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Pathophysiology Lecture 2 Exam 1

Describe Hypotonic Alteration on a blood cell. Sodium decreases in the ECF so there is a higher concentration of Na+ in the ICF. Therefore water moves into the cell causes extreme pressure on the RBC which may cause it to burst .
Describe Hypotonic Alteration on a body cell. Sodium is decreases in the ECF so water moves into the cell causing the body cell to swell.
Describe Hypotonic Alteration on a neuron. Sodium is decreased in the ECF so water diffuses to the inside of the neuron causing cell enlargement.
Describe Isotonic Alteration in a blood cell, body cell, and neuron. Normal concentrations of sodium in the ECF are present so no change in shifts of fluid in or out the cells occur.
Describe Hypertonic Alteration in a blood cell. Sodium levels increase in the ECF so the blood cell is shrunk due to loss of water from the ICF.
Describe Hypertonic Alteration in a body cell. High Sodium levels cause water to leave ICF which shrinks the body cell.
Describe Hypertonic Alteration in a neuron. Since water leaves the ICF to go to the higher concentration of Na+, the neuron shrinks due to water loss.
What are Isotonic Alterations? proportionate changes in electrolytes and water.
What causes isotonic volume depletion? hemorrhage, severe wound drainage, excessive diaphoresis( sweating), intestinal losses, decreased fluid intake
What are some symptoms of isotonic volume depletion? weight loss, dryness of skin and mucous membranes (mouth, rectum, vagina), decreased urine output, hypovolemia, rapid heart rate, flattened neck veins, normal or decreased blood pressure.
What causes isotonic volume excess? excessive isotonic saline administration, aldosterone hypersecretion followed by sodium and secondary water retention.
What are some symptoms of isotonic volume excess? weight gain, decreased hematocrit, increased blood pressure. If severe: pulmonary edema or heart failure.
What are Hypertonic Alterations? increased ECF osmolality due to manipulation of Na+ or its diluent water; result is osmotic movement of water from ICF to ECF
What is Hypernatremia? Na+ levels exceed 147 mEq/L due to gain in Na+
What causes Hypernatremia? hypertonic saline administration; aldosterone hypersecretion, Cushing's Disease ( elevated adrenal glucocorticoid and mineralocorticoid, ex. aldosterone, secretion)
What are some symptoms of hypervolemia in a hypertonic alteration?* weight gain, bounding pulse, increased blood pressure, edema, venous distention
What causes water deficit? inadequate water intake, watery diarrhea, diabetes insipidus, (low ADH secretion, concentrated urine), excessive diuresis, excessive diaphoresis
What are some symptoms of hypovolemia in a hypertonic alteration?* weight loss, weak pulses, postural hypotension, tachycardia
Hypertonic alterations shrink the ICF. What are some effects it has on the body from the ICF?* thirst, fever, decreased urine output, brain cell shrinkage( confusion, coma, cerebral hemorrhage)
What are Hypotonic Alterations? decreased ECF osmolality due to manipulation of Na+ or its diluent water; result is osmotic movement from ECF-ICF
What is Hyponatremia? due to Na+ loss( inadequate intake; hypoaldosteronemia; excessive diuretic therapy)
What causes water excess? excessive pure water intake( psychogenic disorder, water intoxication), excess iv hypotonic solution administration, water ingestion to replace isotonic fluid loss, tap water enemas, dec. urine formation/ renal water retention, SIADH
What does SIADH mean? Syndrome of inappropriate ADH secretion.
What are some symptoms of hypervolemia in patients hypotonic alterations?* acute: cerebral edema with confusion and convulsions. chronic: weakness, nausea, weight gain, headache, muscle twitching
What are some symptoms of hypovolemia in hypotonic alterations?* behavioral and neurological changes( lethargy, headache, confusion)
Hypotonic alterations inflate the ICF. What are some effect it has on the body from the ICF?* brain cell swelling, systemic edema
What is Potassium Homeostasis? Intake must equal excretion, regulated by kidney potassium excretion.
What does Potassium Homeostasis do?** Maintains ICF osmolality, glycogen deposition in liver, skeletal muscle, resting membrane potential of nerve and muscle cells
What is K+ excretion governed by? concentration gradients in kidney tubule cells, pH, electrical potential across distal kidney tubule, aldosterone, and insulin
What is Hypokalemia? decreased K+ intake, increased K+ entry into cells, increased urinary K+ excretion
What is Alkalosis? ECF K+ exchanges with ICF H+ to decrease ECF pH. It is when the body feels it is necessary to swap K+ with H+ instead of keeping the balance.
What all can result in Hypokalemia? treatment of pernicious anemia, diarrhea, excess aldosterone secretion, antibiotics( gentamicin)
What are some symptoms of Hypokalemia? Metabolic, renal, neuromuscular, and cardiac dysfunctions, treated by correction of underlying acid/base/ imbalance, ingestion of K+ rich foods, or intravenous replacement.
What is Hyperkalemia? increased K+ intake; shift of K+ from ICF to ECF, decreased renal excretion
What can result in Hyperkalemia? cell trauma, acidosis, cell hypoxia, burns, crush injuries, decreased aldosterone secretion
What are some symptoms of Hyperkalemia? Muscle weakness, neuromuscular irritability, ECG changes, treated by sodium bicarbonate correction of acidosis, cation exchange resins
Increased plasma K+ has a direct effect on ______. This in turn increases ______ secretion which increases _______ _____________. the adrenal cortex, aldosterone , plasma aldosterone
Increased plasma aldosterone increases __________ ____________ permeability to ____ and ____ and inc. basolateral membrane Na+/K+-ATP activity in __________ ______ principal cells. What does this do? luminal membrane, Na+, K+, collecting duct. This increases K+ secretion which increases potassium excretion.
Calcium's total body content is _______. 1200g, 99% in bone.
Of the existing 1%, it is in ______. * plasma
40% of the remaining 1% exists in what? unbound or free form (biologically active)
Ca+ is the major cation forming what? bones, teeth, nerve transmission, intracellular signaling, muscle contraction.
Calcium and phosphate are regulated by what? parathyroid hormone (PTH), vitamin D, and calcitonin action on bones, GI tract, and kidneys
What is Hypocalcemia? When your Ca+ concentration is low in the ECF
Low Ca+ is detected by what? What does it do as a reaction? The 4 parathyroid glands, releases an Inc of PTH
Increased PTH acts on what 2 things in the body? bone and kidney
The kidney increases what in response to increases PTH? Ca+ reabsorption , phosphate excretion, and increase of Vit D which acts on the small intestines which increase Ca+ reabsorption
What does an increase of PTH do to the bone? Increases Ca+ pumping to the ECF and increased bone reabsorption
What is the main goal of increasing PTH production? Increase Ca+ concentration in the ECF
High Ca+ levels in the ECF are detected by what? Thyroid gland
The thyroid gland releases what? Calcitonin
What does calcitonin do? Stimulates Ca+ deposition in bones and reduces Ca+ uptake in kidneys
As a result of calcitonin release, what happens in the body? Blood Ca+ level declines to set point
Homeostasis for blood Ca+ is what? 10mg/100 mL
What causes Hypocalcemia? inadequate dietary intake, dec. intestinal absorption, calcium deposition into soft tissue, blood transfusions, deficiency of PTH or Vit D, Dec. production of active Vit. D
What are some symptoms of Hypocalcemia? Inc. neuromuscular excitability, confusion, paresthesias, around mouth and digits, carpopedal spasm, hyperreflexia, severe convulsions and tetany
How can Hypocalcemia be treated? IV calcium gluconate, oral calcium, reduced phosphate intake.
What is Hypophosphatemia? Low phosphate levels in the body
What causes Hypophosphatemia? intestinal malabsorption, inc renal excretion of phosphate
What causes intestinal malabsorption ? Vitamin D deficiency, antacid use, alcoholism
What are symptoms of Hypophosphatemia? reduced capacity for oxygen transport by RBCs, disturbed energy metabolism, leukocyte and platelet dysfunctions, bone resorption
Are there treatments of Hypophosphatemia? Administration of phosphate salts is dangerous, low phosphate levels are not considered life- threatening
What is Hypercalcemia? High Ca+ in the body
What causes Hypercalcemia? hyperparathyroidism, excess Vit D, sarcoidosis
What are some symptoms of Hypercalcemia? loss of cell membrane excitability, fatigue, weakness, lethargy, anorexia, nausea, constipation. Kidney stones can form as precipitates of calcium salts
What is a treatment of Hypocalcemia? IV isotonic saline will enhance renal calcium excretion
What role does Magnesium have in the body? It is a major intracellular cation, regulated by small intestine, kidney. It is a cofactor in enzymatic actions, protein synthesis, nucleic acid stability, neuromuscular excitability.
What causes Hypomagnesemia? Malnutrition, malabsorption syndromes, alcoholism, loop and thiazide diuretics
What are some symptoms of Hypomagnesemia? causes depression, confusion, increased reflexes, muscle weakness.
What treats Hypomagnesemia? IM, IV magnesium sulfate
What causes Hypermagnesemia? excessive intake of Mg- containing antacids
What are some symptoms of Hypermagnesemia? depresses muscle contraction and nerve function, causes nausea, vomiting, hypotension, bradycardia.
What are some treatments of Hypermagnesemia? removal of Mg by dialysis
What is sarcoidosis? The growth of tiny collections of inflammatory cells in different parts of the body. Causes Hypercalcemia