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330 Cards in this Set
- Front
- Back
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Inadequate oxygenation of tissues
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Hypoxia
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Hb x SaO2 x PaO2
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O2 content
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decreased arterial inflow or venous outflow
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decreased PaO2
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Increase Alveolar PCO2 = ___ alveolar PO2 = ___ PaO2 = ____ SaO2
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decreased, decreased, decreased
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Ventilation defect
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perfused but not ventilated; intrapulmonary shunt
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Perfusion defect
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ventilated but not perfused; increased dead space
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diffusion defect
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interstital fibrosis, pulmonary edema
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Decreased Hb conc, normal PaO2, normal SaO2
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anemia
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MetHb Rx
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IV methylene blye
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CO poisioning Rx
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O2 via nonbreather mask
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Factors causing a Left shifted O2 curve (Hb increased affinity for O2)
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Decreased: H+ (alkalosis), BPG, Temp;
Increased: HbF, CO, MetHb |
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Factors causing a Reft shifted O2 curve (Hb decreased affinity for O2)
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Increased: H+ (acidosis), BPG, Temp, Altitude
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BPG effects on O2 binding curve
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stabilized taut form of Hb (decreases O2 affinity). O2 moves from Hb into plasma & into tissue by diffusion
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Inhibit cytochrome oxidase
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CO and CN
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CN poisoning Rx
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amyl nitrite, thiosulfate
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Uncouplers of oxidative phosphorylation
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Thermogenin, Dinitrophenol
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Mitochondrial Toxins
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Alcohol, Salicylates
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Watershed areas
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Cerebral vessels, Mesenteric Arteries
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Subendocardial ischemia ECG
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ST-segment depression
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Most adversely affected cell in tissue hypoxia
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Neurons
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Most Susceptible to Hypoxia
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Zone III Hepatocytes
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Primary source of ATP in hypoxia
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Anaerobic Glycolysis
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Can cause Lactic Acidosis
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Anaerobic Glycolysis
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“Point of no return” in hypoxic cell injury
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Increased Ca2+ in cytosol, activates enzymes
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Cytochrom C in cytosol
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activates apoptosis
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Most destructive Free Radicals
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Hydroxyl FRs
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Oxidases reactions produce
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Superoxide FRs
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Drug FRs formed in liver
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Acetaminophen
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Free radicals damage
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Membranes and DNA
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Neutralization of FRs
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SOD, GSH, vitamins C & E
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Best neutralizer of hydroxyl FRs
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Vitamin C
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N-acetylcysteine activates
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GSH
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Reperfusion injury
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superoxide FRs and increased cytosolic Ca2_
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Excess iron and copper cause
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Hydroxyl FR damage of tissues
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SER hyperplasia
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increases drug metabolism
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SER inhibition
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decreases drug metabolism
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Primary lysosomes derive from
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Golgi Apparatus
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Phagolysosomes contain
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lysosomal enzymes
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I-cell Disease
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defect in post-translational modification of lysosomal enzymes
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Lysosomal storage deases
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decrease lysosomal enzymes
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Substrate for Triglyceride Synthesis
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G3-P (glycerol 3-phosphate)
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Kernicterus
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Endogenous Accumulation of Bilirubin; fat-soluble unconjugated bilirubin derived from Rh hemolytic disease of newborn; bilirubin enters basal ganglia nuclei of brain causing permanent damage
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Xanthelasma
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Endogenous Accumulation of Cholesterol; yellow plaque on eyelid, cholesterol in macphs;
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Diabetes Mellitus
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Endogenous Accumulation of Glycogen;
increased glycogen in proximal renal tubules cells (cells are insensitive to insulin & become overlaoded with glycogen); |
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Von Gierke's Glycogenosis
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Endogenous Accumulation of Glycogen; deficienct if glucose-6-phosphate; glycogen excess in hepatocytes & renal tubular cells
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Atherosclerosis
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Endogenous Accumulation of Cholesterol; cholesterol-laden smooth muscle cells & macph (foam cells), components of fibrofatyy plaques
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Melena
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Endogenous Accumulation of Hematin; when blood is exposed to gastric acid, Hb is converted to a black pgment called hematin, which is responsible for black, tarry stools called melena, a sign of upper GI bleed
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Iron Overload Disorders (hemochromatosis)
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Endogenous Accumulation of Hemosiderin and ferritin; excess hemosiderin (breakdown product of ferritin) deposition in parenchymal cells leading to FR damage & organ dysfunction
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Pulmonary Congestion
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Endogenous Accumulation of Hemosiderin and ferritin; In left-sided heart failure there is pulmonary hemorrhage w/ phagocytosis of RBCs by alveolar macphs. Hemosiderin is the breakdown product of RBC degradation in the macph ("heart failure" cells). Responsible for rusty-colored sputum
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Iron deficiency
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decrease in ferritin & hemosiderin
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Anemia of Chronic Disease
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Increase in ferritin & hemosiderin
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Addison's Disease
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Endogenous accumulation of melanin; destruction of the adrenal cortex; hypocortisolism leads to increase in ATCH (melanocyte-stimulating properties) causing excess synthesis of melanin and diffuse pigmentation of the skin & mucosal surfaces
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Amyloid
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Endogenous accumulation of protein; derives from different proteins (i.e. light chains, amyloid precursor protein). Stains red w/ congo red & when polarized has apple green birefringence
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Fatty Liver
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Endogenous accumulation of TG; TG in hepatocytes pushes nucleus to the periphery
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Coal Worker's Pneumoconiosis
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Exogenous accumulation of Anthracotic Pigment; phagocytosis of black anthracotic pigment (coal dust) by alveolar macphs ("dust cells")
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Lead Poisoning
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Exogenous accumulation of Lead; lead depositis in nuclei of proximal renal tubular cells (acid-fast inclusion) contributes to nephrotoxic changes in proximal tubules
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Causes of fatty change in cardiac muscle
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anemia, diptheria
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Serum Ferritin is decreased in
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iron deficiency anemia
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Calcification of necrotic tissue
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Dystrophic calcification
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Calcification of normal tissue
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Metastatic calcification
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decreased size/weight of tissue or organ
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Atrophy
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Autophagic vacuoles, increased lipofuscin in cells
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Atrophy
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increased cell size; increased workload
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Hypertrophy
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increased number of cells
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Hyperplasia
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Labile/stable cells ___ divide
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can
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Permenant cells ___ divide
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cannot
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one cell type replaces another
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metaplasia
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Glandular metaplasia, gastric reflux
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Barrett's esophagus
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disordered cell growth
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dysplasia
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Necrosis type w/ perservation of structural outlines
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Coagulation necrosis
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___ gangrene, predominantly coagulation necrosis
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Dry
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Infarction is less likely in
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dual blood supply, collateral circ
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Cerebral infarction, ___ necrosis
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liquifactive
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___ gangrene, predominantly liquifactive necrosis
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Wet
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Most common cause of caseous necrosis
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TB
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____ necrosis; acute pancreatitis
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Enzymatic Fat necrosis; chalk yellow-white deposits
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Necrosis of immune mediated disease
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Fibrinoud
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Extrinsic pathway of apoptosis requires
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TNF
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Antiapoptosis gene
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BCL2 gene
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gene that is "guardian" of the cell
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TP53
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Apoptosis gene
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BAX gene
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Group of cysteine proteases; activation induces apoptosis
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Caspases
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Deeply eosinophilic cytoplasm with pyknotic nucleus
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Apoptosis
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Marker of diffuse liver cell necrosis (e.g. Viral Hepatitis)
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Aspartate Aminotransferase (AST) & Alanine Aminotransferase (ALT)
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Mitochondrial enzyme preferentially increased in alcohol-induced liver disease
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Aspartate Aminotransferase (AST)
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More specific for liver necrosis than AST
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Alanine Aminotransferase (ALT)
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Isoenzyme increased in acute MI or myocarditis
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Creatinine Kinase MB
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more specific marker for pancreatitis
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Lipase more specific than amylase
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Marker that increased in salivary gland inflammation (e.g. mumps)
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Amylase
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Cardinal Signs of Inflammation
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Rubor (redness), Calor (heat), Tumor (swelling), Dolor (pain)
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Cell that releases preformed histamine
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Mast cells
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Primary cell in acute inflammation
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Neutrophils
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Cells responsible for "rolling" of neutrophils
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Selectins
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Neutrophils adhesion molecules
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Integrins
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Causes of neutrophil leukocytosis
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Catecholamines, Corticosteroids, Lithium
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Causes of neutropenia
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endotoxins
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Deficiency that causes delayed separation of umbilical cord
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selectin or CD11a:CD18
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Directed migration of neutrophils
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chemotaxis
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Opsonins
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IgG and C3b
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Defect in Bruton's agammaglobulinemia
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Opsonization defect
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Chediak-Higashi Sydrome
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can't form phagolysosomes
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Most potent microbicidal system
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O2-dependent MPO system
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End product of O2-dependent MPO system
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Bleach
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Cause of chronic granulomatous disease
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absent NADPH oxidase and respiratory burst
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Myeloperoxidase Deficiency
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AR, both O2 (superoxide radical) and H2O2 (peroxide) are produced (normal respiratory burst, however the abscense of MPO prevents synthesis of HOCl (bleach)
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Most important chemical mediator of acute inflammation
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Histamine
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Most common cause of skin abscess
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S. auerus
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Prostaglandin that causes vasodilation, pain, fever
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PGE2
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Prostaglandin that causes vasodilation, inhibition of platelet aggregation
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PGI2
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Mediator that causes vasoconstriction and platelet aggregation
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Thromboxane Ae
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Leukotriene that causes chemotaxis and activation of neutrophil adhesion molecules
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LTB4
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Leukotriene that causes vasoconstriction, increased venular permeability, bronchoconstriction
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LTC4, LTD4, LTE4
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What activates neutrophil chemotaxis
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Chemokines
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C3a, C5b anaphylaxatonixs fcn
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stimulate mast cell release of histamine
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C3b fcn
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opsonization
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C5a fcn
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activation of neutrophil adhesion molecules, chemotaxis
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C5-C9 fcn
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membrane attack complex; cell lysis
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IL-8 fcn
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chemotaxis
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IL-1, TNF
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-Initiate PGE2 syn in the anterior hypothalamus leading to production of fever
-activate endothelial cell adhesion molecules -Increase liver syn of acute-phase reactants (i.e Ferritan), coagulation factors (i.e. Fibrinogen), & C-reactive protein -Increase release of neutrophils from bone marrow (neutrophil leukocytosis) |
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What cytokine is a promoter of apoptosis
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TNF
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IL-6 fcn
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increase liver syn of acute phase proteins
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NO fcn
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vasodilation, bactericidal
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Serotonin fcn
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vasodilation, increased venular permeability, increases collagen syn
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Causes of pseudomembranous inflammation
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Diptheria, C. Difficile, noninvasive bacteria
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How are all neutrophils cleared in acute inflammation
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Apoptosis
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Most common cause of chronic inflammation
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infection
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Primary Leukocytes of chronic inflammation
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monocytes & macrophages
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Key adhesion gylcoprotein in ECM
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fibronectin
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Cell types in TB granuloma
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Macrophages & CD4 helper T cells
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Epitheliold cells
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macrophages activated by gamma-interferon from CD4 T helper cells
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Important in formation and maintenance of granulomas
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TNF-alpha
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Primary cells involved in acute inflammation
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Neutrophils
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Primary cells involved in chronic inflammation
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Monocytes/macrophages; B & T lymphocytes, plasma cells, fibroblasts
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Pathogenesis in Acute Inflammation
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microbial pathogens, trauma, burns
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Pathogenesis in Chronic Inflammation
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Persistant acute inflammation, foreign bodies (e.g. silicone, glass), AI disease, certain types of infections (TB, Leprosy)
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Primary Mediators in Acute Inflammation
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Histamine (key mediator), Prostaglandins, Leukotrienes
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Primary Mediators in Chronic Inflammation
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Cytokines (i.e. IL-1), growth factors
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Outcome in Acute Inflammation
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Complete resolution, progression to chronic inflam, abscess formation
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Outcome in Chronic Inflammation
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Scar tissue formation, disability, amyloidosis
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Serum Protein Electrophoresis Effect in Acute Inflammation
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Mild hypoalbuminemia
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Serum Protein Electrophoresis Effect in Chronic Inflammation
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Polyclonal gammopathy; greater degree of hypoalbuminemia
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Main immunoglobin in Acute Inflammation
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IgM
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Main immunoglobin in Chronic Inflammation
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IgG
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Peripheral Blood Leukocyte Response in Acute Inflammation
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Neutrophilic Leukocytosis
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Peripheral Blood Leukocyte Response in Chronic Inflammation
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Monocytosis
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Most variable phase in cell cycle
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G1 phase
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Most critical phase in cell cycle
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G1 to S phase
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Genes controlling G1 to S phase
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RB and TP53 suppressor genes
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Gene activated by TP53 & initiates apoptosis
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BAX gene
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Key glycoprotein in basement membrane
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Laminin
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Growth Factors that stimulate angiogenesis
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Vascular Endothelial Growth Factor (VEGF); Basic Fibroblast Growth Factor (BFGF)
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Growth Factor that stimulates keratinocyte porliferation & granulation tissue formation
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Epidermal Growth Factor (EGF)
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Growth Factor that stimulates proliferation of smooth muscle, fibroblasts, endothelial cells
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Platelet-Derived Growth Factor (PDGF)
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Growth Factor that is chemotactic for macrophages, lymphocytes, fibroblasts
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Transforming Growth Factor-Beta (TGF-B)
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Hormone that stimulates synthesis of collagen & promotes keratinocyte migration
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Insulin Growth Factor-1 (IGF-1)
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Interleukin that is chemotactic for neutrophils, stimulates syn of metalloproteinases (i.e. trace metal containing enzymes), stim syn & release of acute phase reactants from the liver
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IL-1
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What tissue is essential for normal CT repair
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Granulation Tissue
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Enzyme that cross-links collagen increasing tensile strength
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Lysyl Oxidase
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Vitamin product required for hydroxylating proline & lysine
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Ascorbic Acid
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Metal Co-factor in Lysyl oxidase
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Copper
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Menedial disorder that has defects in Type I & Type III collagen
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Ehlers-Danlos Syndrome (EDS)
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Metal Cofactor in collagenase
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Zinc
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Most common cause of impaired wound healing
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Infections
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Deficiency that decreases cross-linking of tropocollagen leading to decreased tensile strength
|
Vitamin C
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Rx to prevent scar formation
|
Glucocorticoids
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Keloids
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raised scars due to excess type III collagen
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Type of repair in severe liver injury
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Regenerative nodules & fibrosis
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Repair cell in Lung injury
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Type II Pneumocytes
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Type of repair in Brain Injury
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Proliferation of astrocytes & microglial cells
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Key cell for reinnervation in peripheral nerve transection
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Schwann Cell
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Corticosteroid effect in blood
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Increase neutrophils; Decrease Lymphocytes & Eosinophils
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|
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Increased ESR causes
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Increased fibrinogen, anemia
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Marker of Necrosis & Disease Activity
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C Reactive Protein
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1st defense against pathogens
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Innate Immunity
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Large granular lymphocytes in peripheral blood
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Natural Killer Cells
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"Master Switch" to the nucleus
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NFKappaBeta
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Toll-Like Receptors (TLRs)
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Recognize non-self antigens on pathogens
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When do IgM & IgG syn begin
|
after birth
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Antigen Presenting Cells
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Macrophages, Dendritic Cells
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HLA-B27 associated
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Ankylosing Spondylitis
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Type __ Hypersenisity: IgE activation of mast cells
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I
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Mast cell activation
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allergens cross-link allergen-specific antibodies
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Cells that secrete cytokines (IL-2 --> proliferation of CD4/CD8 T cells; IFN-gamma --> activates macph); help B cells become Ab
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CD4 Helper T cells
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Cells that kill virus infected, neoplastic, & donor graft cells
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CD8 Cytotoxic/Suppressive T cells
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Cells that differentiate into plasma cells that produce Igs to kill encapsulated bacteria; Act as APCs that interact w/ CD4 Cells
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B cells
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Cells that kill virus-infected and neoplastic cells; Release IFN-gamma
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Natural Killer Cells
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Cells involved in phagocytosis & Cytokine production; Act as APCs to T cells
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Macrophages
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Cells that act as APCs to T cells
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Dendritic Cells & Macrophages
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Potentially fatal type I hypersensitivity Rxn
|
Anaphylactic Shock
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Type __ hypersensitivity Rxn: Antibody Dependent Cytotoxic rxns
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II
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Myasthenia Gravis, Graves Disease are Type __ Hypersensitivity Rxns
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II
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Type __ Hypersensitivity Rxn: Complement activation by circulating antigen-antibody complexes
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III
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Types of Hypersensitivity Rxns that are Ab-mediated
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Type I, II, & III
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Type __ Hypersensitivity Rxn: Cellular Immunity
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IV
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Delayed Hypersensitivy Rxn
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Type IV Hypersensitivity Rxn, CD4 cells interact w/ macph; i.e. TB granuloma, PPD rxn, MS
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|
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Antibody-Independent T-cell Mediated Rxns (cellular-mediated Immunity)
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Type IV Hypersensitivity Rxn, altered Class I antigens, killing of tumor cells & virus-infected cells; i.e. Contact Dermatitis (e.g. Poison Ivy, Nickel)
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|
|
Most important requirement for successful transplantation
|
ABO blood groups
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|
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Graft with best survival rate
|
Autograft
|
|
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Type of rejection that is an irreversilble Type II Hypersensitivity Rxn
|
Hyperacute Rejection
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|
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Type of rejection that is an most common, Type IV & Type II Hypersensitivity Rxn
|
Acute Rejection
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|
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Immunosuppressive Rx causes danger of what time of cancer
|
Squamous Cell Carcinoma
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|
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GVH Reaction
|
Jaundice, Diarrhea, Dermatitis
|
|
|
Transplant w/ the best allograft survival rate
|
Corneal Transplants
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|
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Organ-specific Autoimmune disorders
|
Addison's disease, Pernicious Anemia
|
|
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Systemic Autoimmune disorders
|
SLE, Rheumatoid Arthritis
|
|
|
Serum Antinuclear Antibody Tests includes
|
Antibodies against DNA, histones, Acidic proteins, Nucleoli
|
|
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What is the rim pattern of serum ANA fluorescent Ab test associated with
|
associated w/ anti-dsDNA antibodies & presence of renal disease in SLE
|
|
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Anti-Acetylcholine Receptor Autoantibody
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Myasthenia Gravis
|
|
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Anti-Basement Membrane Autoantibody
|
Goodpasture's Syndrome
|
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Anticentromere Autoantibody
|
CREST syndrome
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Antiendomysial IgA Autoantibody
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Celiac Disease
|
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Antiglidin IgA Autoantibody
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Celiac Disease
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Antihistone Autoantibody
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Drug Induced Lupus
|
|
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Anti-insulin Autoantibody
|
Type I Diabetes
|
|
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Anti-Islet cell Autoantibody
|
Type I Diabetes
|
|
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Anti-Intrinsic Factor Autoantibody
|
Pernicious Anemia
|
|
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Anti-Parietal Cell Autoantibody
|
Pernicious Anemia
|
|
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Antimicrosomal Autoantibody
|
Hashimoto's Thyroiditis
|
|
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Anti-Smith (Sm) Autoantibody
|
SLE
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|
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Anti-SS-A (Ro)
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Sjogren's syndrome
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|
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Anti-SS-B (La) Autoantibody
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Sjoren's Syndrome
|
|
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Anti-SS-A (Ro) Autoantibody
|
SLE
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Antithyroglobulin Autoantibody
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Hashimoto's Thyroiditis
|
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Anti-tissue Transglutaminase IgA Autoantibody
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Celiac Disease
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Anti-topoisomerase Autoantibody
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Systemic Sclerosis
|
|
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Antimitochondrial Autoantibody
|
Primary Biliary cirrhosis
|
|
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Antimyeloperoxidase Autoantibody
|
Microscopic Polyangiitis
|
|
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Antinuclear Autoantibody
|
SLE, Systemic Sclerosis, Dermatomyositis
|
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Antiproteinase 3 Autoantibody
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Wegener's Granumatosis
|
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Anti-ribonucleoprotein Autoantibody
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MCTD
|
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Anti-TSH receptor Autoantibody
|
Grave's Disease
|
|
|
Most common cardiac findings in SLE
|
Fibrinious pericarditis w/ effusion
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|
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Most common drug associated with drug-induced Lupus
|
Procainamide
|
|
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What is used to screen for SLE
|
Serum ANA
|
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What is used to confirm SLE
|
anti-dsDNA and anti-Sm antibodies
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|
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What is an LE cell
|
Lupus Erythematous Cell, neutrophil with phagocytosed, altered DNA
|
|
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Excess collagen deposition, digital vasculitis describes
|
Systemic Sclerosis
|
|
|
Most common initial sign of systemic sclerosis
|
Raynaud's Phenomenon
|
|
|
Most common cause of death is systemic sclerosis
|
Respiratory Failure
|
|
|
Calcinosis, Raynauds Phenomenom, Esophageal Dysfunction, Sclerodactyly, Telangiectasia
|
CREST Syndrome in Systemic Sclerosis
|
|
|
Helitrope Eyes; Gottron's Patches
|
Dermatomyositis and Polymyositis
|
|
|
Most common congenital immunodeficiency
|
IgA Deficiency
|
|
|
Failure of pre-B cells to become mature B cells with mutated tyrosine kinase, XRD
|
Bruton's Agammaglobunlinemia (B-Cell Disorder)
Clin: SP infections, maternal Abs protect from birth to 6 mo, decreased Ig's |
|
|
Failure of IgA B cells to mature into plasma cells
|
IgA deficiency (B-Cell Disorder)
Clin: SP infections (giardiasis), anaphylaxis is exposed to blood products containing IgA, decreased IgA and secretory IgA |
|
|
Defects in B-cell maturation to plasma cells; Adult Immunodeficiency Disorder
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Common Variable Immunodeficiency (B-Cell Disorder)
Clin: Sinopulmonary infections, GI infections (Giardia), pneumonia, autoimmune disease (ITP, AIDA), malignancy; decreased Ig's |
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Failure of third and fourth pharyngeal pouches to develop thymus & parathyroid glands to develop
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DiGeorge Syndrome (T-Cell Disorder)
Clin: HypoPT (tetany), absent thymic shadow on radiograph; PCP, danger of GVH reaction |
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Adenosine deaminase deficiency (15%); AR disorder; adenine toxic to B & T cells; decrease deoxynucleoide triophosphate precursors for DNA synthesis
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Severe Combined Immunodeficiency (SCID) (Combined B- and T-Cell Disorder)
Clin: defective CMI, decreased Ig's Treatment: gene therapy, BM transplant |
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Progressive deletion of B and T cells; XRD
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Wiskott-Aldrich Syndrome (Combined B- and T-Cell Disorder)
Symptom Triad: Eczema, Thrombocytopenia, SP infections Increased risk of malignant lymphoma, defective CMI, decreased IgM, normal IgG, increased IgA & IgE |
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Mutation in DNA repair enzymes; Thymic Hypoplasia; AR
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Ataxia-Telangestasia (Combined B- and T-Cell Disorder)
Clin: cerebellar ataxia, telangiectasias of eyes & skin, inc risk of Lymphoma &/or Leukemia, adenocarcinoma, inc AFP; dec IgA (50-80%), dec IgE, IgM low molecular weight variety, dec IgG2 or total IgG, dec T cell fcn |
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Most common acquired immunodeficiency disease worldwide
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AIDS
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Most common cause of death due infection worldwide
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AIDS
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Transmission in Pediatric AIDS
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most due to vertical transmission
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AIDS risk per unit of transfused blood
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1 per 2 million
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Lab test used to detect Anti-Gp120 Antibodies in HIV/AIDS
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ELISA
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What is the confirmatory lab test in HIV
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Western Blot
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Indicator of viral replication in HIV/AIDS
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p24 antigen (positive prior to seroconversion, present before gp120 antibodies)
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Used to monitor immune status in HIV/AIDS
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CD4 T-cell count
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Used for dection of actively dividing virus & as a marker of disease progression in HIV/AIDS
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HIV viral load
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Reservoir cell for HIV
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follicular dendritic cells in lymph nodes
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most common malignancy in AIDS
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Karposi Sarcoma
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most common cause of blindness in AIDS
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CMV
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Cause of death in AIDS
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disseminated infection
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What are the anaphylatoxins
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C3a, C5a
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Deficiency of C1 esterase inhibitor
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Hereditary angioedema
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Deficient in Paroxysmal Nocturnal Hemoglobinuria (PNH)
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Decay Accelerating Factor (DAF)
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Tests indicating activation of the classic complement system show
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Decreased C4, C3
Normal Factor B |
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Tests indicating activation of the alternative complement system show
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Decreased Factor B, C3
Normal C4 |
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Apple green birefringence in polarized light
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Amyloid
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Beta amyloid is associated with
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Alzheimer's Disease in Down Syndrome
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Abnormal Folding of protein
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Amyloid
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Most common complement deficiency
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C2, associated w/ septicemia
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C6-C9 Deficiency is associated with
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increased susceptibility to disseminated Neisseria gonorrhoeae or N. meningitidis infections
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Acquired stem cell disease w/ defect in Decay Accelerating Factor
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Paroxysmal Nocturnal Hemoglobinuria
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Major ECF cation
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Na+
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Major ICF cation
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K+
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Compartment size order
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ICF > ECF; Interstitial > Vascular
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Water moves b/w ECF & ICF; controlled by serum Na+
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Osmosis
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Decrease in Totaly Body Na+ is a sign of
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Volume depletion
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Increase in Totaly Body Na+ is a sign of
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Pitting edema, body cavity effusions
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Isotonic Loss
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dec total body Na+/ dec total body water; loss whole blood, secretory diarrhea (e.g. Cholera)
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Isotonic Gain
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Inc total body Na+/ Inc total body water; excessive infusion isotonic saline
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Hypotonic disorders
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Hyponatremia always present; ICF expansion
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ECF always expands when
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Gain in fluid
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ECF always contracts when
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loss in fluid
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Hypotonic Loss
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Dec total body Na+/ Dec total body water; Loop diuretic, Addison's disease, 21-hydroxylase deficiency
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Central Pontine Myelinolysis
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rapid correction of hyponatremia with saline
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Pitting Edema States
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Right-sided heart failure, cirrhosis, nephrotic syndrome, cardiac output decreased
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Hypertonic Disorder
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Hypernatremia or hyperglycemia; ICF contraction
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Diabetic Ketoacidosis
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Hypertonic state with dilutional hyponatremia; osmotic diuresis
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What part of the kidney reabsorbs Na+, reclaims HCO3-
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Proximal tubule
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Carbonic Anhydrase Inhibitor can cause what in the proximal tubule
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Proximal renal tubular acidosis
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Heavy metal poisoning can produce what
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Fanconi Syndrome
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Inhibited by loop diuretics
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Cl- binding site in Na+-K+-2Cl- cotransporter
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Na+-K+-2Cl- cotransporter generates
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Free water
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Loop diueretics are used
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hyponatremia, hypokalemia, metabolic acidosis
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Thiazides inhibit
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Cl-site in Na+-Cl- cotransported
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Thiazide diuretic use
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hyponatremia, hypokalemia, metabolic alkalosis, hypercalcemia
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Increased risk of metabolic alkalosis
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Hypokalemia
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Amiloride and Triameterene
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diuretics w/ K+-sparing effects
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Spironolactone
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aldosterone inhibitor; K+-spareer
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Primary Aldosteronism
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Hypernatremia, Hypokalemia, Metabolic Alkalosis
Low Plasma renin type of HTN |
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Bartter's Syndrome
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Normotensive
-Hypokalemia, metabolic alkalosis; inc aldosterone and PRA |
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Most common cause small cell carcinoma of lung
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SIADH
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Rx of SIADH
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Restrict Water
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Most common cause of hyperkalemia
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Renal Failure
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RBC hemolysis from difficult venipuncture
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pseudohyperkalemia
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ECG shows peaked T waves
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Hyperkalemia
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Common cause of respiratory acidosis
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Chronic bronchitis
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PaCO2 > 45 mmHg
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Respiratory acidosis
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Most common cause of respiratory alkalosis
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Anxiety
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PaCO2 < 33 mmHg
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Respiratory Alkalosis
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Commonly occurs in acute respiratory alkalosis
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Tetany
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HCO3: < 22 mEg/L
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Metabolic Acidosis
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Normal AG Metabolic acidosis
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Cl- anions replace HCO3
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Most common cause of metabolic alkalosis
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Loop & thiazide diuretics
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HCO3 > 28 mEg/L
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Metabolic alkalosis
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Salicylate intoxication
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often mixture of primary metabolic acidosis & primary respiratory alkalosis; normal pH
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Protein-poor and cell-poor fluid
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Transudate
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Protein-rich and cell-rich fluid
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Exudate
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Lymphatic obstruction after modified radical mastectomy and radiation
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Lymphedema
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Endothelial cell injury produces which type of thrombi
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Arterial
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Stasis of blood flow produces which type of thrombi
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Venous
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Right-sided heart failure due to increased hydrostatic pressure; cirrhosis due to decreased oncotic pressures
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Pitting edema
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Most common site for venous thrombosis
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deep vein in lower extremity below the knee
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Composition of venous thrombus
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entrapped RBCs, platelets, WBCs
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Composition of Arterial thrombus
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fibrin clot composed of platelets
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What drug prevents formation of arterial thrombi
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Aspirin
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What drugs are anticoagulants that prevent venous thrombosis
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Heparin & warfarin
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Where do majority of Pulmonary thromboembolism orginate
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femoral veins
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Where do majority of systemic emboli originate
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left side of the heart
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