Pathophysiology Final
Acute vs chronic disease: An acute disease develops suddenly, is short term,
and lasts a few days to weeks. A chronic disease develops slowly and can get
worse over time, can last months to years
Hypercapnia: Excessive CO2 in the blood stream, a normal PCO2 is
between 35-45 mmHg, often caused by hypoventilation where not enough
oxygen gets to the lungs.
· Bases/Buffers/Bicarbonate/Alkalosis:
Base: Compound that accepts H+ ion in solution; When basic ions are
predominated then it is alkaline/basic
Buffer: These systems help prevent large changes in PH by donating H+ ions
when solution is too basic, and absorbing H+ ions when solution is too
acidic. Three major buffer systems are proteins, phosphate, carbonic
acid/bicarbonate.
Carbonic acid-bicarbonate system: most common, uses CO2, H+ ions,
carbonic acid, and bicarbonate ions to create an equation that can go left or
right to help balance out Ph. Normal 22-26 mEq/L
[Renal and respiratory compensation: Lungs respond within minutes, whereas
kidneys respond in hours to days, but the response is maintained longer]
Respiratory acidosis: pH less than 7.35, CO2 increased and is greater than
45 mmHg, hypoventilation
Respiratory alkalosis: pH more than 7.45, CO2 decreased and is less than 35
mmHg, hyperventilation
Metabolic acidosis: pH less than 7.35, increased ventilation (Kussmaul’s
breathing) to blow off CO2, kidneys excrete H+ and retain bicarbonate
Metabolic alkalosis: pH more than 7.45, decreased ventilation, kidneys
excrete bicarbonate and retain H+
· Diuresis: Loss of water from the body
· Electrolyte abnormalities (Hyper/hypokalemia, hyper/hyponatremia, etc.):
Hyponatremia: Sodium less than 135 mEq/L; hypovolemic hyponatremia is
the loss of both sodium & fluid, caused thirst, hypotension, & tachycardia.
Hypervolemic hyponatremia is excessive fluid diluting sodium levels.
Hypernatremia: sodium greater than 145 mEq/L; cells become dehydrated
and shrink
, Hypokalemia: blood K concentration is less than 3.5 mEq/L; s/s are
prolonged PR interval & flattened T wave.
Hyperkalemia: blood K greater than 5.2 mEq/L; s/s are muscle cramps,
widened QRS complex, peaked T waves & bradycardia; can lead to cardiac
arrest.
Hypercalcemia: greater than 10mg/dl; s/s are elevated parathyroid hormone/
cancer; CHVOSTEK’S SIGN (face) & TROUSSEAU’S SIGN (hand during
BP)
Hypocalcemia: less than 8.7 mg/dl; s/s are paresthesia & hypotension,
increased muscle excitability
Hypophosphatemia: less than 2.5 mg/dl; s/s tremors; OPPOSITE OF
HYPOCALCEMIA
Hyperphosphatemia: greater than 4.5mg/dl; most common cause is kidney
failure; same s/s as hypocalcemia
Hypomagnesemia: less than 1.5 mEq/L
Hypermagnesemia: more than 2.5 mEq/L
· RAAS: Increases blood volume and blood pressure in response to dehydration
1. Renin is released from the kidneys and converts angiotensinogen to
angiotensin I
2. Angiotensin I converted to angiotensin II in lungs by ACE (Angiotensin
Converting Enzyme)
3. Angiotensin II (vasoconstrictor) activates the adrenal cortex to release
aldosterone
4. Aldosterone increases sodium and water reabsorption and potassium
secreted by kidneys
· Autoimmune Disease: body’s natural defense system cannot tell the difference
between your own cells and foreign cells which accidentally attacks the normal
cell
· Chemotaxis: WBCs-attract platelets and more WBCS to the injury site. WBCs
come from bone marrow and go into the bloodstream (leukocytosis). The cells
go from normal range (4,000-10,000) up to 15,000-20,000. Attracts platelets
during inflammation process
· Abnormal wound healing:
a. Keloid- hyperplasia of scare tissue
, b. Contractures- inflexible shrinkage of wound tissue which pulls edges
towards center of wound
c. Dehiscence- opening of a wound suture line ex. Doctor makes incision, and
it comes apart after
d. Evisceration- opening of wound with extrusion of tissue and organs; ex: C
section
e. Stricture- narrowing of an open area. Ex: acid reflux causes esophagus to
narrow.
f. Fistula- abnormal connection between two structures. Ex: tracheoesophageal
fistula. Chron’s and cancer takes away tissue causing fistula (artificial hole)
g. Adhesion: abnormal bands of internal scar tissue limiting mobility
· Neutrophils:
Granulocyte; Matures Neutrophils (FIRST ONES TO RESPOND) have
distinct multisegmented nuclei and are known as segmented neutrophils or
segs. When mature ones die, bone marrow sends out immature ones called
bands. They begin phagocytosis right away. Phagocytosis-recognizes and
attaches leukocytes to foreign matter. Then engulf and kill ingested matter.
· Endemic, pandemic, epidemic, incidence:
Incidence- the number of new cases within a population
Prevalence- number of active ongoing cases
Endemic- incidence and prevalence are relatively stable
Pandemic- global spread of a disease
Epidemic- abrupt increase of disease in a region
· Opportunistic infection: infection caused by microorganisms that flourish
because of a host’s lack of immune system. If an individual is
immunosuppressed, then microorganisms can multiply w/ in the body which
leads to an opportunistic infection.
· Purulent/Transudate:
a. Purulent- fluid rich in protein from WBC, microbial organisms, and cellular
debris also known as pus. (White-green discharge)
, b. Transudate- fluid contains little protein; mainly watery filtrate of blood;
watery, clear fluid is an example of a non-infected blister.
· Histamine:
Included in the inflammatory response. Histamine signals the inflammatory
response and triggers anaphylaxis, which is why antihistamines (EX
Benadryl) are taken to stop the inflammatory response. Effects include
vasodilation, increase vascular permeability, systemic effects. EX: sneezing,
Upper respiratory infection
· Systemic Lupus Erythematosus:
Multisystem disease
Chronic disease w/ remission & exacerbations
Skin rash (butterfly rash across cheeks), joint inflammation, kidney damage,
vasculitis, Raynaud’s phenomenon.
Genetically passed; environmental factors (EBV infection)
S/S- fever, fatigue
Immunocompromised
Tx: NSAIDs, corticosteroids, methotrexate
· Varicella zoster:
Causes chickenpox; vaccine available
Shingles; Vaccine available
S/S- post herpetic neuralgia, pain after shingles, transmittable through
inhalation.
Rash appears on scalp and progresses over body.
Viral infection
· Infectious disease stages:
1. Incubation: time when microorganisms begin replication without identifiable
symptoms; duration: 24 hours to 2-3 months
2. Prodromal: initial symptoms appear; often vague and general
3. Acute: full infectious disease signs and symptoms are present and immune
system is fully engaged
4. Convalescent: body containing the infection and progressively eliminating
the pathogen; duration: days, weeks, or months
Acute vs chronic disease: An acute disease develops suddenly, is short term,
and lasts a few days to weeks. A chronic disease develops slowly and can get
worse over time, can last months to years
Hypercapnia: Excessive CO2 in the blood stream, a normal PCO2 is
between 35-45 mmHg, often caused by hypoventilation where not enough
oxygen gets to the lungs.
· Bases/Buffers/Bicarbonate/Alkalosis:
Base: Compound that accepts H+ ion in solution; When basic ions are
predominated then it is alkaline/basic
Buffer: These systems help prevent large changes in PH by donating H+ ions
when solution is too basic, and absorbing H+ ions when solution is too
acidic. Three major buffer systems are proteins, phosphate, carbonic
acid/bicarbonate.
Carbonic acid-bicarbonate system: most common, uses CO2, H+ ions,
carbonic acid, and bicarbonate ions to create an equation that can go left or
right to help balance out Ph. Normal 22-26 mEq/L
[Renal and respiratory compensation: Lungs respond within minutes, whereas
kidneys respond in hours to days, but the response is maintained longer]
Respiratory acidosis: pH less than 7.35, CO2 increased and is greater than
45 mmHg, hypoventilation
Respiratory alkalosis: pH more than 7.45, CO2 decreased and is less than 35
mmHg, hyperventilation
Metabolic acidosis: pH less than 7.35, increased ventilation (Kussmaul’s
breathing) to blow off CO2, kidneys excrete H+ and retain bicarbonate
Metabolic alkalosis: pH more than 7.45, decreased ventilation, kidneys
excrete bicarbonate and retain H+
· Diuresis: Loss of water from the body
· Electrolyte abnormalities (Hyper/hypokalemia, hyper/hyponatremia, etc.):
Hyponatremia: Sodium less than 135 mEq/L; hypovolemic hyponatremia is
the loss of both sodium & fluid, caused thirst, hypotension, & tachycardia.
Hypervolemic hyponatremia is excessive fluid diluting sodium levels.
Hypernatremia: sodium greater than 145 mEq/L; cells become dehydrated
and shrink
, Hypokalemia: blood K concentration is less than 3.5 mEq/L; s/s are
prolonged PR interval & flattened T wave.
Hyperkalemia: blood K greater than 5.2 mEq/L; s/s are muscle cramps,
widened QRS complex, peaked T waves & bradycardia; can lead to cardiac
arrest.
Hypercalcemia: greater than 10mg/dl; s/s are elevated parathyroid hormone/
cancer; CHVOSTEK’S SIGN (face) & TROUSSEAU’S SIGN (hand during
BP)
Hypocalcemia: less than 8.7 mg/dl; s/s are paresthesia & hypotension,
increased muscle excitability
Hypophosphatemia: less than 2.5 mg/dl; s/s tremors; OPPOSITE OF
HYPOCALCEMIA
Hyperphosphatemia: greater than 4.5mg/dl; most common cause is kidney
failure; same s/s as hypocalcemia
Hypomagnesemia: less than 1.5 mEq/L
Hypermagnesemia: more than 2.5 mEq/L
· RAAS: Increases blood volume and blood pressure in response to dehydration
1. Renin is released from the kidneys and converts angiotensinogen to
angiotensin I
2. Angiotensin I converted to angiotensin II in lungs by ACE (Angiotensin
Converting Enzyme)
3. Angiotensin II (vasoconstrictor) activates the adrenal cortex to release
aldosterone
4. Aldosterone increases sodium and water reabsorption and potassium
secreted by kidneys
· Autoimmune Disease: body’s natural defense system cannot tell the difference
between your own cells and foreign cells which accidentally attacks the normal
cell
· Chemotaxis: WBCs-attract platelets and more WBCS to the injury site. WBCs
come from bone marrow and go into the bloodstream (leukocytosis). The cells
go from normal range (4,000-10,000) up to 15,000-20,000. Attracts platelets
during inflammation process
· Abnormal wound healing:
a. Keloid- hyperplasia of scare tissue
, b. Contractures- inflexible shrinkage of wound tissue which pulls edges
towards center of wound
c. Dehiscence- opening of a wound suture line ex. Doctor makes incision, and
it comes apart after
d. Evisceration- opening of wound with extrusion of tissue and organs; ex: C
section
e. Stricture- narrowing of an open area. Ex: acid reflux causes esophagus to
narrow.
f. Fistula- abnormal connection between two structures. Ex: tracheoesophageal
fistula. Chron’s and cancer takes away tissue causing fistula (artificial hole)
g. Adhesion: abnormal bands of internal scar tissue limiting mobility
· Neutrophils:
Granulocyte; Matures Neutrophils (FIRST ONES TO RESPOND) have
distinct multisegmented nuclei and are known as segmented neutrophils or
segs. When mature ones die, bone marrow sends out immature ones called
bands. They begin phagocytosis right away. Phagocytosis-recognizes and
attaches leukocytes to foreign matter. Then engulf and kill ingested matter.
· Endemic, pandemic, epidemic, incidence:
Incidence- the number of new cases within a population
Prevalence- number of active ongoing cases
Endemic- incidence and prevalence are relatively stable
Pandemic- global spread of a disease
Epidemic- abrupt increase of disease in a region
· Opportunistic infection: infection caused by microorganisms that flourish
because of a host’s lack of immune system. If an individual is
immunosuppressed, then microorganisms can multiply w/ in the body which
leads to an opportunistic infection.
· Purulent/Transudate:
a. Purulent- fluid rich in protein from WBC, microbial organisms, and cellular
debris also known as pus. (White-green discharge)
, b. Transudate- fluid contains little protein; mainly watery filtrate of blood;
watery, clear fluid is an example of a non-infected blister.
· Histamine:
Included in the inflammatory response. Histamine signals the inflammatory
response and triggers anaphylaxis, which is why antihistamines (EX
Benadryl) are taken to stop the inflammatory response. Effects include
vasodilation, increase vascular permeability, systemic effects. EX: sneezing,
Upper respiratory infection
· Systemic Lupus Erythematosus:
Multisystem disease
Chronic disease w/ remission & exacerbations
Skin rash (butterfly rash across cheeks), joint inflammation, kidney damage,
vasculitis, Raynaud’s phenomenon.
Genetically passed; environmental factors (EBV infection)
S/S- fever, fatigue
Immunocompromised
Tx: NSAIDs, corticosteroids, methotrexate
· Varicella zoster:
Causes chickenpox; vaccine available
Shingles; Vaccine available
S/S- post herpetic neuralgia, pain after shingles, transmittable through
inhalation.
Rash appears on scalp and progresses over body.
Viral infection
· Infectious disease stages:
1. Incubation: time when microorganisms begin replication without identifiable
symptoms; duration: 24 hours to 2-3 months
2. Prodromal: initial symptoms appear; often vague and general
3. Acute: full infectious disease signs and symptoms are present and immune
system is fully engaged
4. Convalescent: body containing the infection and progressively eliminating
the pathogen; duration: days, weeks, or months
