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2013-05-15 02:49:19
pathophysiology final

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  1. ischemic heart disease
    • aka myocardial ischemia
    • reduced blood supply to the heart muscle, usually due to coronary heart disease (artherosclerosis)
  2. symptoms of ischemic heart disease
    • angina pectoris
    • acute chest pain
    • heart failure
  3. basic methods of diagnosis for ischemic heart disease
    • electrocardiogram (EKG)
    • exercise thallium test
    • coronary angiography
    • intravascular ultrasound
  4. risk factors of ischemic heart disease
    • clotting factors/hemostatic factors
    • family history of CAD
    • diabetes
    • high blood pressure;high systolic most significant
    • high LDL cholesterol or low HDL cholesterol
    • hyperglycemia
    • blood fats
    • inflammation and infection
    • depression and isolation
    • lack of exercise
    • obesity
    • stress and anger
    • tobacco smoking or exposure to tobacco
  5. atherosclerosis
    • may occur when deposits of cholesterol and plaque accumulate at a tear in the inner lining of an artery.
    • decreases blood flow
    • clots can become lodged
  6. stroke
    • transient ischemic attack (stroke symptoms that resolve in 24 hours)
    • the rapid developing loss of brain function due to a disturbance in the blood vessels supplying blood to the brain.
  7. hemorrahgic stroke (intracranial)
    • intracranial hemorrhage: accumulation of blood anywhere within the skull vault.
    • intra-axial hemorrhage: blood inside the brain
    • extra-axial hemorrhage: blood inside the skull, but outside the brain
  8. hemorrhagic stroke (intracerebral)
    • bleeding directly into the brain tissue, forming a gradually enlarging hematoma.
    • generally occurs in small arteries or arterioles and is commonly due to hypertension trauma, bleeding disorders, amyloid angiopathy, illicite drug use
  9. ischemic stroke
    • blood supply to part of the brain is decreased, leading to dysfunction and necrosis of the brain tissue in that area.
    • due to: thrombosis, embolism, systemic hypoperfusion
  10. thrombosis
    obstruction of a blood vessel by a blood clot forming locally
  11. embolism
    • due to an embolus from elsewhere in the body a broken off thrombus
    • an embolus can also be fat, air, cancer cells, bacteria
  12. systemic hypoperfusion
    general decrease of blood supply
  13. thrombotic ischemic stroke
    • a thrombus usually forms around the atherosclerotic plaques.
    • slower onset of symptoms
  14. embolic ischemic stroke
    refers to the blockage of an artery by an emobolus
  15. ischemic stroke (atriel fibrillation)
    causes heart o beat abnormally
  16. end stage renal disease
    • complete or almost total failure of the kidneys to perform their normal functions
    • most common causes: diabetes and high blood pressure
  17. incidence of kidney disease
    • 1% of total deaths due to hypertension
    • 1.8% due to nephritis, neohrotic syndrome and nepshrosis
  18. normal functions of kidney
    • regulates the composition and pH of blood
    • functions in the elimination of metabolic wastes and drugs and their metabolites
    • serves to regulate the osmolarity of the extracellular fluid
    • plays a central role in blood pressure regulation
    • contributes to metabolic functions of the skeletal system through activation of vitamin D
    • controls the production of red blood cells in the bone marrow
  19. gross structure of kidney
    • multilobular structure¬† composed of up to 18 lobes
    • each lobule is composed of nephrons
    • each nephron has a glomerulus that filters the blood and a system of tubular structures for resorption and secretion as urine is formed
  20. nephron function
    • consists of a glomerulus where blood is filtered and and a tubular component (tubule)
    • in the tubule water, electrolytes and other substances needed to maintain the constancy of the internal environment are reabsorbed into the blood while other unneeded materials are secreted into the tubular filtrate for elimination
  21. reabsorption and sectretion
    • water and urea are passively absorbed along concentration gradients
    • sodium, potassium, chloride, calcium, and phosphate ions as well as urate, glucose and amino acids are reabsorbed
  22. normal kidney conditions GFR
    only 1 mL of the 125 mL of glomerular filtrate that is formed each minute is excreted in the urine. the other 124 mL is reabsorbed into the tubules
  23. glomerular filtrate rate
    • provides a gauge of renal function
    • measured clinically by collecting timed samples of blood and urine
  24. anti-diuretic hormone
    • regulates the ability of the kidneys to concentrate urine
    • stimulus for ADH release and synthesis is increase in serum osmolarity
    • acts at the level of the collecting tubule to increase water absorption
    • when ADH is present, the water that moved from the blood to the urine filtrate returns to the circulatory system
    • when ADH is absent, water is excreted in the urine
  25. renin-angiotensin-aldosterone system
    • decrease in renal perfusion causes kidney to produce renin
    • liver produces angiotensin, which is converted to angiotensin II
    • adrenal cortex produces aldosterone
    • water and salt retention increases effective circulating volume
  26. diabetic nephropathy
    • 30% of people with type 1 diabetes and accounts for 20% of patients with diabetes younger than 40
    • elevations in blood glucose produce and increase in GFR and glomerular intracapillary pressure that leads to an enlargement of glomerular capillary pores
  27. hypertensive nephropathy
    • CVD is the major cause of death in patients with ESRD
    • hypertensive nephropathy increases workload on left heart leads to left¬† ventricle dilation and hypertrophy leads to not enough oxygen to support LV contraction leads to angina, ischemia, LHF
  28. basic attributes to renal failure
    • less waste is removed
    • more waste remains in the blood
    • nitrogenous compounds build up in the blood
    • BUN: blood urea nitrogen
    • creatinine
  29. kidney dialysis
    • filters blood like kidneys do
    • takes out waste substances
  30. alcohol liver disease (ALD)
    • overlapping forms of liver disease
    • hepatic steatosis (fatty liver)
    • alcoholic hepatitis
    • cirrhosis
    • all three forms are collectively referred to as ALD
  31. hepatic portal circulation
    • dual blood supply
    • 300 ml/min
  32. liver structure
    • blood from hepatic portal vein and hepatic artery mix in sinusoids
    • the sinusoids empty into central veins which send the blood to the hepatic vein and inferior vena cava
    • hepatic cells lie along the sinusoids and pick up chemicals from the blood
    • they modify the blood's composition
    • at the back end of each hepatic, bile is released into a canaliculus
    • the bile is carried to the bile duct and then to the gallbladder
  33. liver structure cont...
    • many sinusoids come together to empty into one vein
    • the section of the liver entering into one vein is a lobule
  34. normal liver function (4)
    • 1: energy metabolism and substrate interconversion--> glucose and cholesterol
    • 2: protein synthetic function-->plasma and binding proteins
    • 3: solubilization, transport and storage of fats and fat-soluble vitamins in bile-->drugs, LDL, ADEK
    • 4: Protective and clearance function-->damaged cells, bacteria, antigens
  35. interrelation of ALD stages
    steatosis and hepatitis can lead to cirrhosis
  36. additional effects of alcoholism
    parotitis, esophagitis, GI bleeding, gastritis, diarrhea, IBS, ppression of ADH, clotting disorders
  37. liver failure
    hypoglycemic events, edema/ascites, bleeding, vitamin deficiency, fatty stools, encephalopathy, gynecomastia and testicular atrophy in men, menstrual irregularities in women, jaundice
  38. energy homeostasis
    • adipose tissue__>adipokines
    • hypothalamus-->glucose production
    • liver, muscles, adipose tissue--> overflow of fuel/fat storage
  39. factors of obesity
    • genetics-->ghrelin, insulin, leptin, leptin receptor
    • behavioral
  40. health effects of obesity
    • high BP
    • osteoarthritis
    • high cholesterol
    • type 2 diabetes
    • coronary heart disease
    • stroke
    • gallbladder disease
    • sleep apnea and respiratory problems
    • some cancer
  41. type 1 and type 2 diabetes
    • type: childhood onset, thin or normal weight, ketoacidosis, insulin, damaged pancreas, genetic
    • type 2: after 40 years onset, obese, insulin deficiency, genetic