Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
109 Cards in this Set
- Front
- Back
If CO2 increase what must decrease
|
PaO2
|
|
If PaO2 decreases what else must decrease
|
Plasma O2 Hb gets the oxygen from the plasma
as a side note if PaO2 decreases respirator acidosis |
|
if Given 100% O2 and PaO2 sat does not go up. what does it mean
|
there is a ventilation defect
**shunt** In children it is called hyaline membrane disease Adults = ARDS |
|
What is a perfusion defect
|
Blood cannot get to lungs to perfuse
**pulmonary embolism** causes a increase in dead space ***giving 100% O2 will increase PaO2*** |
|
What is a diffusion defect
|
Fibrosis (sarcoid),Fluid
any thing that causes a thick interface between lungs and blood |
|
Stim of the J-receptor causes what
|
Dyspnea
Cannot take in a deep breath |
|
Anemia causes a drop in what
|
Only a drop in hemoglobin
O2sat and PaO2 are gonna be normal ***just not enough Hb*** |
|
CO causes a drop in what
|
O2sat
Has high affinity for Hb. do not turn hypoxiic due to cherry red pigment it causes |
|
What are the 3 things CO causes
|
Causes a left shift, Decrease O2sat, and blocks cytochrome oxidase
Tx with 100% O2 |
|
What does Methemoglobin cause
|
Decrease in O2sat but 100% O2 will not help
Met Hb is Fe3+ cannot hold O2 Blood looks like chocolate TX with methalene blue |
|
What is Dapsone
|
it is a drug used to treat lepresey but causes Methemoglobinemia and also G6PD hemolitic anemia
along with any kind of sulfa/nitrate drug like TMP-SMX |
|
What causes a right shift on oxigenation curve
|
2,3-BPG,
|
|
What causes a Left shift on oxygenation curve
|
CO
Met Hb HbF alkalosis |
|
What 2 things cause a breakdown of cytochrome oxidase
|
CO
and cyanide |
|
Salicylates, alcohol, and dinitrophenol cause what condition
|
Uncoupling
hyperthermia increases the free protons and cause increase activity of NAD/FAD reactions |
|
What is the first thing that happens inside a cell during hypoxia?
|
Hypoxia leads to anaerobic glycolysis - leads to decrease ATP - leads to Na/K ATPase pump stopping- causeing Na to flow into cell + water follows =
***cellular swelling*** |
|
What happens with Ca and tissue hypoxia
|
Ca ATPase pump stops working and Ca activates :
phospholipases Enzymes in the nucleus and Mitochondira enhances lipid peroxidation bad |
|
What is one of the problems with hypercalcemia
|
pancreatitis
Ca activates all the enzymes |
|
What is lipofucion
|
it is a brown substance that builds up after lipid peroxidation
Caused by free radical damage |
|
Ionizing radiation generates what
|
Hydroxal Free radicals
Damages DNA that can lead to squamous cell carcinomas *** most often causes leukemia*** |
|
What is used to break down superoxide
|
Superoxide dismutase
|
|
Where is glutathion made
|
Pentose phosphate pathway
|
|
What causes pale coagulation necrosis
|
Heart
liver Kidneys Spleen Thick dense tissue |
|
What causes hemorrhagic necrosis
|
Small bowel
testicles lungs |
|
What type of necrosis is dry gangrene
|
Coagulation necrosis
but without infection NO PUS Diabetic foot |
|
What is the only type of brain necrosis
|
Liquefaction necrosis
|
|
What causes caseus necrosis
|
any mycobacteria
and systemci fungi |
|
Sarcoidoisis and crohns are types of what
|
Non-caseating granulomas
|
|
What causes enzymatic fat necrosis
|
Acute pancreatitis
**retroperitoneal organ, with pain radiateing to the back** |
|
What is released during acute pancreatitis
|
amylase and lipase from damaged pancrease
|
|
What are the different causes of fibrinoid necrosis
|
Rheumatic heart disease
SLE Small vessel vasculitis Rheumatoid arthritis |
|
What causes nutmeg liver
|
Right Heart failure
|
|
Why does alcohol cause fatty liver
|
Alcohol increases NADH production and as a result increases DHAP which is converted to glucose-3-P which in turn is converted into fat
|
|
What is the metabolism from alcohol
|
pyruvate is converted to lactate due to the high NADH usage.
Cannot go through gluconeogeneisis because you need pyruvate. but acetyl-CoA is used to make Ketone bodies B-hydroxy-buterate is made in excess because it is NADH driven |
|
What does cycline dependent kinase do
|
It phosphorylates Rb protein that then causes G0 - S phase
|
|
What does Cycline protein do
|
activates cycline dependent kinase
|
|
How does Rb protein work
|
prevents cell going to S-phase
|
|
What chromosome does the Rb protein come from
|
13
|
|
What does P53 gene do
|
It stops the cycline dependent kinase from phosphorylating Rb protein
|
|
what chromosome does P53 gene come from
|
17
|
|
What is Dystrophic calcium
|
Ca deposits in damaged tissue
EX: psammoma bodies, atherosclerotic paques, enzomatic fat necrosis |
|
What is metastatic Ca
|
increased Phosphorus in blood drives Ca into normal tissue
|
|
What is defective in sperocytosis
|
Spectrin
|
|
What are mallory bodies
|
Ubiquinated intermediate filiments
|
|
What are some examples of Labile cells
|
Skin
Bone marrow crypts of intestine ***stem cells*** |
|
What are the stable cells
|
Cells that are stimulated by hormone growth
|
|
What are 2 receptor opsoniation molecules
and what are the receptors on |
IgG and C3b
Neutrophils and monocytes |
|
Describe the MPO system
|
NADPH oxidase causes a respiratory burst making O2 radical. Superoxide dismutase forms H2O2 out of this.
MPO takes H2O2 and adds a Cl to form bleach to kill the bacteria |
|
What is a deficiency in NADPH called
|
Chronic Granulomatosis X-linked recessive
Cannot form respiratory burst NBT test would be negative |
|
What reduces Oxidized LDL
|
Vita E
|
|
What is Brutons Agammaglobulinemia
|
It is a defect in IgG, C3b opsonization
|
|
What is Chediak-Higashi syndrome
|
A defect in microtubule function prevents phagolysome formation
|
|
What is Myelopreroxidase deficiency
|
It is the inability to make Bleach from H2O2.
NBT test would be positive to rule out Chronic granulomatous disease |
|
What are the problems with G6PD deficiency
|
Chronic infections due to no respiratory burst
and also hemolytic anemia due to glutathione deficiency because no NADPH |
|
What is the Function of Prostaglandins
PGE2 PGI2 |
PGE2-Vasodilation, pain, fever
PGI2-Vasodilation, inhibition of platelet aggregation |
|
What is the function of Thromboxane A2
|
Vasoconstriction
**platelet aggregation** |
|
What is the main function of Leukotriene LTB4
|
Leukocyte chemotaxis and activation of neutropohil adhesion molecules
|
|
What are are the main functions of leukotriene's
|
Vasoconstriction and venular permeability
***bronchoconstriction*** |
|
What is the function of bradykinin
|
vasodilation
increased venular permeability **pain** |
|
Main function of IL-1
|
initiate PGE2 synthesis in hypothalamus leading to ***FEVER***
increase release of neutrophils from bone marrow |
|
main function of IL-6
|
increase liver synthesis of acute phase reactants
|
|
main function of IL-8
|
Chemotaxis
|
|
main funciton of Nitric Oxide
|
Vasodilation
Bactericidal |
|
What is serotonin made from
|
Tryptophan
|
|
what is the most common cause of impaired wound healing
|
Infections
|
|
Chronicly draining sinus tract on skin, and antibiotics dont work what is it
|
Squamous cell carcinoma
|
|
What is keloid made up of
|
Type III collagen
|
|
What is the pathogenesis of Granulomas
|
Type IV hypersensitivity
|
|
What all takes place to form a granuloma
EX: TB |
TB is phagocytosed by macrophage and it is processed and presented to CD4 cell VIA MHC II
Macrophage releases IL-12( which causes CD4 --- TH1 cell to be memory) and IL-1 (FEVER) TH1 releases IL-12(proliferation) and releasees cytokines Gamma-interferon (activates macrophages) and macrophage inhibitory factor (keeps macrophages together to form granuloma) |
|
What part of the nephron is most susceptable to hypoxic damage
|
Straight part of proximal tubule
Thick ascending limb |
|
for every Na, Cl, K how much water is obligated
|
20 ml
when body resorbes 1 Na, Cl, K frees up 20 ml each |
|
What is the repair cell for the lungs
|
type 2 pneumocytes
|
|
What is the repair cell for the brain
|
astroctes
**acts like a fibroblast** |
|
What happens when nerve cell is cut
|
Wallarian degeneration
distal degeneration of axon and myelin sheath and proximal degeneration up to the nearest internode slowly grows back together 2-3mm per day |
|
What is involved with cold agglutination
|
IgM causeing the clumping of RBC's
raynauds ** could also be from cryoglobulins** |
|
What has a high association with cryoglobulins
|
Hep C
|
|
Most common Cause of Hypoalbuminemia
|
Chronic Liver DIsease
|
|
What is the Function of Alpha Anti-trypsin
|
inhibits elastases released by neutrophils
|
|
What are the transferrin levels in regards to
1. Iron deficiency 2. Iron toxicity |
1. High transferrin
2. Low transferrin |
|
What is the most common genetic immune deficieny
|
IgA
|
|
does transudates or exudates cause pitting edema
|
Transudates
Exudates = pus and taught skin |
|
having hypoalbumenia causes what
|
EDEMA
Low oncotic pressure |
|
Most common cause of Nephrotic syndrome kids
|
minimal change disease
|
|
Most common cause of Nephrotic syndrome in adults
|
membranous glomerulonephritis
|
|
What is a cause of a transudate from increased hydrostatic pressure
|
left heart failure
**increased venous pressure overides capillary oncotic pressure** |
|
Nephrotic syndrome
crohns disease celiac disease Kwasiorkor Are all types of what? |
transudates from decreased Oncotic pressure
|
|
Most common cause of lymphadema
|
Post-radical mastectomy
|
|
Most common cause of hypertonic condition
|
hyperglycemia
|
|
What is inferred in a hypotonic fluid
|
hyponatremic
Water flows from ECF to ICF |
|
What is the tonicity of diarrhea
|
Isotonic
|
|
In hyponatremia where does the fluid move
|
from the ECF to the ICF
Urine would be hypertonic because of the loss of salts (diuretics) |
|
Why do you restrict only water and not salt for SIADH
|
sodium is normal
problem is holding onto all this water Causes super concentrated urine |
|
oral replacement of hypotonic fluids what needs to be in with the Na
|
Glucose
|
|
if you sweat a lot and need to replenish your fluids what kind to you take
|
hypotonic solution
|
|
What do you restrict for any pitting edema
|
Salt and water
|
|
What do you restrict for SIADH
|
only water
|
|
What is the TILT test
|
pt lying down normal BP and HR
sit up and decrease in BP and increase in HR Due to hypovolemic |
|
most common cause of hypovolemic shock
|
hemorrhage:
|
|
ventilation is the movement of what
|
CO2
|
|
what happens when i hyperventilate
hypoventilate |
hyper = more CO2 blown off = respiratory alkalosis
Hypo = keep more CO2 = respiratory acidosis |
|
most common cause of respiratory alkalosis
|
anxiety
|
|
Where is the spasm in croup
|
Trachea
|
|
ALT is specific for
|
liver
|
|
AST is specific for
|
liver and muscle primarily a mitochondrial enzyme
|
|
obstructive jaundice look for what enzymres
|
AP and GGT are markedly increased
alkaline phosphatase (AP) y- glutamyl transferase: GGT |
|
y- glutamyl transferase is only made in
|
The LIVER
|
|
what is the problem with conjugated bilirubin < 20%
|
primary increase in UCB
(1) extravascular hemolysis (2) problem with uptake or conjugation |
|
what is the problem with conjugated bilirubin 20-50%
|
mixed CB and UCB: hepatitis
|
|
what is the problem with conjugated bilirubin > 50%
|
primarily CB: obstructive jaundice
|