Fluid, Electrolyte, and Acid-Base Imbalances, Renal Disorders, Immunity, Inflammation, Wound Healing, Vascular Inflammation, COPD, Thyroid Disorders, Hypersensitivity, Diabetes, Hypertension, Vascular Issues, Anemia

Flashcards covering key vocabulary from lectures on fluid and electrolyte imbalances, acid-base balance, renal disorders, immunity, inflammation, wound healing, vascular inflammation, COPD, thyroid disorders, hypersensitivity, diabetes, hypertension, vascular issues and anemia.

Intracellular Fluid (ICF)

Fluid inside the cells; comprises about 70% of total body fluid.

Extracellular Fluid (ECF)

Fluid outside the cells, including intravascular volume (blood) and interstitial fluid.

Interstitial Fluid (ISF)

Fluid between cells and blood vessels; excessive accumulation leads to edema.

Obligatory Urine Output

The minimum amount of urine (400-600mL/day or approximately 30mL/hr) needed to rid the body of waste products.

Insensible Water Loss

Immeasurable fluid loss via respiration, feces, skin, and breathing.

Colloid Osmotic Pressure

Pressure exerted by colloids (substances in blood/cells) that pulls water in; mainly due to albumin.

Hydrostatic Pressure

The pressure exerted by a fluid at equilibrium due to the force of gravity. Pushing out of water.

Osmolarity

The concentration of a solution expressed as the total number of solute particles per liter. Change of blood(solute) concentration b/c too much fluid or too less fluid.

Tonicity

The relative concentration of solutes in a solution compared to that in blood; used for IV solutions.

Isotonic Solution

IV solution with the same tonicity as cells; increases fluid volume and blood pressure (e.g., 0.9% Normal Saline).

Hypotonic Solution

IV solution with less tonicity than cells; causes cell swelling (e.g., 0.45% NaCl).

Hypertonic Solution

IV solution with greater tonicity than cells; causes cell shrinking (e.g., 3% NaCl).

Osmoreceptors

Regulate concentrations/water balance

RAAS

Released then vasoconstriction and lower BP

ADH

Released then hold onto water

Natriuretic hormone

Rid of fluid

Third Space Loss

Fluid accumulation in the interstitial space, leading to edema.

Hemoconcentration

Increased blood concentration of solutes due to less water in the blood.

Pitting Edema

Edema where an indentation persists after pressure is applied.

Syndrome of Inappropriate ADH (SIADH)

Excessive ADH release causing fluid retention and hyponatremia.

Diabetes Insipidus (DI)

Deficiency of ADH (neurogenic) or decreased kidney response to ADH (nephrogenic), leading to inability to hold onto fluid.

Oliguria

Urine production lower than 400mL/day.

Orthostatic Hypotension

Drop in systolic BP of 20mmHg or diastolic BP of 10mmHg with associated increase in HR when going from supine to standing.

Hyponatremia

Sodium level below 135 mEq/L.

Hypernatremia

Sodium level above 145 mEq/L.

Respiratory Acidosis

Low pH, high CO2, nml bicarb, urine pH < 6

Respiratory Alkalosis

Lungs, high pH, low CO2, nml bicarb, urine pH>7

Metabolic Acidosis

Kidneys, low pH, low bicarb, nml CO2, urine pH<6

Metabolic Alkalosis

Kidneys, high pH, high bicarb, CO2 nml, urine pH>7

Renal Agenesis

Lack of kidney growth or complete failure in kidney development

Renal Hypoplasia

kidneys small in size(HYPO-LOW or small)

Renal Dysplasia

abnormal development of kidney→cysts may be present or other factors result in dysplasia

Nephronophthisis

Small kidneys, multiple cysts, juvenile Onset. 2 s so think small and cysts; 1 word so kids onset–small

Medullary cystic disease

Small kidneys, Adult Onset

Proteinuria

protein in urine

Glomerular Filtration Rate (GFR)

low GFR is low kidney fxn

Hematuria

blood in urine

Acute Pyelonephritis

BAD UTI Etiology: bacterial infection from usually E.coli

Prerenal

prevent blood supply to the kidney→ before

Intrarenal

damage w/i kidney→ inside: Damage to kidney itself

Post Renal

prevent kidney from getting urine out→ after--Obstruction of urine outflow from kidneys

SLE

lupus renal fxn decline over 3 or more months cause Chronic Kidney Injury

Innate immunity

born, placenta-Initial, broad, natural immunity, rapid but non-specific response

Adaptive Immunity

Acquired, specific immunity, less rapid but more effective via vax or exposure to disease itself

Macrophages

Adult WBC-Engulf and kill invading organisms

Granulocytes

Baby white cell-Short lived-Neutrophils(specific engulfing cells), basophils, and eosinophils(high then allergic rxn).

Lymphocytes

specific to killing bacterial organisms

B- lymphocytes

Produce antibodies-Humoral immunity

T- lymphocytes

CD4+ Trigger immune response

Epithelial Barrier

skin, respiratory tract, GI, GU tracts→ have mucus that traps microbes and cilia that moves trapped microbes to rid of them

Opsonins

bind and tag microbes for recognition from activated leukocytes

Cytokine

released from activated leukocytes

MMunoglobulins

IgG→ increasing sickness but going away

Clotting Cascade

Prevent further bleeding-Concern for DVT in surgical pts

Kinin Cascade

Bradykinin that cause pain, vasodilation, and vascular permeability→ to allow increased blood flow and get healing factors to reach

Complement Cascade

Stimulate opsonins(tag microbes), chemotactic factors(location of injury), and anaphylatoxins degrade Mast cells to release histamine(vasodilator)

Chemotactic factors

attract neutrophils(WBCs

Exudate/Drainage

how well wound is healing and stage of healing

Fever

specific cytokines cause this→ endogenous pyrogens

Leukocytosis

increased WBC>11,000 and in infection a left shift ratio→ signify systemic inflammation or bacterial/viral infection→ check for other s&s

Keloids

over larger scars→ purple and shiny looking

Homocysteine Level

Elevate in reduced folate levels, vit B, riboflavin<15-Inhibit AB cascade and increase endothelial damage in arteries

Hashimoto thyroid

autoimmune disorder that destroys gland

Myxedema

Severe sxs of hypothyroidism

Goiter

Overactive thyroid--> heat intolerance, exophthalmos(eyes bulging)

Type1 hypersensitivity

Mediated by IgE, allergic rxn

Type 2 hypersensitivity

IgG or IgM mediated against antigens

Type 3 hypersensitivity

Complement and antibody mediated cell destruction→ autoimmune response causes destruction-Formation and deposition of insoluble antigen antibody complexes

Type 4 hypersensitivity

cell mediated-Direct cell cytotoxicity

HGA1C

Last 3 months average blood glucose level-> 6.5 Diabetes Most Accurate

Oral Glucose Tolerance Test

Body’s ability to remove glucose from body w/i 2 hrs after 75g glucose in 300ml water Always repeated if abnml

beta-cell destruction

Insulin deficiency-Type 1 dm->Common in children and adolescents Genetic, environmental, infection, t-lymphocyte mediated hypersensitivity

Type 1B idiopathic

Rapid onset- beta-cell destruction--> Tx: Insulin

Insulin resistance

can’t use insulin as it is supposed to so decreases insulin production -Type 2 dm--> Older and overweight genetic(increased risk), behavioral, environmental-Metabolic syndrome: hyperglycemia, hypertriglyceridemia, low HDL, high LDL, elevated CRP Tx: insulin

hypertension

Consistent elevation of BP greater than 140/90

B/E FAST

balance, eyes, face, arm, speech, time

HDL

GOOD cholesterol - higher is better

LDL

BAD cholesterol, lower is better

atherosclerosis

Artery thickens due to accumulation of fatty materials, plaque formation in main arteries (usually talking about the coronary arteries : on top of the heart : feed the heart itself)

Troponin

Elevated 3 hours after onset of MI, can stay elevated for 7-10 days-Acute Coronary Syndrome-All types of ischemic heart disease

anemia

low RBC, Angina, SOB, fatigue, coldness

Erythropoiesis

RBC production (occurs in bone marrow and kidneys)

Blood Loss Anemia

Depends on rate of blood loss (rapid=shock), slower symptoms progressiveCan lead to iron deficiency - slowing production of RBC, body can compensate

Hemolytic anemia

Destroying RBCs too soon. Causes pts to retain iron. CBC: you can see the different types of RBCs - normal color and size RBCs, Increase in baby RBC (reticulocytes)

Iron deficiency anemia

Results from dietary deficiency, loss of iron through bleeding or increased demand (pregnancy).Decreased hemoglobin, poor O2 delivery

Megaloblastic anemia (pernicious anemia)

Deficiency in B12 -Found in animal products.■ Vegetarians and vegans get this type of anemia because they’re not consuming animal products, therefore not consuming enough B12

Aplastic anemia

Reduction in RBC, WBC, and plt■ Sudden onset: fatigue, pale, red dots (petechiae), susceptible to infection , bleeding everywhere