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hyperventilation can cause

respiratory alkalosis

HCO-3 + H+ H2CO3CO2 + H2O

Circulating hydrogen ions and bicarb are shift through the carbonic acid intermediate to make more carbon dioxide.

How is respiratory failure defined?

PaO2 = 50 and PaCO2 = 50, pH = 7.35

Hypoxia

a decreased or insufficient level of O2 in the tissues. May develop because of pneumonia because fluid in the lungs prevents diffusion of O2.

Cystic fibrosis

impedes growth and development due to lack of a pancreatic enzyme which leads to nutritional deficits. A defective gene affects a protein that controls the normal movement of sodium chloride in & out of cells and causes thick, sticky secretions in the respiratory, digestive and reproductive tracts.

Risks of Cystic Fibrosis

may develop respiratory issues such as bronchiectasis, chronic infections, collapsed lung, respiratory failure; digestive issues like diabetes, blocked bile duct, rectal prolapsed and intussusceptions.

Signs of CF in newborn

can't excrete meconium, salty skin, trouble with weight gain, cough or wheezing and large, greasy stools

Why does hypercalcemia occur because of a tumor with bronchogenic carcinoma?

Tumors secrete PTH which promotes absorption in the digestive tract, resorption of calcium from bone and inhibits secretion from the kidneys.

progressive emphysema prevents

gas exchange because increased residual lung volume prevents sufficient inhalation of O2 for the exchange

Tension pneumothorax contributes to hypoxia because

the victim can breathe in but, because of the flutter valve, air does not leave the plural space. As the condition progresses, there is less room to breathe in new air and mediastinal shift can compress the inferior vena cava

What confirms a diagnosis of TB?

The use of X-rays to detect calcifications in lungs.

Pancytopenia

a decrease or lack of all types of blood cells

Name a sign of sickle cell anemia

jaundice

Why does jaundice occur in sickle cell anemia?

RBCs deoxygenate, harden and take on the typical sickle shape. The repeated change in shape shortens the life span of an RBC to about 20 days.

signs of anemia

pallor, chills, dyspnea, tachycardia and irritability. Anemia can cause angina in stressful situations. Chronic severe anemia can lead to CHF.

Why does pernicious anemia have an effect on RBCs?

The lack of B12 shortens the life span of RBCs.

What formed blood particles do leukemias decrease?

platelets in blood

Secondary polycythemia increases

hemoglobin due to chronic hypoxia. Doing a phlebotomy can lower the amount of RBCs.

Iron deficiency anemia is caused by

vegetarian diets, excessive menstrual flow, and hemorrhage due to hemorrhoid or cancer. Only 5-10% of ingested iron is absorbed but that increases to approx. 20% when there is a deficit.

Severe hypoxia with pneumonia occurs because

there is less O2 perfusion due to congestion in the lungs. Hypoxia is also caused by the residual volumes caused by emphysema.

Define Premature Ventricular Contraction (PVC)

an additional beat arising from a ventricular muscle cell or an ectopic pacemaker. These are related to pulse deficit (difference in rate between apical pulse and radial pulse). With premature ventricular contraction, no blood is being pumped; the PVC is only an extra beat. Occasional PVCs don't interfere with heart function, but as frequency increases or with paired PVCs, V-Fib can result and lead to cardiac arrest.

Define Preload

venous return to heart (pre-beat) while atria are relaxed

Afterload is determined by

peripheral resistance to opening of semilunar valves. It is increased by high diastolic pressure resulting from excessive vasoconstriction.

Epinephrine and Norepinephrine increase

systemic vasoconstriction

What is important about CSF?

an equal amount of cerebro-spinal fluid must be absorbed and produced simultaneously to maintain correct pressure

strabismus

crossed eye or deviated eye, occurs when focusing on an object, causes diploplia. could lead to a reduction in vision of the affected eye

nystagmus

involuntary, sideways jerking motions of eyes; involuntary unilateral, bilateral or rhythmic eye movement; caused by Meniere's disease, brain tumor, brain injury, stroke, alcoholism, labrynthitis, stroke, some drugs

pink eye is caused by

an infection of S. aureus.

What causes DIC (disseminated intravascular coagulation)?

multiple clots which have used up all the clotting factors; heparin may be used to thin the blood and make more clotting factors available; caused by cancers of lung, pancreas, prostate, stomach and by acute myeloid leukemia, abruption placenta, pre-eclampsia, massive tissue injury, gram negative infections, liver disease.

What is the primary treatment for leukemia?

chemotherapy

Is stroke volume identical from both ventricles?

YES

Why is there a normal delay in conduction in the AV node?

It allows the ventricles to fill completely.

Increased HR and force of contraction is caused by:

epinephrine

vasodilation in the skin and viscera results from

relaxation in the smooth muscles of the arterioles

diuretics cause

a decrease in Na and fluid retention in the body

What causes thrombus formation?

immobility, vascular damage, atrial fib, artificial valves, hypercoagulability

With total heart block, what happens to ventricular contractions?

They are not as forceful and are irregular.

What are two characteristics of paroxysmal nocturnal dyspnea?

rales and hemoptysis

What are the effects of rheumatic fever?

changes in heart, can cause an abnormal immune response that affects all layers of the heart. signs include subQ nodules, epistaxis, fever, leukocytosis, issue with large joints like knees and hips.

Intermittent claudication

pain in legs during exercise (progresses to pain while resting) due to interruption of flow in the iliac artery. Intermittent claudication is a symptom od PAD.

dissecting aortic aneurysm

tear in endothelium that allows bleeding between layers of arterial wall

What is a common adverse effect of anti-hypertensive meds?

orthostatic hypotension

What's the most dangerous cardiac dysrhythmia?

Ventricular fibrillation because it's hard to shock the heart back into a normal sinus rhythm.

What is a confirming diagnosis of MI?

Changes in EKG and in isoenzymes like troponins, CKs and NBs

Does quiet expiration requires energy?

No

What is vital capacity?

The maximum amount of air that can be exhaled after the maximum amount of air is inhaled.

What is the air left in lungs between breaths?

Residual volume

Hypercapnia or increased PaCO2(too much CO2) causes

respiratory acidosis

Patients with respiratory alkalosis will

have too little CO2.

What is the most effective compensation for respiratory acidosis?

Kidneys increase production of bicarb.

Why do humans suffer repeated flu virus infections?

The virus mutates continually so that our immune systems are unable to recognize it.

Fibrosis of bronchial wall causes

chronic bronchitis

Atelectasis with airway obstruction causes

decreased breath sounds on the side of the affected lung

Adults or infants with ARDS have

respiratory alkalosis

Why does collateral circulation develop?

develops in a brain affected by atheroma if the condition develops over time. This may help prevent a CVA.

Where does a Berry aneurysm normally occur?

in bifurcations of the circle of Willis

What are the signs of a Berry aneurysm?

they are asymptomatic until they burst, then indicated by blood in CSF collected by LP.

What are the signs of meningitis?

nuchal rigidity, headache, vomiting, seizures, confusion, fever, lack of hunger or thirst, sleepiness or difficulty staying awake and skin rash, in some cases.

What causes encephalitis?

tick (spirochete) and mosquito bites

What is a depressed skull fracture?

A skull fracture where the broken bone is pushed to a level below the rest of the skull.

After a head injury, what causes secondary damage?

infection, pressure, bleeding

Secondary damage after SCI can include

catecholamine release, fracture of vertebrae, BP issues

How is seizure diagnosed?

EEG

What is flail chest?

a break of consecutive ribs in two places

What is tension pneumothorax?

a hole in the chest that allows air into the pleural cavity, air can't move back out because of a flap of skin or tissue that covers the opening on expiration.

Where is lumbar puncture performed and why?

between L3 and L4 because there is a wider opening there to accommodate the needle. At this level, there is less chance of damage to the spinal column because this is below the level of the cord.

What are the signs of Parkinson's disease?

difficulty swallowing and chewing, urinary retention problems and orthostatic hypotension.

Define cor pulmonale.

right side congestive heart failure which affects venous return to the heart, so blood backs up into the system.

What does left sided heart failure cause?

blood backup into lungs.

What do focal and generalized seizures indicate?

a tumor because of pressure from inflammation

How is CO2 transported through the blood?

as bicarb on an amino acid on the globin portion of hemoglobin

Necrosis

groups of cells die

ischemia

decrease of blood flow to tissue

preventative measures

sunblock and other measures meant to prevent injury or disease

examples of specific defenses

lymphocytes, macrophages,

phagocytosis

destruction of foreign substances, microbes, debris, etc.

generalized cutaneous dilation

blood vessels enlarge & can reduce temperature

granulation tissue

highly vascular tissue which appears pink or red in color; fragile & easily broken

rule of nines

can help determine fluid replacement needs, esp. in case of burns and protein shift

prostaglandins

manufactured in mast cells & causes vasodilation; increase capillary permeability

neutrophils

phagocytosis of microorganisms

signs/symptoms of AIDS

Kaposi's sarcoma; low Tcell count; loss of body fat; lymphoma

tests to diagnose HIV

ELISA, Western Blot and RNA/DNA testing; test lasts 20 minutes

opportunistic infection

can be caused by yeast or other resident flora

local signs of infection

hyperemia, pain, edema, loss of function, exudates

antiviral drugs

interfere w/ attachment of virus to host cells; interfere w/ shedding of protein coat

example of ionizing radiation

gamma rays from cobalt machine

neutropenia (during chemo)

low white blood cell count; will delay chemo id WBC is below threshold

glucocorticoids (steroids)

given during chemo or radiation can decrease inflammation around the tumor

increase in osmotic pressure

will cause water to shift from high to low; water shifts from interstitial fluid into blood

osmotic pressure, high to low

a high concentration will facilitate movement of nutrients from the arteriolar end (higher pressure) into tissue. At the venous end, low pressure allows wasters to flow back into the vascular system. Na+ highest outside cells; K+ highest concentration is intracellular

hyponatremia

most common cause is sweating

hypernatremia

condition in which too much sodium is present

hypokalemia and hyperkalemia

both cause cardiac dysrhythmias

PTH

causes increased absorption of calcium in the digestive tract

phosphate ions

important in ATP production & important in acidbase balance (buffer system)

normal pH

7.35 to 7.45 below 7.35 is acidosis; above 7.45 is alkalosis

metabolic acidosis

caused by diabetic ketoacidosis, diarrhea

excess in acids (lactic acid)

bicarbonate levels will decrease because it's being used to counteract the acid

emphysema

causes respiratory acidosis due to decline in CO2 expulsion (obstructive disorder)

infants are more susceptible to dehydration because

they have less fluid to begin with

respiratory acidosis

due to sedation, respiration becomes shallow and less CO22 is expelled. bicarbonate levels decrease due to increased usage (counteracting increased acid)

metabolic acidosis leads to

an increase in K+, pulls K+ out of cells into blood

how many chromosomes does a human have?

23 pairs, including 1 pair of sex chromosomes

teratogens

can cause issues or defects during organogenesis

organogenesis

period during first 2 months of pregnancy when organs and systems differentiate

local sign of osteomyelitis

pain, redness, swelling

form of Staphylococcus

clustered (think of staph meeting)

form of Streptococcus

strip (think of strep bar)

hyponatremia

causes: sweating, low sodium diet, excessive water intake, use of diuretics; hormone imbalance (insufficient aldosterone or excessive ADH, due to water retention dilutes NA+ concentration), adrenal insufficiency, renal failure

effects: muscle cramps, hypovolemia, brain cells swell causing confusion, seizures, headache, decreased BP, fatigue, heart problems due to conduction issues

ileum

What is the primary site for absorption of nutrients?

forms the outer covering of the stomach

Where is the visceral peritoneum?

anabolism

In the liver, amino acids are used to created complex molecules through the process of _________ .

loss of acids in stomach and dehydration

Prolonged vomiting causes alkalosis because of...

lactic acid

Dehydration causes acidosis because of increased production of _______ .

5th, 9th, 10th and 12th (trigeminal, glossopharyngeal, vagus and hypoglossal)

Which cranial nerves are responsible for swallowing?

esophageal atresia (narrowing)

_______ causes the inability to get food or fluid into the stomach

floor of the mouth

A common location for oral cancer is the ________.

raw eggs and uncooked poultry

What causes gastroenteritis due to salmonella?

via the oral-fecal route (restaurants or day care centers)

How is hepatitis A transmitted?

lower left quadrant

Where is the pain from diverticulitis felt?

the liver

Where is the first area that colon cancer usually metastasizes?

cuts off blood supply

Volvulus (twisting of bowel on its mesentery) causes gangrene in the bowel because the twisting _________________ .

leakage of intestinal bacteria into the gut, paralytic ileus (paralysis of the intestinal muscles which prevents peristalsis) and shock.

Why does chemical peritonitis occur because of perforated gallbladder?

the proximal duodenum

What is the most frequent location for peptic ulcers?

dark-colored, bloody stool caused by bleeding in the GI tract. often a sign of peptic ulcer or bowel disease

What is melana?

eating smoked food or food with lots of nitrates, heredity

Predisposing factors for gastric carcinoma -

Cirrhosis

______ causes elevated serum bilirubin, both conjugated and unconjugated.

genetics, environmental factors & auto-immune issues

Inflammatory bowel disease is caused by __________.

the trigone

What is the area formed by the three openings of the bladder?

flank pain and urinary casts

What are the symptoms of pyelonephritis?

problems with tubular exchanges cause problems excreting bicarb

Why does metabolic acidosis develop with bilateral kidney disease?

gradual onset of chronic renal failure after age of 40

What is the onset of polycystic kidney disease?

cardiac dysrhythmias

Kidney disease can cause hypokalemia or hyperkalemia which both lead to ________.

chronic renal failure

persistent glomerulonephritis will eventually cause

sacral reflexes

Defecation reflex requires coordination of _____________.

hypertension and chronic renal failure

With nephrosclerosis (hardening of the kidney), you will likely also see ________________ and _____________ .

serious infection, dehydration, pancreatitis, surgery, trauma, myocardial ischemia

Precipitating factors for DKA include __________.

staggering gait, confusion, disorientation, sweating

Signs of hypoglycemia -

abnormal metabolism in the lens

Visual impairment in diabetes is caused by ______________.

Decreased glucocorticoids; increased glucocorticoids

____________ cause Addison's disease, _____________ cause Cushing's disease.

pendulous abdomen and breasts, truncal obesity, staring eyes, buffalo hump, increased levels of glucocorticoids, atrophy of lymph nodes

What are the characteristics of Cushing's disease?

a poor stress response. Symptoms include muscle weakness and fatigue or pain, joint pain, weight loss and decreased appetite, hyperpigmentation, low blood pressure and syncope, salt craving, hypoglycemia, irritability or depression

Addison's disease causes

deficiency of ADH

Diabetes insipidus caused by a __________________ .

immune complex causes deposits in glomerular tissue causing inflammation

Post-streptococcal glomerulonephritis -

microscopic hematuria

Initial sign of adenocarcinoma of kidney -

absorption of NA+ and water

Furosemide or Lasix decreases

negative feedback loop

Increased blood glucose causes increased secretion of insulin, which is an example of a _________________ .

prolonged use of steroids

Decreased secretion of glucocorticoids in the adrenal glands results from _______________ .

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