ADVANCED PHARMACOLOGY NSG 533 STUDY GUIDE
QUESTIONS AND ANSWERS RATED A+
✔✔5 mechanisms of edema formation - ✔✔1. Increased capillary venous hydrostatic
pressure
2. Decreased capillary oncotic pressure
3. Lymphatic obstruction/dysfunction
4. Increased capillary permeability
5. Sodium and water retention
✔✔Metabolic acidosis and an elevated anion gap ... - ✔✔"Abnormal" numbers and
types of anions present
✔✔Metabolic acidosis and a normal anion gap ... - ✔✔A loss of bicarb
Typically either GI or renal (RTA - type 1, type 2, or type 4)
"Hyperchloremic metabolic acidosis"
✔✔Type 1 or distal RTA - ✔✔Decrease in the ability of the distal nephron to produce
new HCO3 (or secrete H+)
Results in hypokalemia
✔✔Type 2 or proximal RTA - ✔✔Involves a decrease in the ability of the proximal tubule
to reabsorb filtered HCO3
✔✔Type 4 or hyperkalemic RTA - ✔✔Involves a lack of aldosterone activity at the distal
nephron
Hallmark is hyperkalemia
✔✔Metabolic acidosis and an elevated anion gap ... - ✔✔Addition or retention of acid
due to derangements in metabolism or exogenous ingestions (PLUMSEEDS)
✔✔Retention of acid usually occurs due to: - ✔✔Renal defects (uremia), decrease in
number of functional nephrons and a decrease in ammonium secretion, usually occurs
when GFR <25%
✔✔(Metabolic acidosis) 2 derangements in metabolism - ✔✔1. Ketoacidosis
2. Lactic acidosis
✔✔Type A lactic acidosis - ✔✔Results from tissue hypoxia, leading to anaerobic
metabolism
✔✔Type B lactic acidosis - ✔✔Results from a mitochondrial defect in oxygen utilization
✔✔PLUMSEEDS - ✔✔Paraldehyde
, Lactic acidosis
Uremia
Methanol
Salicylates
Ethanol
Ethylene glycol
DKA
Starvation
✔✔Anion gap - ✔✔(Na) - (Cl + HCO3)
✔✔Reference range for anion gap without K - ✔✔12 +/- 2
✔✔Serum potassium falls about 0.3 mEq/L for each ... - ✔✔0.1 increase in pH
(alkalosis)
✔✔Serum potassium rises about 0.3 mEq/L for each ... - ✔✔0.1 decrease in pH in
respiratory acidosis and 0.7 mEq/L in metabolic acidosis
✔✔Cause of pre-renal AKI - ✔✔Decreased renal perfusion
✔✔4 causes of intra-renal AKI - ✔✔1. Vascular
2. Glomerular
3. Tubular
4. Interstitial
✔✔Most common cause of AKI - ✔✔Tubular
✔✔2 major causes of acute tubular necrosis - ✔✔1. Ischemic
2. Nephrotoxic
✔✔Cause of post-renal AKI - ✔✔Obstruction anywhere along the GU tract can cause
blockage of urine flow and kidney failure
✔✔Relationship of creatinine with GFR - ✔✔As GFR decreases, creatinine levels will
increase
✔✔Hemolytic jaundice: basic defect - ✔✔Excessive production of bilirubin
✔✔Hemolytic jaundice: elevation of serum bilirubin - ✔✔Mild
✔✔Hemolytic jaundice: type of bilirubin in plasma - ✔✔Unconjugated
✔✔Hemolytic jaundice: bilirubin in urine - ✔✔Absent
QUESTIONS AND ANSWERS RATED A+
✔✔5 mechanisms of edema formation - ✔✔1. Increased capillary venous hydrostatic
pressure
2. Decreased capillary oncotic pressure
3. Lymphatic obstruction/dysfunction
4. Increased capillary permeability
5. Sodium and water retention
✔✔Metabolic acidosis and an elevated anion gap ... - ✔✔"Abnormal" numbers and
types of anions present
✔✔Metabolic acidosis and a normal anion gap ... - ✔✔A loss of bicarb
Typically either GI or renal (RTA - type 1, type 2, or type 4)
"Hyperchloremic metabolic acidosis"
✔✔Type 1 or distal RTA - ✔✔Decrease in the ability of the distal nephron to produce
new HCO3 (or secrete H+)
Results in hypokalemia
✔✔Type 2 or proximal RTA - ✔✔Involves a decrease in the ability of the proximal tubule
to reabsorb filtered HCO3
✔✔Type 4 or hyperkalemic RTA - ✔✔Involves a lack of aldosterone activity at the distal
nephron
Hallmark is hyperkalemia
✔✔Metabolic acidosis and an elevated anion gap ... - ✔✔Addition or retention of acid
due to derangements in metabolism or exogenous ingestions (PLUMSEEDS)
✔✔Retention of acid usually occurs due to: - ✔✔Renal defects (uremia), decrease in
number of functional nephrons and a decrease in ammonium secretion, usually occurs
when GFR <25%
✔✔(Metabolic acidosis) 2 derangements in metabolism - ✔✔1. Ketoacidosis
2. Lactic acidosis
✔✔Type A lactic acidosis - ✔✔Results from tissue hypoxia, leading to anaerobic
metabolism
✔✔Type B lactic acidosis - ✔✔Results from a mitochondrial defect in oxygen utilization
✔✔PLUMSEEDS - ✔✔Paraldehyde
, Lactic acidosis
Uremia
Methanol
Salicylates
Ethanol
Ethylene glycol
DKA
Starvation
✔✔Anion gap - ✔✔(Na) - (Cl + HCO3)
✔✔Reference range for anion gap without K - ✔✔12 +/- 2
✔✔Serum potassium falls about 0.3 mEq/L for each ... - ✔✔0.1 increase in pH
(alkalosis)
✔✔Serum potassium rises about 0.3 mEq/L for each ... - ✔✔0.1 decrease in pH in
respiratory acidosis and 0.7 mEq/L in metabolic acidosis
✔✔Cause of pre-renal AKI - ✔✔Decreased renal perfusion
✔✔4 causes of intra-renal AKI - ✔✔1. Vascular
2. Glomerular
3. Tubular
4. Interstitial
✔✔Most common cause of AKI - ✔✔Tubular
✔✔2 major causes of acute tubular necrosis - ✔✔1. Ischemic
2. Nephrotoxic
✔✔Cause of post-renal AKI - ✔✔Obstruction anywhere along the GU tract can cause
blockage of urine flow and kidney failure
✔✔Relationship of creatinine with GFR - ✔✔As GFR decreases, creatinine levels will
increase
✔✔Hemolytic jaundice: basic defect - ✔✔Excessive production of bilirubin
✔✔Hemolytic jaundice: elevation of serum bilirubin - ✔✔Mild
✔✔Hemolytic jaundice: type of bilirubin in plasma - ✔✔Unconjugated
✔✔Hemolytic jaundice: bilirubin in urine - ✔✔Absent
