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- Super Oxide Dismutase
Vitamin E (lipophilic)
Which cells are particularly susceptible to damage from radiation?
- GI tract
- Bone Marrow
- Lymph Nodes
- ovarian follicles
- a fetus!
- Cancer cells
decrease in cell SIZE (starving)
Increase in cell SIZE (feasting)
Permanently non-dividing cells (stay in G0)
Causes of hypoxemia.
- improper ventilation
- improper diffusion of oxygen from the alveolus to the blood
- improper BF through lungs
Causes of hypoxia.
- anything that causes hypoxemia
- decreased oxygen carrying content
What is ischemia and an example?
- insufficient blood supply to a tissue or organ
- constricted BV
What is infarction?
ischemia with necrosis
What is responsible for secondary active transport?
Four common themes in cell injury
- ATP depletion
- free radicals & ROS
- Lots of increased intracellular Ca++
- Defects in plasma membrane
Where does lactate come from? What is it?
- anaerobic respiration (2 pyruvates are converted to lactate)
- It acts as a buffer
What two main things happen with decreased ATP production that leads to membrane damage?
- Decreased fxn of Na+ pump, so there is an increase in intracellular Na+ (causing increase in water and then swelling) and Ca++ and increase in extracellular K+
- ER dilation - ribosomes detach, protein synthesis decreases, and lipids are deposited
What two things cause IRREVERSIBLE cell injury?
- Membrane damage
- Release of lysosomal enzymes
Difference b/w osmolarity and osmolality.
- Osmolarity is the concentration of molecules per WEIGHT (kg) of water
- Osmolality is the concentration of molecules per VOLUME (Liter) of solution
What is tonicity?
The effective osmolality of a solution
A nernst potential will develop across a membrane if what two criteria are met?
- 1. if a concentration gradient exists across the membrane for a given ion
- 2. If selective permeation pathways (i.e. selective ion channels) exist that allow that transmembrane movement of the ion of interest.
What can hypoparathyroidism cause?
tetany (because of low Ca++)
Five types of necrosis and where they are.
- Coagulative (everywhere but the brain)
- Liquefactive (brain)
- Caseous (TB)
- Fat (pancreas)
Difference b/w ADH and aldosterone secretion?
- ADH: retains water
- Aldosterone: retains Na+
Dominant or recessive? Familial Hypercholesterolemia
Dominant or recessive? Sickle Cell Anemia
Five nondisjunctions and their associated chromosomes
- Down Syndrome (21)
- Edward (18)
- Patau (13)
- Turner (45:X)
- Klinefelter (47:XXY)
Dominant or recessive? Cystic Fibrosis
Dominant or recessive? Lysosomal Storage Diseases (Tay-sachs, Gaucher, Niemann-Pick)
Dominant or recessive? Glycogen Storage Diseases
Dominant or recessive? PKU
Dominant or recessive? Huntington disease
Dominant or recessive? Achondroplasia
Dominant or Recessive? Retinoblastoma
Dominant or recessive? Marfan Syndrome
Dominant or recessive? Li-Fraumeni
How can thrombophlebitis or hepatic obstruction lead to edema?
This is a venous obstruction, causing increased hydrostatic pressure within capillaries, forcing fluid OUT.
How can liver disease or protein
malnutrition cause edema?
They cause decreased plasma protein production, which decreases capillary oncotic pressure
How can glomerular disease of the kidney
(nephrotic syndrome) or serous drainage from open wounds cause edema?
They cause loss of capillary plasma protein = decreased oncotic pressure
How can hemorrhage, or cirrhosis of the liver cause edema?
They cause loss of capillary plasma protein = decreased oncotic pressure
How do burns cause edema?
- They cause loss of capillary plasma protein = decreased oncotic pressure
- Protein escapes from the plasma, causing an increase in capillary membrane permeability
How do crushing injuries, neoplastic disease, & allergic reactions cause edema?
Protein escapes from the plasma, causing an increase in capillary membrane permeability
How does a lymph obstruction contribute to edema?
- It usually absorbs interstitial fluid and the small amount of proteins that pass across the capillary membrane.
- When the lymphatic channels are blocked or surgically removed, proteins and fluid
- accumulate in the interstitial space causing lymphedema.
Two things that cause increased hydrostatic pressure, leading to edema.
- venous obstruction or
- salt and water retention.
How can edema cause dehydration?
large amount of fluid is lost to interstitial space, reducing plasma volume and causing shock (ex = burns)
How does ANP work?
- targets kidneys and causes decrease in Na+ reabsorption & increase in Na+ excretion
- water follows, decreasing BV & BP
- Also causes vasodilation
What could be a cause of insuffecient oncotic pressure leading to edema?
- liver failure = decreased production of plasma proteins
- kidney damage = proteinuria
Increased capillary hydrostatic pressure is usually secondary to what?
- (venous pressure increases, so net drainage decreases)
- (fluid is retained at higher rate than can be drained by lymph)
Some causes of hypernatremia.
- inappropriate admin of hypertonic soln (ie. NaHCO3 during cardiac arrest)
- oversecretion of aldosterone (primary hyperaldosteronism)
- Cushing syndrome (excess secretion of ACTH, which causes an increase in aldosterone secretion)
Some causes of hyponatremia.
- fever or respiratory infection
- DI (deficiency in ADH)
- Polyuria, profuse sweating, diarrhea
- *vomiting, diarrhea, GI suctioning, burns
Usual causes of hyperchloremia.
- excess Na+
- HCO3- deficit (metabolic acidosis)
Tx for hyperchloremia.
depends on the cause (i.e. ingestion of ammonium chloride diuretic)
S/S of hyperchloremia
no specific s/s
Usual causes of hypochloremia.
- hyponatremia or
- elevated HCO3-
- (metabolic alkalosis)
What happens to K and H in acidosis?
- H moves from ECF to ICF b/c K shifts out of the cell to maintain balance of
What happens to K+ in alkalosis?
causes K+ to shift into the cell which causes hypokalemia
3 hormones that promote K+ movement from ECF to ICF.
Acidosis causes ____kalemia.
- (H+ moves into cells, K+ moves out)
Alkalosis causes ____kalemia
How do anti-hypertensives cause K+ loss?
- they cause Na+ loss, and
- the kidney tries to recover Na+ in exchange for K+ = hypokalemia
If you see hypochloremia, what is most likely the problem?
An increase in anion gap means ____ acid
Most common cause of hypokalemia.
Free Ca++ is affected by what?
amount of protein in body (lots is bound to plasma proteins)
An increase in phosphate usually means what?
Uric acid is usually the result of what?
DNA/cell breakdown (it's a waste product)
Two conditions where a pt would have incresaed uric acid levels.
- (decreased ability to get rid of it)
What does increased direct bilirubin mean?
- the liver is conjugating it but can't get rid of it, so increased conjugated bilirubin
- possible prob w/ biliary system
- possible GI problem
- (light feces, dark urine)
What does an increase in total or unconjugated bilirubin mean?
- bilirubin is being made but there is a problem conjugating it (hepatocytes)
- can be due to increased bilirubin production secondary to hemolytic disease
What type of lab results would you see with a liver problem r/t bilirubin?
- increased AST/ALT
- increased total bilirubin
- normal direct bilirubin
Where is albumin made?
What does it mean if you have decreased albumin & decreased total protein?
- losing albumin in kidney, or
- liver failure (not making it fast enough)
What does it mean if you have decreased albumin & NORMAL total protein?
- another protein is being made at an increased rate and
- the liver is only making enough albumin as it need to make
How does the measure of RBCs and H&H relate to anemia?
- RBCs does not
- anemia = decreased Hgb & Hct
- Hgb is a measure of protein content in bld
If H&H are significantly increased, what does this mean?
- it is difficult for the heart to pump blood
- more RBCs than plasma (very thick) cardiomyopathy (heart working too hard)
- pathological hypertrophy
What is MCV?
- Mean corpuscle volume
- size of RBCs
- (ex: pernicious anemia)
________ increase in most bacterial infections;
_____ increase in some viral infections.
What would be the indication if a pt was anemic but there was no increase in reticulocytes?
- normally there will be an increase
- if not, there is a problem with the BM b/c that is where they are made
- could be a problem with the signal (EPO) to make more RBCs
If plt ct is less than 140,000, what does that mean?
clotting too slow
What does a INR of < 1.0 mean?
pt is clotting faster than normal
What does a INR of > 1.0 mean?
pt is clotting slower than normal
INR is the result of ________ testing.
Main fxn of DNA
blueprint for ribosomes to make proteins
mRNA is used to make _____
a series of _______ is translated into a series of _____ to make a protein.
What is DNA methylation and its significance?
- can inhibit transcription
- can silence a tumor-suppressor gene & increase risk of cancer