but you get a buildup of lactic cid
coagulation necrosis
tissue hypoxia --> causes coagulation necrosis (infarction). it's caused by a buildup of lactic acid in a cell
when lack ATP, all ATPase pumps are screwed up because
they run on ATP. so Na goes into cell and causes swollen cells.
what drug blocks NaK pump?
digitalis. so that Na goes into cardiac muscle to open Ca to increase force of contraction
tissue hypoxia will cause tissue to swell up because
Na goes into cell (irriversible)
mature RBC energy source is
anaerobic glycolysis
what happens to Ca in tissue hypoxia?
it enters cells via CaATPase pump. ATPase decreases, so Ca has easy access to cell. When it's in the cell, it activates phospholipases (damages cell membrane) and causes nuclear chromatin disappearance.
what happens when Ca goes into mitochondria?
destroys it.
hypercalcemia causes
acute pancreatitis because it activates enzymes in pancreas. it does the same thing in cells
Ca most destroys what?
cell membrane, irriversable damage
what is lipofucin?
wear and tear in old people. when you have free radical damage, the end product is lipofucin. lipofucin is lipids that you can't break down all the way
what is free radical?
unpaired electron in outer orbit
RDS
oxygen related free radical injury such as retinopathy of prematurity, damage to lungs (fibrosis in lungs)