Term
| What is the resting membrane potential |
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Definition
| The difference between charges inside the cell and outside the cell. |
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Term
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Definition
| This is the value reached when the cell will continue to depolarize with no further stimulation. |
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Term
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Definition
| The rapid change that occurs when a nerve or muscle cell recieve a stimulus that exceeds the membrane threshold value |
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Term
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Definition
| When the membrane potential moves foward from a neg value to 0 |
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Term
|
Definition
| When the negative polarity of the resting potential is reestablished |
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Term
| Absolute refractory period |
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Definition
| When the plasma membrane can not respond to additional stimulation |
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Term
| relative refractory period |
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Definition
| Time when the permeability to K increases, a stronger than normal stimulus can cause a action potential |
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Term
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Definition
| measure of number of milliosmoles per kg of water or the concentration fo molecules per wt of water |
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Term
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Definition
| number of milliosmoles per liter of solution or concentration of molecules per vol of solution |
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Term
| What is an isotonic solution and give examples |
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Definition
| The same osmolality of particles as ICF and ECF, 5%dextrose in water, .09%nacl- |
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Term
| What hypotonic solution and give example |
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Definition
| It has a lower concentration and is more dilute than our body fluid, water |
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Term
| What is an hypertonic solution |
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Definition
| It has a higher concentration than our body fluids, 3% saline solution |
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Term
| What is mediated transport |
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Definition
1. involves transport P
2. Has channels that require a protein transporter that creates a water filled channel so sp. ions can diffuse through the cell membrane |
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Term
|
Definition
Does not require energy
movement of water down a concentration gradient
movement of water and solutes through a membrane because of increase pressure on one side of the membrane
movement of water from an area of greater solute concentration to area of lesser solute concentration |
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Term
|
Definition
Does require energy
Na K pump
Protein transporter moves molecules up the concentration gradient
plasma membrane enfolds substances on one side of the membrane and invaginates them |
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Term
| How are body fluid classified |
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Definition
Intracellular
Extracellular
intersitital
intravascular |
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Term
| Volume of total body water. What are the reasons for variances |
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Definition
| The is in porportion to fat the more fat the less water. In infants tbw is75-80 after one year is is 67%. In adulthood women have less water than men because they have more fat. In the erlderly water decreases because of decrease in muscle and increase in fat, and reduce ability to regulate sodium and water balance. The kidneys wear out and have a hard time maintaining water and na balance. |
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Term
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Definition
| the forces favoring filtration minus the forces opposing filtration, movement of fluid back and forth across the capillary wall. |
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Term
| Hydrostatic pressure and oncotic and osmotic pressure have what effect |
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Definition
| Hydrostatic has pushing effect verses osmotic pressure has a pulling effect |
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Term
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Definition
| two thirds of the body's water |
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Term
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Definition
| 1/3rd of the body's water |
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Term
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Definition
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Term
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Definition
| an accumulation of fluid in the interstital spaces. The prov of fluid distribution and doesn't mean there is an excess of fluid |
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Term
| what is the pathophysiology behind edema |
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Definition
| an increase in hydrostatic pressure can result from venous obstruction or salt and water retention |
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Term
| what are the clinical manifestations of edema |
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Definition
| weight gain, swelling, tight-fitting shoes |
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Term
| what are some disease processes that cause edema |
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Definition
| chf, malnutrition, stroke post, cirrhorois of liver |
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Term
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Definition
| Imbalances that result in an ecf concentration > than .9% sale solution example hypernatrenia |
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Term
|
Definition
When na levels > 145 intercelluar dehydration
causes decreased fluid intake
too much hypertonic saline sol such as sodium bicarb
too much aldosterone
cushing syndrome
too much acth |
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Term
| What are the s/s of hypernatremia |
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Definition
thirst, dry mouth, low b/p, restlessness
serious- convulsions, pulmonary edema |
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Term
| what is the treatment for hypernatremia |
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Definition
| give isotonic salt free fluid such as 5% dextrose in water untill the serum level returns to normal |
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Term
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Definition
| Occurs when there is and excess of sodium and deficit of bicarb |
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Term
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Definition
| when osmolality of ECF is less than norm. |
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Term
| What is the most common cause of hypertonic alterations |
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Definition
| not enough sodium or free water excess |
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Term
| What is the pathophysiology of hyponatremia |
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Definition
| When na level drops below 135 the decrease causes m.m. of water in the cell and cell swelling. |
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Term
| What are the most common causes of hyponatremia |
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Definition
| use of diuretis, vomiting, loose stools, gi suction, and burns |
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Term
| Interstitual hydrostatic pressure |
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Definition
| outward push of the intersitiual fluids against the outside of the capillary walls. |
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Term
| Increases in hydrostatic pressure |
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Definition
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Term
| Increase in capillary permeability |
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Definition
| decrease in plasma osmotic pressure |
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Term
| capillary hydrostatic pressure |
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Definition
| refers to the pushing outward of fluid against the capillary wall |
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Term
| potassium concentration is ECF |
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Definition
|
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Term
| How is the concentration of K regulated |
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Definition
| Through the na k pump active transport system |
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Term
|
Definition
| regulation of icf osmolality, glycogen deposition, maintains resting membrane potential |
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Term
| What organ mostly controls the amount of K |
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Definition
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Term
| What in the kidneys filters K and where is it reabsorbed |
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Definition
| It is filtered by the glomerulus and reabsorbed by the proximal tubule and loop of henle |
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Term
| What system is set up to conserve K loss |
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Definition
| protein tyrosine kinaase dependent signal transduction pathway |
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Term
| What regulates water in the kidney |
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Definition
|
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Term
|
Definition
| synthesised by cells in the hypothalamus |
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Term
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Definition
| When osmoreceptors in the hypothalamus since changes greater or = to 1%, or baroreceptors sensitive to changes in the central bl. vol of > 5% |
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Term
| What determines the the concentration of K in the distal tubular cell |
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Definition
| plasma concentration in the peritubular capillaries |
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Term
| What happens to K when s/o is taking diuretics |
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Definition
| the rate of filtrate flow through the distal tubule will be higher and K will be excreted because the amount of K will be lower more will be excreted |
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Term
| How do changes in ph and h ion concentration affect K balance |
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Definition
| H ions move from ecf to icf during acidosis and k shifts out of the cell into the ecf this decrease results in decrease secretion of k into the urine by the distal tubular cells causing hyperkalemia. In contrast with alkalosis K shifts into the cell so the distal tubular cells increase their secretion of K into the urine causing hypokalemia. |
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Term
| How does aldosterone play a part in K regulation |
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Definition
| When k concentrate is increased, aldosterone is released, stimulating secretion of K into the urine by distal tubules of the kidney. it also increases the secretion of K from the sweat glands. |
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Term
| How does insulin contribute to the regulation of plasma K levels |
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Definition
| by stimulating the na, k atpase pump and promoting the movement of k into the cell of the liver and muscle cells. I tcan be used to treat hyperkalemia and cause low levels of bl k. |
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Term
| How do catecholamines influence K |
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Definition
| Beta 2 receptors adrenergics stimulate the movement of K into the cells and a adrenergics shift K out of cells. |
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Term
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Definition
| The body is able to safely excrete K as long as the dose is no more than 120mEq per day |
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Term
| how is resp alk corrected |
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Definition
| h is pulled into ecf pco is decreased renal restores ph by < H excretion and bicard absorb |
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Term
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Definition
| When serum potassium concentration less than 3.5, I alkalosis K shifts in to the cell in exchange for H to maintain plasma acid base balance. It may be normal or elevated when total k is depleted when K shifts ifrom the ICF to the ECF. |
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Term
| What is the Disease process that causes K levels to present as normal when total body K levels are depleted. |
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Definition
| Diabetic ketoacidosis which the increae in H concentration causes to shift into the cell in exchange for K. A normal level of K is maintained in the plasma but K continues to be depleted in the urine. |
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Term
| What are some factors that cause hypokalemia |
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Definition
| reduced intake of K, increased ento of k into cells, and increase losses of body K. diet deficit such as elderly with low P intake and inot enough fruits and veg, Alcholism or anorexia nervosa. |
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Term
| What are some medications that cause hypokalemia |
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Definition
| amphotericin b, gentamicin, and carbenicillin |
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Term
| What are some of the clinical manifestations of Hypokamia |
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Definition
| high blood sugar, plyuria and polydipsia , mscle weakness, cardia dysrhythmias, |
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Term
| What is the treatment for hypokalemia |
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Definition
| Eating foods rich in K and K replacement not to exceed 80meq a day if renal fun is norm. |
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Term
| What changes happen on the ECG in regards to hypokalemia |
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Definition
| amplitude of the T wave in decreased and U wave is increased st segment is depressed, in severe cases the P waves peak and QRS is prolonged. It also increased r.f. dig tox |
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Term
| Why do dysrhythmias occur |
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Definition
| because K contributes to the repolar phase of the action pot, thus delaying ventricular repolarization. |
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Term
| What are some of the treatments for hyperkalemia |
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Definition
| glucose and insulin, Na bicarb, ca gluconate, cations exhange cations and resins |
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Term
| If ECF concentration of K increases but ICF concentration K stays the same what happens to the resting membrane potential |
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Definition
| the cell becomes more positive and the cell membrane becomes hypopolarized. With mild increases in k the cell repolarizes more readily and becomes more irritable. Action pot is easier because the difference between the resting membrane and threshold has been shortened. |
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Term
| Where is calicum found at |
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Definition
| Bone (hydrozyapatite and inorganic compound causes bone rigidity). , plasma (50% bound to plasma proteins and 40% free form) |
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Term
| Which kind of ca2 has the most important function |
|
Definition
|
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Term
|
Definition
| structure of bone, enzymatic cofactor for bl. clotting, hormone secretion and fun of cell receptors. Plasma mem stability and permeability are directly related to ca2 ions, transmission of nerve impulses and contraction of muscles. ICF ca2 is primarly in the mitho. |
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Term
| Where is phosphate found and what are norm serum levels |
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Definition
| found in bones, 2.5-4.5 in adults, 6.0-7.0 as high in infants and children |
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Term
| What fun.s does phosphate have |
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Definition
| ICF and ECF anion buffer in the reg of acid base balance in the form of ATP it provides energy for muscle contraction. |
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Term
| What is the formula for concentration of ca to phosphate |
|
Definition
CA++× HPO=4=K+
If the concentration of one increases the concentration of the other decreases |
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Term
| What hormones control Ca HPO=4 |
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Definition
| parathyroid, vit K and calcitonin. Acting together these substances determine the am of ca and hpo4 absorpted from the intestines, the deposition and absorbtion in the bone, and reabsorption and excretion by the kidney |
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Term
| How does PTH control ca2 and hpo4 levels |
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Definition
| Decrease levels of pth cause decrease renal act of vit d when decreases reabsorption and decrease excretion of phosphate . In hypocalcemia increase pth incease renal activation of vit d and increase reabsorption and increase excretion of phosphate |
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Term
| Explain how vit d is activated |
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Definition
| renal activation starts when levels of ca2 are decreased which stimulates secreation of pth pth acts to stimulate ca2 reabsorption and excretion of phosphate. activated d then comes in the plasma and acts to increase reabsorption of ca2 in sm intestine, increase bone absorption of ca2, and increase renal tubular reabsorption of ca2. |
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Term
| when is vit d not activated |
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Definition
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Term
|
Definition
- Decrease in dietary intake of green leafty vegatables dairy products
- blood transfustions because the product they use to store binds with ca2
- pancreatitis because of release of free fatty acids which bind ca2
- neoplastic bone metastases
- vitamin d deficit
- metavolic or respitory alk
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Term
| What are the clinical manifestation of hypocalcemia and how are they primarily caused by |
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Definition
- chvostek sign by tapping on the facial nerve just behind temple a + sign is a twitch of the nose or lip
- trousseau sign is contraction of the hand and fingers when the arterial blood flow in the arm is occluded for 5 minutes
- convulsions and tetany
- ecg prolged QT interval
- hyperactive bowel sounds
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Term
| What is the treatment for hypocalcemia |
|
Definition
- ca2 gluconate
- oral replacement
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Term
| What causes hypercalcemia |
|
Definition
- hyperparathyroidism
- bone metastases
- prostate and cercvical cancer
- sarcoidosis
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Term
| what are s/s of hypercalcemia |
|
Definition
- fatique
- anorexia
- nausea
- constipation
- behavioral changes
- impaired renal function
- shortened QT segment and depressed t waves
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Term
| What is the treatment of hypercalcemia |
|
Definition
- oral phosphate
- normal saline iv
- corticosteriods mithramycin
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|
Term
| How is mg metabolism regulated |
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Definition
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Term
| Who compensates in met acidosis and what does it do |
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Definition
| the lungs compensate by breathing by increasing ventilations lowering h2co2 and paco2 and kidneys excrete the excess acid as ammonia |
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Term
| what are some of the ss of med acid |
|
Definition
- ha
- tireness
- coma
- severe deep rapid rr
- dysrhymias
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Term
| how is met acid evualated and what is the treatment |
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Definition
| if ph <7.36 and hco <=24. If ph < 7.1 iv sodium hco3 is indicated |
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Term
| What are some of the causes of met alkalosis |
|
Definition
- nausea
- vomiting
- gastric suctioning
- excessive HCO3 intake
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|
Term
Which met alk condition can not be treated by the kidneys and why
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|
Definition
| hypochloremic met alk b/c vol dep of electroyles stim kidneys to reabsorb bicard and na while excreting h. when there is no more K hydrogen enters into the cell and is also excreted to maintain balance. The urine is acidic but the reabsorbed biccarb make it impossible to correct balance must give asolut of na with K. This reduces the renal stim to reabsord Na and cl is replaced. bicarb is excreted and H reabsorbed. |
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Term
| How do you evual and tx met alk |
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Definition
| met alk is evual when bicard level is greater than 26 ph >7.45 rr compen is when pco2>40 in hypochloremci alk a na iv sol in hyperadlosteronism K is required to move H to move back into the ECF and < loss of H from distal tubule. |
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Term
| How do the kidneys compensate in resp acidosis |
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Definition
They sec H and regenerate bicarb, bicarb and pco are elevated and ph will return to norm
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Term
|
Definition
|
|
Term
|
Definition
| excessive reduction of co2 |
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|
Term
|
Definition
|
|
Term
| what is the evual and treatment of resp alk |
|
Definition
| ph>7.45, and Pco<38 with compensation a < in bicarb levle treating the ph |
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|
Term
| what disease processses mostly cause resp. alk |
|
Definition
| chf, pulmonary dz, fever, anemia, thyrotoxicosis, cirrhosis |
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