NURS-UL 3366 Exam 1

homeostasis

maintenance of constant conditions in the body's internal environment

compensation

the return to homeostasis after being challenged by a stressor

Glycogenolysis

breakdown of glycogen to glucose

decompensation

the failure to compensate, adapt, doesn't return to homeostasis

disease

harmful condition of the body or mind

disorder

disturbance in the healthiness of the body

syndrome

a collection of symptoms

risk factors

decors that contribute to or increase the probability that a disease will occur

examples of risk factors

smoking, age, ethnicity, diet, environment

precipitating factors

a condition or event that triggers a pathologic event or disorder

examples of precipitating factors

asthma attacks can be precipitated by exertion

etiology

the cause of a disease, includes all factors that contribute tot he development of the disease

idiopathic

disease with unidentifiable cause

iatrogenic

occurs as a result of medical treatment

nosocomial infection

hospital acquired infection

clinical manifestations

the demonstration of the presence of a sign or symptom

sign

manifestations that can only be objectively ideated by a trained

symptoms

subjective manifestations that can be only reported by the person experiencing them

local S&S

redness, swelling, heat, rash and lymphadenopathy in a particular area

system S&S

fever, urticaria, malaise, systemic lymphadenopathy

acute S&S

fairly rapid appearance of disease of several days, usually only last a short time

chronic S&S

develop slowly and often insidious and last longer

remissions

periods when S&S disappear of diminish signitcantly

exacerbations

periods when S&S become worse or more severe

central

a problem that is occurring towards the center or core of the body

proximal

closer to the central area of the body

shock

low blood pressure and signs and symptoms of not getting enough blood to different parts of the body

prognosis

the predicted outcome of a disease based certain factors like the usual course of that disease, age, and comorbidities

sequela

abnormal condition that follows and is the result of disease, injury, or treatment, a complication

genetic disorders

a disease caused by abnormalities in an individuals genetic material

teratogen

anything that can cause a congenital defect

example of a teratogenic disorder

fetal alcohol syndrome occurs because of the toxicity of alcohol causing gene mutations

thalidomide babies born without arms or legs because of the drug thalidomide taken for nausea during early pregnancy

chromosomal disorders

a genetic disorder that results from alterations to the numbers or structures of chromosomes which disrupts gene function

aneuploidy

alterations to the number of chromosomes

polysomy

more than the usual number of chromosomes

down's syndrome

trisomy 21

example of alterations to the structure of chromosomes

Philadelphia chromosome, a translocation that results in a shortened chromosome

example of an autosomal recessive disorder

sickle cell anemia caused by an abnormal recessive allele that codes from sickle shaped hemoglobin resulting in sickle shaped RBCs incapable of correctly carrying hemoglobin

anemia

less than the normal amount of RBCs

S&S of sickle cell anemia

SOB, weakness and fatigue due to less oxygen, anemia, ischemic pain in the joints where abnormal RBCs build up

example of autosomal dominant disorders

polycystic kidney disease, mutated gene coding for kidney tissue causes cysts to develop and reduce kidney function and leads to kidney failure.

S&S of PKD

hematuria, proteinuria, frequent kidney infections, pain at costovertebral angles and abdomen, kidney stones

example of a sex-linked disorder

hemophilia, caused by a mutation on the X chromosome, mutates coagulation factors resulting in an altered ability to clot

hypoxia

decrease in the amount of oxygen to cells or ability to use oxygen appropriately

positive side to anaerobic glycolysis

it can give 2 molecules of

ATP per molecule of glucose, temporary

negative side to anaerobic glycolysis

2 ATP molecules are not enough, pyruvic acid (pyruvate) build up resulting in acidosis

two main sequela of hypoxia

deficiency of ATP and alter acid/base balance

hormones triggered by low glucose

epinephrine, cortisol, growth hormone and glucagon

Gluconeogenesis

use of other substances besides carbohydrates for cellular energy, breaking down fats and proteins for energy

Mcardle's disease

a glycogen storage autosomal recessive disease where normal ability to breakdown glycogen is diminished

S&S include sucre weakness and cramps during exercise because of no energy reserves

type 1 diabetes

gluconeogenesis to the extreme, do not make insulin so glucose is unable to get into the cells and glycogen is eventually used up , there is high levels of ketones in the blood and low blood pH

hyperketonemia

high levels of serum ketones, low blood pH, ketonuria, acetone breath

Thiamine deficiencies

beriberi, vitamina B1, can lead to Wernicke-Korsakoff syndrome and paresthesia

Wernike-Korsakoff syndrome

associated with alcoholics and manifests as memory loss and ataxia (staggering)

paresthesia

numbness or tingling or other unusual sensations, usually in the legs

cyanide poisoning

found in insecticides, burning wool and silk and certain drugs, inhibits cytochrome oxidase

S&S include headache, adaptation, confusion, vomiting, respiratory problems and death

RMP when a cell is resting between contractions

about -90mV

the charge needed to do work

+30mV

if the RMP is reset to a more positive number than normal it will shorten the polar status

hypopolarization

if the RMP is reset to a less positive number than normal, it will lengthen the polar status

hyperpolarization

hypopolarized states

situations in which membranes have been reset to a more positive number than normal, shortening the polar gap status and making them more sensitive

states where cells become hypopolarized

hyperkalemia, hypernatremia, hypocalcemia

hypocalcemia causes

more Na+ to go into cells so that cells have abnormally more cations inside them, hypo polarized

S&S of hypopolarization

muscles that are too sensitive, hyperactive, irritable, contact with smaller than normal stimulation often resulting in muscle tics or spasms, Chvostek's sign

hyper polarized states

situations in which membranes of cells have been reset to a less positive number than normal, lengthening the polar gap and making them less sensitive

states when cells become hyperpolarized

hypokalemia, hyponatremia, hypercalcemia

S&S of hyperpolarization

muscles that are less sensitive than usaul, hypoactive, they contract more slowly, fatigue, lethargy, mental slowness

normal aerial blood gas levels

pH: 7.35 - 7.45

HCO3: 22-26

pCO2: 35-45

PO2: 80-100

SaO2: 97% - 100%

acidosis

pH is <7.35

S&S of acidosis

headache, disorientation, nausea, vomiting, muscle pain, cramps, shortness of breath, low blood pressure, shock, organ failure, death

metabolic acidosis is caused by

excess accumulation of H+, not enough excretion of H+ in the urine, not enough HCO3 being made, too much HCO3 being excreted in the urine

the compensatory systems for metabolic acidosis

the lungs will increase the amount of CO2 exhaled by increasing the rat and depth of respirations, pH will be increased back to normal

respiratory acidosis

state of low pH caused by ventilation problem such as diminished effectiveness of breathing or decreased repertory rate, the retention of CO2

the compensatory system for respiratory acidosis

HCO3 production by the kidneys will be increased to buffer the situation, to counteract the acid (CO2) that has accumulated from poor ventilation

alkalosis

pH >7.45

metabolic alkalosis causes

excess accumulation of HCO3 in the body, not enough excretion of HCO3 in the urine, too much acid being excreted, not enough acid being made

large amount of vomiting, over ingestion of bicarbonate

compensatory system for metabolic alkalosis

the lungs will decrease the rate and depth of respirations

respiratory alkalosis causes

state of high pH from hyperventilation that causes there to be less CO2 in the blood

compensatory system for respiratory alkalosis

kidneys decrease the amount of HCO3 made and increase its secretion

osmolality

how concentrated a compartment is

tonicity

interchangeable with the term salinity

normal blood tonicity

0.9%

osmotic pressure

the pressure exerted by all solutes in a compartment, it correlates with osmolality, the higher the osmolality, the higher the osmotic pressure

oncotic pressure

exact same as osmotic pressure but refers to protein molecules

higher osmolality

pulls in water

increased blood osmolality is pathologic water

loss

common causes of increased blood osmolality

inadequate intake, vomiting, diarrhea, increased urination

step by step dehydration via diarrhea

microbes causes disruption of capillaries that line the intestines-->water leaks from capillaries into the lumen-->eventually the whole blood system is more concentrated and water will be pulled into the plasma leaving tissues shrunk and dehydrated

S&S caused by T-to-B fluid shift

dehydration, dry mucus membranes, poor skin turgor, sunken eyes, diminished urinary output, low blood pressure, acute CNS changes related to dehydrated brain cells, high serum osmolality

Renin-Angiotensin-Aldosterone system

renin stimulates secretion of angiotensin 1 --> angiotensin 2 via ACE --> stimulates peripheral vasoconstriction and increases secretion of aldosterone from the adrenal gland

common causes of decreased blood osmolality

excess water intake or loss of solutes

decreased blood osmolality is pathologic

water gain or protein loss

concept map for decreased blood osmolality

disease causing overall water gain to body --> water gain to blood --> decreased osmolality --> water gain to tissue (edema) --> overall fluid overload

concept map for decreased blood osmolality via solute loss

disease causing loss of protein from body --> decreased oncotic pressure of blood --> water gain to tissue (edema)

syndrome of inappropriate antidiuretic hormone

increased ADH from small-cell bronchogenic cancer, various drugs like general anesthetics, trauma to the brain like brain tumors or head injuries

S&S of syndrome of inappropriate antidiuretic hormone

high levels of ADH, you hold on to too much water by decreasing urination, edema

S&S of B-toT fluid shifts

tissues pull in water from the blood, skin appears tight and puffy, pitting edema, wet cough, SOB, crackles, CNS changes related to swelling of brain cells, low serum osmolality

Natriuretic peptide system

fluid volume is high and the right atria and left ventricle detect that and secrete ANP and BNP --> in the kidneys they stimulate them to increase urination and fluid volume will go down

creatine kinase

an enzyme,e found in most sucre cells that catalyzes the transference of phosphate groups back and forth between ADP and ATP

myoglobin

found in most muscle cells