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What are the 3 mechanisms that all work together in concert to minimize any changes in blood ph? 1.Ec and Ic buffering. 2. Adjustment in blood pCO2 by alteration in the ventilation rate of the lungs. 3.Adjustment in renal acid excretion. ...*also restoration of the blood pH to its normal value requires correction of the underlying process.
What is a buffer? A buffer prevents any change in the PH when H is removed.
What is a major and minor extracellular buffer and its pK? Bicarb is major pk-6.1 phoshphat is minor pk 6.8
What are some intracellular buffers? proteins like hgb, deoxyhgb, organic phosphates liek amp, adp, atp
What are 3 primary systems in the body that regulate the H in body fluids? 1. Chemical acid/base buffer systems of body fluids by combining w/SA/B to convert to weak. 2. 2nd line is respiratory center acts in few minutes to eliminate CO2. 3. Kidneys acts in hours to days . this is the most powerful which includes bbs, pbs, abs
What are some ways to gain H? generation of h ions from co2 in tissue capillaries. loss of bicarb in urine, diarrhea, production of non-volatile acids from metabolism of protein and organic sourcdes.
What is the Henderson Haseelbach equation? To calculate pH in a solution of a WA/WB. Its used to determine which buffer can be used in a solution at a specific pH.
The phosphate buffer is a minor buffer but the most important ________ urinary buffer
What are the 3 fundamental processes that regulate the H in ECF? 1.Reabsorption of filtered HCO3. 2. Production of new HCO3 3. Secretion of H in tubular lumen.
What is the anion gap? Refers to concentration of unmeasured anions in the body. ie. proteins. po4.so4.organic acids
Metabolic acidosis associated with increased AG and Normal Cl MUDPILES methanol, uremia, diabetic ketoacidosis, paraldehyde,phenformin, iron tablets or inh, lactic acidosis, ethylene glycol, salicylates
metabolic acidosis associated with normal AG but Increased CL CARD carbonic anhydrase,addisons disease, renal tubular acidosis, diarrhea
80% of UTIs are caused by E. Coli
UTI associated with renal calculi Klebsiella, Proteus, Pseudomonas
UTI associated with young females Staph. Saprophyticus
UTI associated with instrumentation St. Aureus, enterococcus
cystitis Sudden onset, suprapubic tenderness, urethral discharge think std ,treat uncomplicated w/bactrim x3days,cipro x3d, fluids-cranberry-water, sitz bath
why cant you give a quinolone to children. <18yrs old Children less than 18 years of age have a higher chance of getting bone, joint, or tendon (musculoskeletal) problems such as pain or swelling while taking CIPRo
Urethritis Hallmark is internal dysuria, caused by STD-hsv, gonorrhea, chlmaydia,
Pathogen for Acute Pyelonephritis EPP-e coli, proteus, pseudo
Hallmark for Acute pyelonepritis CVA tenderness
Pathognomonic for APN WBC cast
Treatment for uncomoplicated APN Oral quinolone 7-14days . Initial dose IV Cefrtrioxine followed by oral Bractrim for 14 days.
Treatment for complicated APN Requires hospitalization. Parental quinolone, ceftriaoxne, ampicillin/gentamicin
Most common pathogen for acute bacterial prostatitis e coli
prostate describition in abp swollen tender boggy
clinical manifestations of abp fever, chills, low back pain or perineal pain, dysuria
Treatment for ABP Admit to hospital, Initiate IV flouroquinolone, follow with oral ofloxacin 400mg bidx14 days ....if gonorrhea/chlymydia present give them ceftriaxone 250mg IM them doxycycline 100mg bids 14days
Chronic prostatitis occurs in middle age men, history of bacteriuris, chronic pelvic pain, prostalgia
Common pathogens for chronic prostatitis EPP e coli, proteus, psedomonas
Test for Diagnosing chronic prostatitis 4 glass localization test
Treatment for chronic prostatits urology referral/ciprofloxacin xweeks, ofloxacin for 6 weeks
prostate description for chronic prostatis normal prostate, large and smooth
epididymitis pathogen for <35years and >35 <35 years -chlamydia/gonorrhea >35 years-e coli
clinical manifestations of epididymitis scrotal discomfort, fever, shills, warm scrotal mass, swollen tender epididymis
what 2 signs/reflex are positive with epididymitis Phrens' sign -pain relieved with elevatin of scrotum or when supine. Cremasteric reflex is present on the ipsilateral side.
treatment for epididymitis gon-ceftriaxone 250mg IM chlamydia-doxycycline 10mg bid x 10days e coli-ciprofloxacin 500mg bid for 10 days
Orchitis is a secondary manifestation of ____ mumps from paramyxovirus
treatment for orchitis mumps-symptomatic bacteria- same regimen as epididymitis
name the 3 major syndromes in glomerular disease nephritic syndrome, nephrotic disease, asymptomatic renal disease
what are some clinical manifestations of nephritic syndrome proteinuria, hematuria,, pyuria, hypertension, fluid retention, rise in serum creat
name all of the nephritic syndromes RPGN, crescenteric gn, post strep, bergers, post strep, endocarditis related, lupus
whats special about the rpgn creat rises quickly in few days
crescenteri gn characteristic a characteristic glomerular lesion.
endocarditis associated glomerulonephritis typically a complication of subacute bacterial endocarditis, in pts. who remain untreated for long time with neg. bloood cculture patients wwho have right sided endocarditis.
lupus nephritis most severe in african american female adolescents, it results from deposition of circulating immune complexes--activate complement cascade--complement mediated damge--leukocye infiltration--release of cytokines.
most common symptom for lupus nephritis proteinuria, hematuria, hypertension, varying degreee of rheumatic fever.
which nephritic syndrome has a depressed ch50, decreased c3, and normal c4 post streptococcal glomerulonephritis
what is the most common form of glomerulonephritis worldwide with male predominance iga nephropathy/berger disease
what are the 2 presentations of iga nephropathy 1. recurrent episodes of macroscopic hematuria during or immediatedly following an upper respiratory infection in children. 2. asymptomatic microscopi hematuria often in adults.
What is used to treat alkalosis? NH4CL is used to treat alkalosis.
Chronic kidney disease is marked by a GFR of what? <60
over 70% of cases of renal disease are do to ___and ___ diabetes mellitus and hypertension
Created by: emorgan03