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Main Concepts
PASS program drill notes
| Question | Answer |
|---|---|
| What electrolytes does the low volume state have? | ↑ total Na Serum Levels: ↓Chloride ↓K ↓ Calcium (bound to albumin) ↓serum Na (dilutional effect) |
| What pH does the low volume state have? | Alkalotic (except diarrhea, RTA type II, and DKA) because Aldosterone dumps H+ |
| What pH does vomiters have? | Alkalotic because you vomit out H+; low volume state |
| What pH does diarrhea have? | Acidosis because stool has bicarbonate from pancreas |
| What happened if pulse ↑ > 10 on standing? | Hypovolemic shock |
| What happened if pulse ↑ > 5 on standing? | Autonomic dysfunction |
| What are the symptoms of a low energy state in major systems? | CNS: mental retardation, dementia; ↓ activity CV: heart failure, pericardial effusion MUSCLE: weakness, SOB, vasodilation, impotence, urinary retention, constipation |
| What are the symptoms of a low energy state in rapidly diving cells? | Skin -> dry Cuticles -> brittle nails Hair-> alopecia Bone marrow --> suppressed Vascular endothelium --> breaks down, vasculitis Lungs --> infection, SOB Kidney --> PCT will feel the effect first GI --> N/V/D Bladder --> urinary retention Sperm --> Low count Germ cells --> predisposed to cancer Breast --> atrophic Endometrium --> amenorrhea |
| What are the most common signs of low energy state? | Tachypnea and dyspnea |
| What are the most common symptoms of low energy state? | Weakness and SOB |
| What are the most common infections of the low energy state? | UTI and respiratory infections |
| What is the MCC of death in the low energy state? | Heart failure |
| Explain all Restrictive lung diseases: | Restrictive: Interstitial problem (non-bacterial); ↓ diffusion & perfusion 1. Small stiff lungs (↓ VC) 2. Trouble breathing IN ==> FEV1FVC >0.8 3. ABG: ↓pO2 ==> ↑RR, ↓pCO2, ↑pH 4. CXR: reticulo-nodular pattern, ground-glass appearance 5. Die of cor pulmonae 6. Ex: Neuromuscular diseases (breathing out is passive), drugs, autoimmune disease 7. Tx: Pressure support on ventilator, ↑O2, ↑RR, ↑inspiratory time, ↓TV |
| Explain all Obstructive lung diseases: | Obstructive: Airway problem (bacterial) 1. Big mucus-filled lungs (↑RV, ↑Reid index = ↑airway thickness/airway lumen) 2. Trouble breathing OUT ==> FEV1/FVC < 0.8 3. ABG: ↑pCO2 ==> ↑RR, ↓pH 4. Die of bronchiectasis 5. Ex. COPD 6. Tx: Manipulate rate on ventilator, ↑RR, ↑expiratory time, ↑O2 only if needed |
| What symptoms does a "more likely to depolarize" state have? | 1. Brain --> psychosis, seizures, jitteriness 2. Skeletal Muscle --> muscle spasms, cramps 3. Smooth Muscle --> weakness, SOB 4. Cardiac --> tachycardia, arrhythmias |
| What symptoms does a "less likely to depolarize" state have? | 1. Brain --> lethargy, mental status changes, depression 2. Skeletal muscle --> weakness and SOB 3. Smooth muscle --> constipation 4. Cardiac --> hypotension, bradycardia |
| What is the humoral immune response? | B cells and PMNs patrol the blood looking for bacteria |
| What is the cell-mediated immune response? | T cell and macrophages patrol the tissues looking for non-bacteria |
| What are macrophages called in each area of the body? | Blood --> Monocytes Brain --> Microglia Lung --> Type 1 pneumocytes Liver --> Kupffer cells Spleen --> RES cells Lymph --> Dendritic cells Kidney --> Mesangial cells Payer's patches ---> M cells Skin --> Langerhans cells Bone ==> Osteoclasts Connective tissue: 1. Histiocytes 2. Giant cells 3. Epithelioid cells |
| What is the CBC for every vasculitis? | ↓ RBC, ↓ platelets, ↑WBC, ↑T cells, ↑ MP, and schistocytes, ↑ ESR |
| What is the time course of the inflammatory response? | 1 hr. --> swelling Day 1 --> PMNs show up at 4.5 hours, predominate at 24 hours Day 3 --> PMNs peak Day 4 --> MP/T cells show up Day 7 --> MP/T cells peak, fibroblasts arrive Day 30 --> Fibroblasts peak Month 3-6 --> Fibroblasts complete fibrosis |
| What state does estrogen mimic? | The neuromuscular disease state (estrogen is a muscle relaxant) |
| What does high GABA levels lead to? | Bradycardia, lethargy, constipation, impotence, and memory loss |
| What is Necrosis? | Non-programmed cell death = noisy, inflammation, nucleus destroyed first |
| What part of the cell is destroyed first in Necrosis? | Nucleus |
| Non-programmed cell death | Necrosis |
| What is Apoptosis? | Programmed cell death = quiet, no inflammation, nucleus guides it --> |
| What is Pyknosis? | Nucleus turns into blobs "pic blobs" |
| What is Karyohexis? | Nucleus fragments |
| What is Karyolysis? | Nucleus dissolves |
Created by:
rakomi
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