What electrolyte s does the low volume state cause?

total Na, serum Na (dilutional effect), Cl, K

What pH does the low volume state have?

Alkalotic (except diarrhea, RTA Type II, & DKA b/c Aldo dumps
H+)
What pH do vomiters have?
Alkalotic b/c you vomit out H+

What pH does diarrhea have?

Acidosis b/c stool has bicarb
What happened if pulse >10 on standing?
Hypovolemic shock
What happened if pulse <5 on standing?
Autonomic dysfunction
What are the sx of a low energy state?
CNS: mental 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 marrow-suppressed, vascular endothelium- breaks down,
lungs-infection, SOB, Kidney-PCT will feel effect first, GI: n/v/d,
bladder: oliguria, sperm-low, germ cells-predisposed to ca,
breasts-atrophic, endometrium-amenorrhea
What are the MC SIGNS of the low energy state?
Tachypnea & dyspnea
What are the MC SX of the low energy state?
Weakness & SOB
What are the MC infections of the low energy state?
UTI & respiratory infections

What is the MC COD in the low energy state?

Heart failure
Explain all restrictive lung diseases.
Restrictive: interstitial problem (non-bacterial)
- Small stiff lungs (VC)
- Trouble breathing IN FEV1/FVC >0.8
- ABG: pO2 RR, pCO2, pH
- CXR: reticulo-nodular pattern, ground-glass appearance
- Die of cor pulmonale
- Ex: NM dz (breathing out is passive), drugs, autoimmune dz
- Tx: Pressure support on ventilator, O2, RR, inspiratory time
Explain all obstructive lung diseases:
Obstructive: airway problem (bacterial)
- Big mucus-filled lugns (RV, Reid index = airway
thickness/airway lumen)
- Trouble breathing OUT FEV1/FVC <0.8
- ABG: pCO2 RR, pH
- Die of bronchiectasis
- Ex: COPD
- Tx: Manipulate rate on ventilatior, RR, expiratory time, O2
only if needed
What symptoms does a "more likely to depolarize" state have?
Brain: psychosis, seizures, jitteriness
Skeletal muscle: muscle spasms, tetany
Smooth Muscle: diarrhea, then constipation
Cardiac: tachycardia, arrhythmias
What is the humoral immune response?
B cells & PMNs patrol the blood looking for bacteria
What is the cell-mediated immune response?
T cells & macrophages patrol the tissues looking for non-bacteria

What are macrophages called in different body areas?

Blood: monocytes,
Brain: miroglia,
Lung: T1 pneumocytes,
Liver: Kupffer cells,
Spleen: RES cells,
Lymph: Dendritic cells,
Kidney: Mesangial cells,
Payers patches: M cells,
Skin: Langerhans,
Bone: osteoclasts,
CT: histiocytes, giant cells, epitheloid cells
What is the CBC for every vasculitis?
RBC, platelets, WBC, T cells, Macrophages, schisotcytes,
ESR
What is the time course of the inflammatory response?
1 hr: swelling
Day 1: PMNs show up
Day 3: PMNs peak
Day 4: MP/T cells show up
Day 7: MP/T cells peak, fibroblasts arrive
Day 30: Fibroblasts peak
Month 3-6: Fibroblasts leave
What state does estrogen mimic?
The NM dz state (estrogen is a muscle relaxant)
What do high GABA levels lead to?
Bradycardia, lethargy, constipation, impotence, memory loss