Main Concepts

zofugema's version from 2017-06-08 23:26

Main Concepts

Question Answer
What electrolytes does the low volume state have? Increase total Na, Decrease serums Na & Cl & K & Ca2 (Bound to albumin)
What pH does low volume state have?Alkalotic(except diarrhea, Renal tubular Type II & DKA) because Aldo dumps H+
What pH does vomiters have?Alkalotic because you vomit out H+ -> low volume state
What pH does diarrhea have?Acidosis because stool has bicarb from pancreas
What happens if pulse increase greater than 10 on standing?Hypovolemic shock
What happens if pulse increase less than 10 on standing?Autonomic dysfunction
Symptoms of low energy state?CNS - MR, Dementia, Decreased activity / Cardiovascular - CHF, pericardial effusion / Muscle weakness - SOB, weakness, Impotence, distillation, urinary retention, constipation
Symptoms of low energy state in rapidly dividing cells?Dry skin, brittle nails, loss of hair, BM suppression, endothelial & endometrial & breast atrophy, lungs SOB with infection, Kidney PCT affected first, GI nausea vomiting & diarrhea, Urinary retention, azoospermia
Symptoms of low energy state with cancer?Skin, GI, Bone marrow Cancers
What are the most common SIGN of the low energy state?Tachypnea & Dyspnea
What are the most common SYMPTOM of the low energy state?Weakness & SOB
Most common infection of LESUTI & Respiratory
What is the most common cause of death in LESHeart Failure
Explain all restrictive lung diseaseInterstitial problem Decreased diffusion & perfusion / Small Stiff lungs( decrease VC ) / Trouble breathing FEV1/FVC ratio >80 / ABG - decrease pO2-> Increase RR -> Decrease pCO2 -> Increase ph
Restrictive lung disease CXR?Reticulonodular pattern, ground glass appearance -> DIE FROM Corpulmonale
Restrictive lung disease examplesNM diseases(breathing out is passive), drugs, autoimmune
Restrictive lung disease txPressure support on ventilator, Increase O2 & RR, Inspiratory time. Decrease in TV
Explain all obstructive lung diseaseObstructive airway problem(bacterial), big mucus filled lungs (Increase RV, Reid index ->Increase Airway thickness/airway lumen), Trouble breathing out FEV1/FVC <0.8, ABG -> Increase pCO2 -> Increase RR, Decrease pH
COPD die fromBronchiectasis. Tx - Manipulate rate on ventilator , Increase RR, Increase expiratory time & O2
What symptoms does a more likely to depolarize state have?Brain - Psychosis, seizures, jitterniess / Skeletal muscle - muscle spasms, cramps / SM - Diarrhea / Heart - Tachycardia, arrythemias
What symptoms does a less likely to have depolarize state have?Brain - Lethargy, mental status changes, depression / Skeletal muscle - Weakness, SOB / SM - Constipation / Heart - Hypotension, Bradycardia
What is the humoral immune responseB cells and Neutrophils patrol the blood looking for bacteria
What is the cell mediated immune response?T cells and Macrophages patrol the tissues looking for non-bacteria
What is karyolysisNucleus dissolves
What is karyohexxisNucleus Fragments
What is PyknosisNucleus turns in blobs "pick blobs"
What is apoptosisProgrammedcell death -> quiet no inflammation, nucleus guides it
What is necrosisNon-programmed cell death -> noisy inflammation, nucleus destroyed first
What does high GABA levels lead to?Bradycardia, lethargy, constipation, impotence, memory loss
What state does estrogen mimic?The neuromuscular disease state (estrogen muscle relaxant)
What is the CBC for every vasculitis?DECREASE RBC, Platelets, INCREASE WBC, Tcells, MP, schistocytes, ESR
What is the time line of inflammatory response?1HR- Swelling / DAY 1 - PMNs showup at 4hrs, predominate at 24 hrs / DAY 3 - PMNs peak / DAY 4 - Macrophages/t-cells / DAY 7 - Macrophages/T-cells peak, fibroblasts arrive / DAY 30 - Fibroblasts peak / MONTH 3-6 - Fibroblasts complete fibrosis
Blood macrophage?Monocytes
Brain macrophage?Microglia
Lung macrophage?T1 pneumocytes
Liver macrophage?Kupffer cells
Spleen macrophage?Raticulo Endothelial Cells
Lymph macrophage?Dendritic cells
Kidney macrophage?Mesangial cells, found in the macula densa, (renin found in juxtaglomerular cells)
Peyers Patch macrophage?M cells
Skin macrophage?Langerhans cells
Bone macrophage?Osteoclasts
CT of macrophages exampleHistiocytes, Giant cells, Epitheliod cells


Question Answer
What is the most common intracellular bufffer?Protein
What is the most common extracellular buffer?Bicarbonate
What is a Zwitterion?A melcule with one negative and one positive end
What is the isoelectric point?The pH at which there is no net charge?
Rate limiting enzyme in Glycolysis?PFK1
Rate limiting enzyme in Gluconeogenesis?Pyruvate carboxylase
Rate limiting enzyme in HMP shunt?G6pd
Rate limiting enzyme in Glycogenesis?Glycogen synthase
Rate limiting enzyme in Glycogenolysis?Glycogen Phosphorylase
Rate limiting enzyme in FA synthesisAcCoA carboxylase
Rate limiting enzyme in B-oxidation?CAT-1
Rate limiting enzyme in cholestrol synthesis?HMG CoA reductase
Rate limiting enzyme in Ketogenesis?Hmg CoA synthase
Rate limiting enzyme in Purine synthesisPRPP synthase
Rate limiting enzyme in Pyrimidine synthesisAsp transcarbamoylase
Rate limiting enzyme in TCA cycle?Isocitrate dehydrogenase
Rate limiting enzyme in Urea cycle?Carbamoyl Phosphate Synthetase I
Rate limiting enzyme in Heme synthesis?D-ALA synthase
What are the catabolic pathways that create energy?ABC AcetylCoA production, B-oxidation, Citric acid cycle
What are the anabolic pathways that store energy?EFGH ER, Fatty acid synthesis, Glycolysis, HMP shunt
What are the anabolic + catabolic pathways?HUG Hemesynthesis, Urea cycle, Gluconeogenesis
What does an Isomerase do?Creates an Isomer
What does and Epimerase do?Creates an epimer, which differs around 1 chiral carbon
What does a mutase do?Moves side chain from one substrate to another(interchain)
What does a transferase do?Moves sidechain from one substrate to another (interchain)
What does a kinase do?Phosphorylates using ATP
What does a phosphorylase do?Phosphorylates using Pi
What does a carboxylase do?Forms C-C bonds(w/ ATP and biotin using CO2)
What does a synthase do?Consumes 2 substrates equally
What does a Synthetase do?Consumes 2 substrates uses ATP
What does a Phosphatase do?Breaks phosphate bond
What does a Hydrolase do?Breaks a bond with water
What does a lyase do?Cuts C-C bonds w/ATP
What does a dehydrogenase do?Removes H with a cofactor
What does Thio do?Breaks S bonds
What is diffusion?From high to low concentration
What is Active transport?Goes agianst concentration grradient
What is Zero order kinetics?Metabolism independent of concentration
What is 1 st order Kinetics?Constant drug percentage metabolism over time depends on drug
What is efficacy? Max effect regardless of dose(lower w/ non-competitive antagonist)
Question Answer
What effects efficacy?Vmax
What is potency?Amount of drug needed to produce effect (lower w/ competitive anatagonist)
What affects Potency?Km
What is Kd?Concentration of drug that binds 50% of receptors
What is EC50?Concentration of drug that binds 50% of maximal response
What is Competitive inhibition?Fights for active site, no Vmax, potency decreases
What is Non-competitive inhibition?Binds to regulatory site, no Km, efficacy decreases, decrease Vmax
What is Endothermic Reaction?Consumes heat
What is Exothermic reaction?Gives off heat
What is the peak level?4hrs after dose (too high -> give less often)
What is trough level?2 hrs before dose (too high -> give less often)
What is t12?Half life, the time it takes for the body to use half of the drug ingested
What is Von Gierke?G-6Pase deficiency -> hypoglycemia, hepatosplenomegaly
What is Pompe?Cardiac a-1,4-gulcosidase deficiency -> Die early
What is Cori's?Debranching enzyme deficiency -> short branches of glycogen
What is Andersons?Branching enzyme deficiency -> Long chains of glycogen
What is McArdles?Muscle phosphorylase deficiency -> muscle cramps w/exercise
What is Essential Fructosuria?Frucktokinase Deficiency -> Excrete fructose (still have hexokinase)
What is Fructosemia?Fructose Intolerance -> Aldolase B deficiency -> liver damage
What does a galactokinase deficiency cause?Cataracts
What does Galactosemia cause?Cataracts, MR, liver damage
What does the Citrate shuttle do?FA transport out of the mitochondria
What does the Carnitine shuttle do?FA transport into the mitochondria
What lysosomal diseases have cherry-red macula?Tay-sachs, Neimann Pick