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What is the Normal Value for Potassium?
3.5-5.0 mEq/L
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What is the Normal Value for Sodium?
136-140 mEq/L
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What is the Normal Value for Chloride?
90-1110 mEq/L
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What is the Normal Value for Calcium?
10mg/DL
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What is the normal value for PaCO2 ?
35-45 mm. Hg
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What is the normal value for PaO2 ?
75-100 mm.Hg
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What is the normal value for bicarbonate?
22-26 mEq/L
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What is the normal Va/Q ratio?
0.4L air per minute/ 0.5L blood per minute =0.8
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What is the normal value for pH?
7.35-7.45
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What is the order of the RAA, ADH mechanism?
ADH-Renin-Angiotensinogen-Agiotension I- Angiotension II- Aldosterone
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Cappillary Hydrostatic Pressure does what?
Is the pressue moving fluid through a capillary
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Capillary Osmotic pressure does what?
Pushes fluid against hydrostatic pressure causing a slight accumulation of fluid in the tissues.
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Cause of Increased Sodium (Na)
- Excess Sodium intake
- Imipaired thirst sensation
- Dysphagia
- Profuse Sweating
- Diabetes Insipidus
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Signs and Symptoms of Increase Sodium (Na)
- Thirst
- Cell Shrinking
- Cns Irritability
- Confusion
- Seizures
- Coma
- Tachycardia
- Oliguria
- Anuria
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What are the causes of decreased Sodium (Na)
- Aldosterone deficiency
- Renal Failure
- CHF
- SIADH
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Signs and Symptoms of Decreased Sodium (Na)
- Cellular Swelling
- CNS depression
- Lethargy
- Apathy
- Stupor
- Diminished reflexes
- Muscle Cramps
- Anorexia
- Coma
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Causes of increased Potassium (K)
- Insulin deficiency
- Lysis of large number of cells
- aldosterone deficiency
- Metabloic acidosis
- Kidney disease
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Signs and Symptoms of increased Potassium (K)
- Decreased membrane potential
- Increased Neuromuscular Irritability
- Tingling of lips and fingers
- Muscle weakness
- Paralysis
- Cardiac Arrhythmias
- V-Fib
- Asystole
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Causes of Decreased Potassium (K)
- Dietary Deficiency
- Vomiting
- Diarrea
- Laxative abuse
- Insulin
- Epinephrine
- Metabolic Alkalosis
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Signs and Symptoms of decreased Potassium (K)
- Increased membrane potential
- Muscle Weakness
- Paralysis
- Cardiac Arrhythmia
- CNS depression
- Coma
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Causes of increased Calcium (Ca)
- Hyperparathyrodism
- Bone Breakdown
- Excessive Vitamin D Ingestion
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Signs and symptoms of incresed Calcium (Ca)
- Depressed Neuromuscular excitibility
- Depression
- Muscle weakness
- Constipation
- Anorexia
- Nausea
- Vomiting
- Kidney Srone Formation
- Osteopenia
- Bone fractures
- Bone Deformaties
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Causes of Decreased Calcium (Ca)
- Decreased Vitamin D ingestion
- Blood Transfusions
- Hyperparathyroidism
- Kidney Disease
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Signs and Symptoms of Decreased Calicum (Ca)
- Excessive neuromuscular excitability
- Muscle Spasms
- Cardiac Arrhythmias
- Seizures
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What are the causes of Edema?
- Increasesd Capillary Hydrostatic Pressure
- Right Ventricular Failure
- Left Ventricular Failure
- Sodium-Water Excess
- Local Venous Obstruction
- Hepatic Obstruction
- Decreased Capillary Osmotic Pressure
- Increased Capillary Permeabiliry
- Lymphatic Obstruction
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Edema Signs Caused by Right Heart Failure
Pedal Edema
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Edema carused by Left Heart Failure
Pulomary Edema
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What causes Acute Renal Failure (ARF)?
Sudden Supression of Kidney function
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What are the types of Acute Renal Failure?
- Prerenal
- Intrarenal
- Postrenal Obstructive
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What are the stages of Acute Renal Failure (ARF)
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What are the signs of ARF?
- Oliguria
- Hyponatremia
- Hyperkalemia
- Acidosis
- Azotemia
- Anemia
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What are the signs of recovery in ARF?
- Polyuria
- Return of concentrating ability of the kidney
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Oliguria
Decrased urine output
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Azotemia
The accumulation of nitrogenous waste in the blood
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Polyuria
increased urine output
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Isosthenuria
Urination of plasma
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What is an Metabolic Acidosis?
- There is a change is amount of fixed acids
- pH decreases, bicarbionate decreases
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What is Metabolic Alkalosis?
- The pH increases
- The bicarbonate increase
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What is respiratory acidosis?
Excessive retention of CO2
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What is Respiratory alkalosis?
Excessive excretion of CO2
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What is the cause of metabolic acidossi?
The loss of bicarbonate or the accumulation of non-volatile acid due to
- Renal failure
- Diabetic Ketoacidosis
- Decompensated Shock
- Diarrhea
- Bilious Vomiting
- Poisoning
- Starvation
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What are the Signs and symptoms of metabolic acidosis?
- Deep rapid respiration
- Acetone Breath
- Decreased LOC, disorientation, coma
- Ventricular Arrhythmias
- Dimished Cardiac Output
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How does the body compensate for Metabolic Acadosis?
- Buffering
- Increased respiratory rate and depth
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What causes Respiratory Acidosis?
- Accumulation of carbonic acid due to CO2 retention caused by
- Obstructive lung diseases
- Neuromuscular weakness
- Depression of CNS respiratory center
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What are the signs and symptoms of Respiratory Acidosis?
- Decreased LOC
- Disorientation
- Coma
- Ventricular Arrhythmias
- Diminished Cardiac Output
- Pulmonary Hypertension
- Reduced Cardiac Output
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What does the body do to compensate for Respiratory Acidosis?
- Buffering
- Renal: H+ excretion; bicarbonate retention
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What are the causes of Metabolic Alkalosis?
- Excess bicarbonate of loss of non-volatile acid caused by
- Gastric vomiting
- Nasogastric Suctioning
- Diuretics that cause H+ excretion, Bicarbonate retention
- Ingestion of Alkali
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What are the Signs and symptoms of Metabolic Alkalosis?
- Apathy
- Mental Confusion
- Dizziness
- Parasthesias
- Shallow Breating
- Muscle Spasm
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What does the body do to compensate for Metabolic Alkalosis?
- Buffering
- Decreased Respiratory rate and depth
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What is the cause of Respiratory Alkalosis?
- Loss of carboinic acid because of hyperventilation due to
- Anxiety
- Hypoxia
- CNS disorders: Stroke, Tumors, Trauma, Meningitis
- Fever
- Pregnancy
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What are the signs and symptoms of respiratory alkalosis?
- Anxiety
- Mental confusion
- Dizziness
- Parasthesias
- Decreased LOC
- Coma
- Neuromuscular Tetany
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How does the body try and compensate for Respiratory Alkalosis?
- Buffering
- Renal: H+ retention, bicarbonate excretion
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What is the normal Ventilaion-Perfusion Ratio?
4L air/5L blood/min=0.8
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What is Ventilation Perfusion Mismatch?
The ratio of normal Ventilation Perfusino is skewed.
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Obstuction does what to the ventialtion perfusion ratio?
Decreases ventialion
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What is anemic-anemia?
Anemia resulting from the failure of oxyger delivery to the tissues
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What is histoxia?
Decreased uptake by the tissues
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What are the areas of respiratroy control?
- Medulla
- Pons
- Central Chemoreceptors
- Peripheral Chemoreceptors
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What is the function of central chemoreceptors?
Respond to changes in the pH of cerebrospinal fluid
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What is the function of peripheral chemoreceptrors?
Respond to increases in CO2 or H+ and if the arterial O2 saturation falls.
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What is Acute Respiratory Failure?
The sudden failure of the respiratory system
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What are the causes of Acute Repiratory Failure?
- CNS depression
- Neuromuscular disease
- Severe chest wall/diagphragm trauma-pneumothorax
- Airway obstruction
- Lung Disease
- Vascular Disease
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What are the Signs and Symptoms of Acute Respiratory Failure?
- PaO2 < 66 mm Hg
- PaCO2 > 50 mm Hg
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What are the effects of acute respiratory failure?
- Confusion
- Tremors
- Compensatory Hypertension then Hypotension
- Tachycardia
- Decreased LOC
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What are the causes of Adult Respirattory distress syndrome?
- Hypovolemic Shock
- Trauma
- Embolism
- Aspiration
- Drug Overdose
- Inhaled Toxins
- Radiation
- Hematologic Disorders
- Infection
- Burns
- Cancer
- Anaphylaxis
- Eclampsia
- Decreased Surfactant
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What are the signs and symptoms of Adult Respiratroy Distress Syndrome?
- Refractory Hypoxia
- Widespread Alveolar Infiltrate
- Dyspnea
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What are the effects of Adult Respirtory Distress Syndrome?
- Increased vasculature and alveolar permeablility
- Decreased Lung Compliance
- Decreased Gas Exchange
- Protein Rich Edema
- Obstruction
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What is the cause of Pulmonary Hypertension?
- Decreased area for gas exchange and increased resistance
- Emphysema
- Embolism
- Compensatory Vasoconstriction
- Heart Defects
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What are the Effects and Signs and Symptosms of Pulmonary Hypertension?
- CHF
- "Blue Bloater"- Cyanotic
- Ventricular Hypertrophy
- Embolism
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What is the main cause of Lung Cancer?
Smoking
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What are the signs and symptoms of Lung Cancer?
- Cough
- Hemoptysis
- Hoarseness
- Pleural Effusion
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What are the effects of Lung Cancer?
Acute Respiratory Failure
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What are the causes of Emphysema?
- Increased Protelytic Enzymes and Decreased alpha1 Antitrypsin
- Smoking
- Chronic Bronchitis
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What are the Signs and Symptoms of Emphysema?
- Weight loss
- Use of acessory breathing muscles- "barrel Chest"
- Cyanosis
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What are the effects of Emphysema?
- Decreased Alveolar area for gas exchange
- Bronchiolar Collapse
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What are the causes of Bronchitis?
- Acute- infection
- Chronic- smoking
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What are the signs and symptoms of bronchitits?
- Coughing
- Excess Mucous Production
- Scarring
- Airway Obstruction
- Hypoxia
- Hypercapnia
- Vasoconstriction
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What are the effects of bronchitis?
- Pulmonary Hypertension
- Right Sided CHF
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What condition results in regractory Hypoxia?
- ARDS and IRDS
- Due to damage to the respiratory membrane and progressive pulmonary edema
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What are the causes of Pnumonia?
- Aspiration
- Aerosol
- Systemic
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What are the signs and symptoms of Pnumonia?
- Rales and Sputum
- Inflammatory response
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What are the effects of pnumonia?
- Va/Q mismatch
- Exudate in Alveolar Spaces
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What are the causes of tuberculosis?
- Mycobacterium Tuberculosis
- Aspiration or Ingestion
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What are the Signs and Symptoms of inflammatory response?
- Inflammatory Response
- Skin Test
- Chest Radiograph- Ghon Tubercles
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What are the effects of Tuberculosis?
- Low grade fever
- Productive COugh with hemoptysis
- Anorexia
- Lethargy
- Night Sweats
- Dyspnea
- Chest pain
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What are the intristic causes of asthma?
- Exercise
- Stress
- Irritants
- Drugs
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What are the extrinsic causes of Asthma?
Allergens
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What are the signs and symptoms of asthma?
- Wheezing
- Dyspnea
- Hyperventilation
- Productive Cough
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What are the effects of Asthma?
- Acute, reversible episodes of airway obstruction
- bronchospasm
- excessive mucus production
- bronchiolar mucosal edema
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