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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