EXAM III

Pathophysiology

100

What are the three I's of Hypoxic cell damage? Bonus "I"?

1. Injury

2. Ischemia

3. Infarction

Bonus: Inflammation

200

Explain the difference between Isotonic, Hypertonic, and Hypotonic concentrations.

Isotonic: Same concentration of solutes and solvent.

Hypertonic: More solutes and less solvents

Hypotonic: Fewer solutes and more solvents

300

What is it and what is the function:

1. Renin

2. Angiotensin 1

3. Angiotensin 2

4. Aldosterone

5. ADH

1. Is an Enzyme, catalyzes the conversion of a plasma protein(angiotensinogen)and stimulates the formation of angiotensin 1 and 2. 

2. Inactive form of angiotensin, coverts to angiotensin 2 by ACE.

3. Vasoconstrictor, acts to stimulate the secretion of aldosterone.

4. A hormone secreted by the adrenal cortex, increases the reabsorption of sodium and excretion of potassium.

5. Antidiuretic Hormone, primarily increases water reabsorption to the kidneys in response to dehydration. 

400

Explain the movement of substances by Hydrostatic and Oncotic Pressure.

Hydrostatic is the force pushing substances out of the arteriole end of the capillary.

Oncotic pressure is the presence of too large plasma proteins that cant pass through the wall, causing a pull pressure.

500

Name one symptom related to each Electrolyte:

1. Potassium

2.Magnesium

3. Sodium

4. Calcium

1. Weakness, fatigue, alkalosis, shallow resps,confusion, drowsiness

2. Deep tendon reflexes

3.Seizures, AMS, Muscle twitching, Skin turgor, Sunken eyes

4. Parasthesia, convulsions, Neural excitability, abdominal cramps, twitching of cheeks

Pulmonology

100

Name the upper airway anatomy and the lower anatomy. 

Upper: 

Nasopharynx, Oropharynx, Laryngopharynx

Lower:

Larynx, Trachea, Bronchi, Alveoli

200

What is the oxyhemoglobin disassociation curve? What are the 4 things we know about it ?

It is the relationship between oxygen and hemoglobin.

1. Its a thing

2. Relationship changes based on variable factors

3. Describes the relationship between oxygen and hemoglobin. 

4. The more hypoxic you are the faster you become more hypoxic.

300

What is the Virchow triad? 

(p. 925)

Venous Stasis, Hypercoagulability, Vessel injury.

400

Pt has fluid and mucus build up in their larger airways, he is making a "snoring" breath sound when auscultated. What is the lung sound?

Rhonchi

500

Hypoxia vs Hypercarbia

1. Hypoxia- restlessness, anxiety, combativeness

2. hypercarbia- drowsiness, lethargy

Cardiology

100

Explain what is:

Chronotropy

Inotropy

Dromotropy

Chronotropy - Time 

Inotropy - Strength

Dromotropy - Rate

200

Explain the cardiac action potential phases.

Phase 0- Resting membrane potential

Phase 1- Rapid early repolarization

Phase 2- Plateau Phase

Phase 3- Terminal Phase

Phase 4- Period b/w action potentials (Na+/K+ pump)

300

Absolute Refractory Period vs Relative Refractory Period

ARP- Cardiac muscle absolutely cannot respond to any stimulation regardless of how long stimulus is applied.

RRP- Cardiac muscle more difficult to excite but can still be stimulated. 

400

Explain the flow of a drop of blood starting at the capillary beds.

You should know this!

500

Explain the difference between Parasympathetic control of the heart vs Sympathetic control of the heart.

Parasympathetic: Vagus nerve (CN X), acetylcholine is chemical mediator, Activation may not restrict SV due to filling times. 

Sympathetic: Norepi, Chrono, Ino, Dromo, Hormonal Regulation, Electrolytes

Drugs

100

What is the MOA of albuterol and the dosage?

MOA: Bronchodilation via stimulation of the adrenergic receptor sites. 

Dose: 2.5 mg diluted to 3mL with NS nebulized.

200

What is the Class and the MOA for Diltiazem?

Class: Calcium Channel Blocker, Class IV antiarrhythmic

MOA: Blocks Calcium from moving into the heart muscle cell, which prolongs the conduction of electrical impulses through the AV node. 

300

What is the Side Effects, Indications, and Dose of Methylprenisolone Sodium Succinate? 

Side Effects: Fluid retention, hypertension, GI distress, hyperglycemia, headache, dizziness

Indications: Allergic reaction, Anaphylaxis, Adrenal Crisis, Status Asthma

Dose: A: 125-250 mg IV/IM P: 1-2mg/kg IV/IM

400

What is the MOA, Indications, and Dose for Dexamethasone? 

MOA: Reduces inflammation by multiple mechanisms.

Indications: Anti-inflammatory agent from a wide variety of medical conditions, primarily bronchospasms.

Dose: A: 4-20mg IV P: 0.6 mg/kg IV

500

What is the entire drug card for Furosemide? 

C: Loop Diuretic 

MOA: Inhibits the reabsorption of sodium and chloride at the loop of Henle, resulting in diuresis.

Indications:CHF, Pulmonary edema, Hypertensive emergencies

Contraindications: Hypovolemia, anuria, hypokalemia

SE: Dehydration, hypotension, hypokalemia, GI distress

Dose: A: 20-80 mg SIVP P: 1mg/kg IM/IV

Onset/ Duration:

5-15min/ 4-6 hours