Pathophysiology Lecture 2 Exam 1
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| 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 .
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| 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.
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| Describe Hypotonic Alteration on a neuron. | Sodium is decreased in the ECF so water diffuses to the inside of the neuron causing cell enlargement.
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| 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.
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| 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.
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| Describe Hypertonic Alteration in a body cell. | High Sodium levels cause water to leave ICF which shrinks the body cell.
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| 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.
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| What are Isotonic Alterations? | proportionate changes in electrolytes and water.
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| What causes isotonic volume depletion? | hemorrhage, severe wound drainage, excessive diaphoresis( sweating), intestinal losses, decreased fluid intake
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| 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.
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| What causes isotonic volume excess? | excessive isotonic saline administration, aldosterone hypersecretion followed by sodium and secondary water retention.
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| What are some symptoms of isotonic volume excess? | weight gain, decreased hematocrit, increased blood pressure. If severe: pulmonary edema or heart failure.
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| 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
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| What is Hypernatremia? | Na+ levels exceed 147 mEq/L due to gain in Na+
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| What causes Hypernatremia? | hypertonic saline administration; aldosterone hypersecretion, Cushing's Disease ( elevated adrenal glucocorticoid and mineralocorticoid, ex. aldosterone, secretion)
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| What are some symptoms of hypervolemia in a hypertonic alteration?* | weight gain, bounding pulse, increased blood pressure, edema, venous distention
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| What causes water deficit? | inadequate water intake, watery diarrhea, diabetes insipidus, (low ADH secretion, concentrated urine), excessive diuresis, excessive diaphoresis
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| What are some symptoms of hypovolemia in a hypertonic alteration?* | weight loss, weak pulses, postural hypotension, tachycardia
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| 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)
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| What are Hypotonic Alterations? | decreased ECF osmolality due to manipulation of Na+ or its diluent water; result is osmotic movement from ECF-ICF
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| What is Hyponatremia? | due to Na+ loss( inadequate intake; hypoaldosteronemia; excessive diuretic therapy)
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| 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
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| What does SIADH mean? | Syndrome of inappropriate ADH secretion.
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| 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
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| What are some symptoms of hypovolemia in hypotonic alterations?* | behavioral and neurological changes( lethargy, headache, confusion)
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| Hypotonic alterations inflate the ICF. What are some effect it has on the body from the ICF?* | brain cell swelling, systemic edema
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| What is Potassium Homeostasis? | Intake must equal excretion, regulated by kidney potassium excretion.
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| What does Potassium Homeostasis do?** | Maintains ICF osmolality, glycogen deposition in liver, skeletal muscle, resting membrane potential of nerve and muscle cells
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| What is K+ excretion governed by? | concentration gradients in kidney tubule cells, pH, electrical potential across distal kidney tubule, aldosterone, and insulin
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| What is Hypokalemia? | decreased K+ intake, increased K+ entry into cells, increased urinary K+ excretion
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| 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.
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| What all can result in Hypokalemia? | treatment of pernicious anemia, diarrhea, excess aldosterone secretion, antibiotics( gentamicin)
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| 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.
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| What is Hyperkalemia? | increased K+ intake; shift of K+ from ICF to ECF, decreased renal excretion
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| What can result in Hyperkalemia? | cell trauma, acidosis, cell hypoxia, burns, crush injuries, decreased aldosterone secretion
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| What are some symptoms of Hyperkalemia? | Muscle weakness, neuromuscular irritability, ECG changes, treated by sodium bicarbonate correction of acidosis, cation exchange resins
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| Increased plasma K+ has a direct effect on ______. This in turn increases ______ secretion which increases _______ _____________. | the adrenal cortex, aldosterone , plasma aldosterone
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| 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.
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| Calcium's total body content is _______. | 1200g, 99% in bone.
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| Of the existing 1%, it is in ______. * | plasma
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| 40% of the remaining 1% exists in what? | unbound or free form (biologically active)
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| Ca+ is the major cation forming what? | bones, teeth, nerve transmission, intracellular signaling, muscle contraction.
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| Calcium and phosphate are regulated by what? | parathyroid hormone (PTH), vitamin D, and calcitonin action on bones, GI tract, and kidneys
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| What is Hypocalcemia? | When your Ca+ concentration is low in the ECF
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| Low Ca+ is detected by what? What does it do as a reaction? | The 4 parathyroid glands, releases an Inc of PTH
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| Increased PTH acts on what 2 things in the body? | bone and kidney
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| 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
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| What does an increase of PTH do to the bone? | Increases Ca+ pumping to the ECF and increased bone reabsorption
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| What is the main goal of increasing PTH production? | Increase Ca+ concentration in the ECF
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| High Ca+ levels in the ECF are detected by what? | Thyroid gland
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| The thyroid gland releases what? | Calcitonin
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| What does calcitonin do? | Stimulates Ca+ deposition in bones and reduces Ca+ uptake in kidneys
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| As a result of calcitonin release, what happens in the body? | Blood Ca+ level declines to set point
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| Homeostasis for blood Ca+ is what? | 10mg/100 mL
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| 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
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| What are some symptoms of Hypocalcemia? | Inc. neuromuscular excitability, confusion, paresthesias, around mouth and digits, carpopedal spasm, hyperreflexia, severe convulsions and tetany
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| How can Hypocalcemia be treated? | IV calcium gluconate, oral calcium, reduced phosphate intake.
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| What is Hypophosphatemia? | Low phosphate levels in the body
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| What causes Hypophosphatemia? | intestinal malabsorption, inc renal excretion of phosphate
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| What causes intestinal malabsorption ? | Vitamin D deficiency, antacid use, alcoholism
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| What are symptoms of Hypophosphatemia? | reduced capacity for oxygen transport by RBCs, disturbed energy metabolism, leukocyte and platelet dysfunctions, bone resorption
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| Are there treatments of Hypophosphatemia? | Administration of phosphate salts is dangerous, low phosphate levels are not considered life- threatening
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| What is Hypercalcemia? | High Ca+ in the body
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| What causes Hypercalcemia? | hyperparathyroidism, excess Vit D, sarcoidosis
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| 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
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| What is a treatment of Hypocalcemia? | IV isotonic saline will enhance renal calcium excretion
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| 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.
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| What causes Hypomagnesemia? | Malnutrition, malabsorption syndromes, alcoholism, loop and thiazide diuretics
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| What are some symptoms of Hypomagnesemia? | causes depression, confusion, increased reflexes, muscle weakness.
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| What treats Hypomagnesemia? | IM, IV magnesium sulfate
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| What causes Hypermagnesemia? | excessive intake of Mg- containing antacids
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| What are some symptoms of Hypermagnesemia? | depresses muscle contraction and nerve function, causes nausea, vomiting, hypotension, bradycardia.
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| What are some treatments of Hypermagnesemia? | removal of Mg by dialysis
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| What is sarcoidosis? | The growth of tiny collections of inflammatory cells in different parts of the body. Causes Hypercalcemia
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