BIO-483 GCU Exam 1

Etiology

cause of disease

atrophy

decrease in cell size

hypertrophy

increase in cell size

Hyperplasia

increase in cell number

Metaplasia

reversible replacement of one mature cell type by another less mature cell type

Dysplasia

Abnormal "deranged" cell growth

Kwashiorkor

protein deficiency leading to protruberant abdomen

Marasmus

A disease of severe protein-calorie malnutrition during early infancy, in which growth stops, body tissues waste away, and the infant eventually dies.

hypoxic cell injury

1) ATP Depletion

2) Increased intracellular calcium

3) ROS

4) Defects in membrane permeability

Coagulative necrosis

Kidney, heart, tissue appears pale

liquefactive necrosis

Brain (glial cells/neurons)

Cells digested by their own hydrolyses and tissue becomes soft, forming cysts

Caseous Necrosis (cheese like)

MC w/ infection of mycobacterium

think lungs

Fat necrosis

Breast, pancreas, liver

Saponification (soap)

Gangrenous necrosis

Dry: Coagulative, skin dries and shrinks, turns brown/black

Wet: Liquefactive, damage to internal organs, cold swollen and black site, foul odor

Gas: Wet with Clostridium infection and forms gas bubbles

fever

Calor: Temp

Rubor: Red

Tumor: Swelling

Dolor: Pain

Release of IL-1, IL-6, and TNF and stimulates hypothalamus to make more PGE-2

SIRS

systemic inflammatory response syndrome

Sepsis

Dangerous infection of the blood

Tachycardia, Tachypnea, Pallor, AMS

Shivers, Extreme pain, Pale, Sleepy, I feel like I might die, Shortness of breath

Septic Shock

Hypotensive sepsis

MODS

multiple organ dysfunction syndrome

causes of edema

increased capillary hydrostatic pressure, decreased capillary osmotic pressure/reabsorption, loss of plasma proteins, obstruction of lymphatic circulation, increased capillary permeability

pitting edema

indentation left after examiner depresses the skin over swollen edematous tissue

right sided CHF

pulmonary edema

accumulation of fluid in the lungs --> hypoxia

left sided CHF

ascites

abnormal accumulation of fluid in the abdomen

low albumin and low COP

ANP (atrial natriuretic peptide)

release wtih increase BP/BV - kidneys excrete more Na+ and water, thus decrease BP and BV

BNP

Decrease BP

ADH

increases water reabsorption and urine concentration - keeps water in the body increasing BP/BV

Aldosterone

"salt-retaining hormone" which promotes the retention of Na+ by the kidneys. na+ retention promotes water retention, which promotes a higher blood volume and pressure

SIADH (increased ADH)

syndrome of inappropriate antidiuretic hormone

low urine output

high urine osmolarity

low serum osmolarity

causes water intoxication

DI (decreased ADH)

Diabetes Insipidus

high urine output

low urine osmolarity

high serum osmolarity

caused dehydration

Dehydration

high ADH

low urine output

high urine osmolarity

high serum osmolarity

Hypernatremia

restlessness, sweating, dehydration, diarrhea, vomiting, twitching, spasms,seizures, confusion, disorientation, hyperreflexia SIADH

hypontatremia

Lethargy, dehydration, diarrhea, vomiting, weakness, seizures, confusion, disorientation, cramps, hyporreflexia, DI

Hypercalcemia

Pseudohyponatremia--> Hyporeflexia, short ST, Bones, stones, groans, thrones, psychiatric overtones, Arrhythmias, Hyporreflexia, Muscle weakness

Hypocalcemia

Pseudohypernatremia--> Hyperreflexia, (CATS) convulsions, arrhythmias, tetany, stridor/spasms, paresthesias, carpopedal spasms, Long QT interval, Trousseau and Chovstek

Hyperkalemia

Acidosis, crush injuries, release of K inside cells, Renal failure, low aldosterone, peaked T waves, weakness, spasticity

Hypokalemia

Alkalosis, aldosterone increase, Lasix wastes, weakness, cramps, Prominent U wave, Depressed flattened T waves

Acidosis

Hyperkalemia, hypercalcemia, lethargy, confusion

Alkalosis

Hypokalemia, hypocalcemia, restlessness, convulsions

Respiratory compensation

Arrow PCO2 and HCO3 opposite of pH, 3 compensated 2 uncompensated

Metabolic compensation

Arrow PCO2 and HCO3 same of pH, 3 compensated 2 uncompensated

CO2

Think as it is an acid high=low pH

Anion gap

Na - (Cl + HCO3)

Beefy red tongue

B12 deficiency

3 D's

B3 deficiency

Microcytic Hypochromic

iron deficiency

low MCV

low MCHC

macrocytic normochromic anemia

Folic acid(B9) or Vitamin B12 deficiency

B9 deficiency anemia

Low RBC, Hg, Hct

High MCV

Normal MCHC

vWF

binds collagen in the basement membrane of blood vessels and adhesion glycoproteins on platelets, forming a bridge

Anemia of acute blood loss

low RBC, Hg, Hct

normal MCV

normal MCHC

Anemia of chronic blood loss iron deficiency anemia

low RBC,Hg,Hct

low MCV

low MCHC

B12 deficiency anemia

low RBC, Hg, Hct

high MCV

normal MCHC

Low platelets

think wVD, thrombocytopenia

Factor-type bleeding

- Ex: Hemophilia

- Ecchymosis/Hematoma/Bruising, Hemarthrosis

- Labs: Normal BT, platelet plugs are still effective

(High PT or aPTT depending on the condition)

aPTT

Intrinsic pathway (factor VIII and factor IX)

heparin therapy

PT

Extrinsic factor (tissue facto and factor VII)

warafarin (coumadin) therapy

Hemophilia

Normal PT, high aPTT, normal BT, normal PLT,petechia, purpura, ecchymosis

vWD

Normal PT, high BT, High aPPT in 50% of patients, normal platelet count

Fibrinolysis

Breakdown and removal of a clot

DIC

High PT, High aPPT, High BT, High fibrinogen, High D-dimer, Low platelets

ALL

acute lymphocytic leukemia

20 years and younger (most common in 2-4 yrs)

accumulation of lymphoblasts in bone marrow → bone marrow failure

blast cells: lymphoblasts

AML

acute myelogenous leukemia

over 60 years old

sccumulation of myeloblasts in bone marrow → bone marrow failure

blast cells: myeloblasts

auer rods

CLL

chronic lymphocytic leukemia (smudge cells & low neutrophil count)

CML

Chronic Myelogenous Leukemia (Philadelphia Chromosome) (chromosomes 9 and 22)

Lymphoid

Lymphoblast (B, T, NK)

Myeloid

Everything else

multiple myeloma

Bence Jones Protein

Punched out bone lesions

Hypercalcemia symptoms (bgstpo)

Excruciating pain

Give fluid, pain management

monitor bone fraction, renal failure

Fluids!

Non-Hogkin's Lymphoma

Burkitt, mass on face (B cell most common) no reed Sternberg, not good

Hogkin's lymphoma

EPV (mono) Reed Sternberg, painless lymphadenopathy in neck, spreads (stage 1-4)

Uncompensated respiratory acidosis

Low pH

High PCO2

HCO3- normal

Compensated respiratory acidosis

Low pH

High PCO2

High HCO3

Uncompensated metabolic acidosis

Low pH

Normal PCO2

Low HCO3

Compensated metabolic acidosis

Low pH

Low PCO2

Low HCO3

Uncompensated metabolic alkalosis

High pH

Normal PCO2

High HCO3

Compensated metabolic alkalosis

High pH

High PCO2

High HCO3

Uncompensated respiratory alkalosis

High pH

Low PCO2

Normal HCO3

Compensated respiratory alkalosis

High pH

Low PCO2

Low HCO3