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What electrolytes does the low volume state have?
- itotal Na, J.scrurn
- Na (dilutiomil affect), J-CI,
What pH does the low volume
AUrnJotic (except diarrhea , RTA TnJe II, and DK.A)
What pH do vomiters have?
Alkalotic b/c you vo1nit out H-
What pH does diarrhea have?
Acidosis b/c stool has bicarb
What happened if pulse j>10 on standing?
What happened if pulse l <5 on standing?
Au tonomic dvsfunction
What are the symptoms of a low energy state?
- CNS: n1ental retardation, dementia
- CV: heart failure, pericardial effusion
- Muscle: weakness, SOB, vasodilation, impotence, urinary retention, constipation
Rapidly Dividing Cells:
- Skin: dry
- •Cuticles: brittle
- •Hair: alopecia
- •Bone n1arrow: suppressed
- •Vascular endothelium: breaks down
- •Lungs: infection, SOB
- •Kidney: PCT will feel the effect first
- •G I: N /V/D
- •Bladder: oliguria
- •Sperm: decreased
- •Germ cells: predisposed to cancer
- •Breasts: atrophic
- •Endo1netrium: amenorrhea
What are the most common signs of the low energy state?
Tachypnea and dyspnea
What are the most common symptoms
of the low energy state?
Weakness and SOB
What are the most common infections of the low energy state?
UTIand respiratory infections
What is the most common cause of death in the low energy state?
Explain all restrictive lung diseases:
Restrictive: interstitial problem (non-bacterial)
- •Small stiff lungs (l VC)
- •Trouble breathing in ::::> f EV 1/ FVC: > 0.8
- •ABG: J.p02 ::::> f RR, J. pCO:i, ipH
- •CXR: reticulo-nodular pattern, ground-glass appearance
- •Die of cor pulmonale
- •Ex: NM <liseascs O)teathing out is passive), drugs, autoin1111w1c dz
- •Tx: Pressure support on ventilator, to, t U.,
- iinspiratory tin1e
Explain all obstructive lung
- Obstructive: airway problem Q)acterial)
- •Big mucus-filled lungs (iRV, jReid index =
- iairwar thicknessI airway lumen)
- •Trouble breathing out =>FEV J FVC:< 0.8
- •rBG:ipC02 => iRR, .J...pH
- •Die of bronchiectasis
- •Ex: COPD
- •Tx: Manipulate rate on ventila
- tor, tRR, texpira tory time, to2 only if needed
What symptoms does a "more likely to depolarize" state have?
- Brain: psychosis, seizures, jitteri.ness Skeletal muscle: muscle spasms, tetany SM:
- diarrhea, then constipation Cardiac: tachycardia, arrhytluTiias
symptoms does a "less likely to depolarize" state have?
- Brain: lethargy, mental status changes, depression Skeletal muscle: weakness,
- SM: constipa tion, tl1en diarrhea Cardiac: hn)otension,
- brad ycardia
What is the humoral
B cells and PMNs patrol the blood looking for bacteria
is the cell-mediated immune response?
- T cells and
- Macrophages patrol the
- tissues looking for non-bacteria
What are macrophages called in each area of the body?
- Lung=Tl pnemnocytes
- Liver=Kupffer cells
- Spleen=RES cells
- Lymph=Dendritic cells
- Kidney=Mesangial cells
- Payers patches=M cells
- • Histiocytes
- •Giant cells
- •Epitheloid cells
What is th.e CBC for every vasculitis?
- lRBC, lplatelets, i!BC, iT cells, iMP, and
- schistocytes, jE SR
What is the time course of the inflammatory response?
- l hr: Swelling
- Day I : PMNs show up Day 3: PMNs peak
- Day -k MP/T cells show up
- Day 7: MP/T cells peak, Fibroblasts arrive Day 30: l'ibroblasts peak
- Month 3-6: Fibroblasts leave
What state does estrogen mimic?
The neuromuscular disease state (estrogen is ;1 muscle relaxant)
What does high GABA levels lead to?
Bradycardia, lethargy, constipation, impotence, and memory loss