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D236 Pathophysiology - final exam with full solution

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D236 Pathophysiology - final exam with full solution

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D236 Pathophysiology - final exam
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C

Terms in this set (508)
hydrostatic pressure pushing force exerted by water in the bloodstream.


osmotic pressure pressure exerted by the solutes in solution. Most often
electrolytes


Oncotic pressure (colloid osmotic pressure) a form of osmotic pressure exerted by proteins, notably
albumin, in a blood vessel's plasma (blood/liquid) that
usually tends to pull water into the circulatory system.


Normal albumin levels 3.1-4.3 g/dL


osmolality the concentration of solutes in body fluids


Normal plasma osmolality 282-295 milliOsmoles/kg
*higer the number the more dehydrated

,RAAS (renin-angiotensin-aldosterone Renin is released by kidneys in response to decreased
system) blood volume; causes angiotensinogen to split & produce
angiotensin I; lungs convert angiotensin I to angiotensin II;
angiotensin II stimulates adrenal gland to release aldosterone
& causes an increase in peripheral vasoconstriction
causes vasoCONSTRICTION (raises BP) and sodium &
water RETENTION to the blood stream and potassium
excretion (urine)




Natriuretic peptides Natriuresis is the excretion of a large amount of sodium
and water.
Three Major peptides:
ANP: produced by the
atria BNP: produced by
ventricles
CNP: secreted by endothelial cells



edema Abnormal accumulation of fluid in interstitial spaces of tissues.


acid H+


base hco3-


blood pH 7.35-7.45


protein buffer system largest buffering system in the body. the amino and carboxyl
groups enable proteins to absorb or donate H+ (acid).
primarily done by hemoglobin.


phosphate buffer system PO4- can take on the acidic form


carbonic acid-bicarbonate buffer system chemical system that helps maintain pH homeostasis of
the blood


Lung pH balance responds within minutes- reaches max by 24hrs.
increase ventilation: lowers CO2 raising pH
Decrease ventilation: raises CO2 lowers pH
Normal range of PCO2 is 35-45




Kidney pH balance takes hours to a day to respond.
When pH is too low: the kidneys excrete H+ (urine)
and reabsorb HCO3-
When pH is too high: the kidneys excrete HCO3- (urine)
and reabsorb H+

,metabolic alkalosis high pH, high HCO3


Respirations decrease


FROM:
Vomitting



metabolic acidosis low pH, low HCO3


Respirations increase


FR
OM:
D
KA
diarrhea

respiratory acidosis low pH, high CO2
Kidneys excrete H+ reabsorb HCO3-




respiratory alkalosis high pH, low CO2
Kidneys excrete HCO3- reabsorb H+




PCO2 normal range 35-45 mmHg


PO2 Normal Range 90-100 mmHg


HCO3 normal range 22-26 mEq/L


SaO2 (Oxygen Saturation) 95-100%


Anion gap Difference between the concentrations of serum cations and
anions: determined by measuring the concentrations of
sodium cations and chloride and bicarbonate anions.
Higher pH= higher gap




Sequestered Fluids fluid accumulates in body cavities normally free of fluids


Syndrome of Inappropriate Antidiuretic too much water in blood stream often cause by cirrhosis,
Hormone (SIADH) polycystic kidney disease, and HTN. causes HYPONATREMIA

, Sodium Imbalances: Hyponatremia Sodium level less than 135.


Casues:
Adrenal insufficiencies
diuresis
diuretics
diarrhea
vomiting
sweating
CF
burns
excess water in blood- diluting sodium levels


Symptoms:
thirst
drymouth
hypotenison
tachycardia
high BUN
siesures
coma


Sodium Imbalances: Hypernatremia Sodium level greater than 145


Causes:
medications
Cushing's
diarrhea
excess sodium
hypercalcemia
potassium depletion


Treatment: titration of fluid to decrease risk of coma and death




natremia normal levels 135-145


kalemia normal range 40-60

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