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HCO-3 + H+ H2CO3CO2 + H2O
Circulating hydrogen ions and bicarb are shift through the carbonic acid intermediate to make more carbon dioxide.
a decreased or insufficient level of O2 in the tissues. May develop because of pneumonia because fluid in the lungs prevents diffusion of O2.
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
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.
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.
Afterload is determined by
peripheral resistance to opening of semilunar valves. It is increased by high diastolic pressure resulting from excessive vasoconstriction.
What is important about CSF?
an equal amount of cerebro-spinal fluid must be absorbed and produced simultaneously to maintain correct pressure
crossed eye or deviated eye, occurs when focusing on an object, causes diploplia. could lead to a reduction in vision of the affected eye
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
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.
Why is there a normal delay in conduction in the AV node?
It allows the ventricles to fill completely.
vasodilation in the skin and viscera results from
relaxation in the smooth muscles of the arterioles
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 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.
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.
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 vital capacity?
The maximum amount of air that can be exhaled after the maximum amount of air is inhaled.
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.
Why does collateral circulation develop?
develops in a brain affected by atheroma if the condition develops over time. This may help prevent a CVA.
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 is a depressed skull fracture?
A skull fracture where the broken bone is pushed to a level below the rest of the skull.
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.
How is CO2 transported through the blood?
as bicarb on an amino acid on the globin portion of hemoglobin
highly vascular tissue which appears pink or red in color; fragile & easily broken
interfere w/ attachment of virus to host cells; interfere w/ shedding of protein coat
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
excess in acids (lactic acid)
bicarbonate levels will decrease because it's being used to counteract the acid
due to sedation, respiration becomes shallow and less CO22 is expelled. bicarbonate levels decrease due to increased usage (counteracting increased acid)
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
In the liver, amino acids are used to created complex molecules through the process of _________ .
5th, 9th, 10th and 12th (trigeminal, glossopharyngeal, vagus and hypoglossal)
Which cranial nerves are responsible for swallowing?
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?
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 -
genetics, environmental factors & auto-immune issues
Inflammatory bowel disease is caused by __________.
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?
Kidney disease can cause hypokalemia or hyperkalemia which both lead to ________.
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 __________.
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
immune complex causes deposits in glomerular tissue causing inflammation
Post-streptococcal glomerulonephritis -
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 _______________ .
pannus in rheumatoid arthritis. A pannus will covers and deprives the cartilage of nutrients it would otherwise receive from the synovial fluid.
Articular cartilage is damaged by
increased glucose in urine changes osmotic pressure
Polyuria in diabetes occurs because ____________________.
In what situations does phosphate play a key role?
Bone metabolism, ATP production, acid-base balance
Why do patients with sickle cell anemia suffer infarctions and occlusions?
abnormal shape of RBC's obstructs capillaries which causes hypoxia
How does blood flow in ventricular septal defect?
blood flows from the left ventricle to right ventricle (oxygenated to unoxygenated)
What is flail chest?
a break of consecutive ribs in two places which causes paradoxical motion during respiration
Why do patients with cirrhosis have an increase in ammonia?
because of increased bleeding in abdominal cavity
What occurs in renal disease due to the increase of renin secretion and congestion in the glomeruli?
colloid osmotic pressure decreases
What are signs of hydrocephalus in a neonate?
bulging fontanelles, irritability, won't eat, eyes gaze downward
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