EXAM 1 - PATHO

Gene

Fundamental unit of DNA

Karyotype

Paints a picture of the chromosome

Epigenetic changes

Changes that can alter gene expression

Familial hypercholesterolemia

• autosomal dominant

• Very high levels of cholesterol

• Causes young people to have myocardial infarction

Taysachs disease

• lysosomal storage disease

• Hexoaminidase

• Prevalent among Ashkenazi Jews

• Cherry red spot in the retina

• Disruption in brain

Huntington’s disease

• autosomal dominant

• Lose control of muscles

• First shows at 35

• No cure

• Respiratory failure

General adaption syndrome

How body responds to stress overtime

3 stages

1. alarm

2. Resistance

3. Exhaustion

What happens in the alarm stage

• SNS activates fight or flight

  • UP BP

  • UP HR

  • pupils dilate

  • DOWN GI stimulation

  • UP increases

What happens in the resistance stage

• stress abates - PNS induces relaxation

• Stress doesn’t abate - body’s response lessens

Selye’s stress response theory

involves stressor and adaptive ability to cope

McEwen’s stress response theory

• Constant state of stress → leads to a new set point to re-establish homeostasis

• Can also go into Allostatic overload when there is too much stress

Allostasis

Dynamic state of balance that changes due to stress

Allostatic load

wear and tear on body’s systems due to stress reactions

Allostatic overload

Stress excesses body’s ability to adapt

Lifestyle treatments to stress

• sleep

• Exercise

• Reduce caffeine

Pharmacological treatments for stress

• sedatives

• Alcohol

• Antidepressants

• Benadryl

• Xanax

Benefits of exercise

1. increases # of mitochondria

2. Raises HDL-C

3. Angiogenesis

4. Enhances glucose entry into muscle cells

5. Increases venous return

6. Increases coronary blood flow

7. Makes bones stronger (osteoblastic activity)

8. Decreases body fat

9. Builds muscle mass

10. Endorphins to boost mood and stress relief

Effects of immobility

1. atelectasis

2. Bone demineralization

3. Reconditioning of heart and muscles

4. Decreased pulmonary ventilation

5. Pressure ulcers

6. Depression

7. Diminished peristalsis and constipation

8. Disorientation

9. Gait and balance disruption

10. Gerd - acid reflux

11. Increased aspiration

12. Increased orthostatic hypotension

13. Joint contractures

14. Kidney stones

15. Loss of appetite

16. Muscle atrophy

17. Reduced efffectiveness

18. Increased risk of pneumonia

19. Urinary stasis

20. UTI

21. Venous stasis

22. Venous thromboembolism

Sources of pain

• subcutaneous

• Deep somatic

• Visceral

• Phantom

• Referred

OLDCART

used to assess pain

• Onset

• Location

• Duration

• Characteristics

• Aggravating factors

• Relieving factors

• Treatment

Fibromyalgia

• stabbing pain

• 11 out of 18 points to test

Cervical radiculopathy

• neck pain

• Shooting pain cowards to numbness in hands and fingers

Neuropathic pain

• injury or malfunction of spinal cord/peripheral nerves

• Feeling burning, tingling, stinging, shooting

  • Paresthesia

WHO step ladder approach for pain control

Assess the pain to give a certain medication

Step 1 WHO step ladder

• 0-3

• Mild to moderate pain

• USE

  • Nonopioids

  • NSAIDS

  • Acetaminophen

Step 2 WHO ladder

• 4-7

• Moderate to severe

• USE

  • Mild opioids (codeine)

Step 3 WHO ladder

• 8-10

• Severe

• Strong Opioids

• USE

  • Morphine

Natriuresis

body’s natural way of excreting water and sodium

• due to ECF

Role of albumin in the body

Attracts water to go into vasculature

Oncotic pressure opposes

Hydrostatic pressure

Low albumin =

Edema → stuck in ICF

Hydrostatic pressure

Pressure exerted from heart pumping

Symptoms of dehydration

• skin turgor decrease

• Tachycardia

• Hypotension

• Dark and less frequent urine

Normal UO

30 mL/hour

Oliguria

Low urine output

Signs and symptoms of fluid volume excess

• swollen lungs

  • Develop edema

• Gain weight

physical assessment findings of fluid volume excess

• asceties - fluid in abdomen

• Crackles in lungs

Hypotonic IV

• 0.45 NaCl

• Less particles / more water

• ECF → ICF

• Use if someone lost volume (dehydrated)

Isotonic IV

• 0.9 NaCl

• Balanced

• 2 kinds

  • Normal saline

  • Ringers lactate - potassium, calcium, lactate

Hypertonic

• 3% NaCl

• More particles / less water

• ICF → ECF

Normal level of sodium

135-145

• hyponatremia

• Hypernatremia

Normal level of potassium

3.5 - 5

• HYPOkalemia

• HYPERkalemia

Normal level of calcium

9 - 11

• hypocalcemia

• HYPERcalcemia

Normal levels of phosphate

2.5 - 4.5

• hypophosphatemia

• Hyperphosphatemia

Symptoms of HYPOkalemia

• CAUSE - diuretic therapy

• SYMPTOMS

  • Anorexia

  • Nausea

  • Vomiting

  • Muscle weakness

  • Muscle cramps

  • Paresthesia

  • Confusion

  • FLAT T WAVES

Symptoms of HYPERkalemia

• HIGH T WAVES

• Nausea

• Vomiting

• Muscle weakness

• Muscle cramping

• Dizziness

• Diarrhea

• Renal failure

Respiratory acidosis causes

• too much CO2

• Creating too much H+

• Those with COPD asthma

Respiratory acidosis treatment

• nasal cannula

• Bronchodilators

Respiratory alkalosis causes

• hyperventilating

• Too little CO2

• Too little H+

• Anxiety

Respiratory alkalosis treatment

• Slow the breathing rate

• Paper bag

• Sedative

Metabolic acidosis symptoms

• LOSS OF HCO3- (-)

• Too much acid in bloodstream

• Nausea

• Vomitting

• Anorexia

Metabolic acidosis treatment

• sodium bicarbonate IV

• Treat disorder (EX: if diabetes, treat diabetes)

Metabolic alkalosis symptoms

• EXCESSIVE BICARBONATE (+)

• Prolonged vomiting

Metabolic alkalosis treatment

• IV acetazolamide