SLCC Pathophysiology FINAL 2024-2025
Exam Questions and Answers
4 Major Cations
Sodium - Answer-Sodium: 135 - 145 "EXCITES"
-Extracellular cation
-Affects brain and nervous system = changes in LOC/seizures
4 Major Cations
Potassium - Answer-Potassium: 3.5 - 5.0 "EXCITES"
- Intracellular cation
- Affects heart (either high or low values)
4 Major Cations
Calcium - Answer-Calcium: 8.5 - 10.5 "CALMS"
- Extracellular cation
- Affects nerves and muscles
4 Major Cations
Magnesium - Answer-Magnesium: 1.5 - 3.0 "CALMS"
- Intracellular cation
- Affects deep tendon reflexes and smooth muscle (lungs/ uterus/ heart/ intestines)
ABG values
pH - Answer-7.35 - 7.45
ABG values
PCO2 (respiratory) - Answer-35 - 45
ABG values
HC03- (Renal) - Answer-22 - 26
ABG values
PaO2 - Answer-80 - 100
Kussmaul respirations - Answer-If the body is acidic, the lungs try to raise pH by
"blowing off" CO2 (which makes a weak acid in the body - carbonic acid). This results in
KUSSMAUL breathing pattern - deep rapid breathing
How to determine if ABG is compensated/ uncompensated/ partially compensated -
Answer-Compensated = pH is NORMAL and other two values are abnormal
Uncompensated = pH and ONE other value is abnormal
PartiALLy Compensated = ALL values are abnormal
,Causes of Anemia
1. Anemia due to blood loss - Answer-~Gastrointestinal (GI) Conditions - upper or lower
GI bleeds
~non-steroidal Anti-inflammatory drug over use (so patients with chronic pain are at risk
for anemia)
~Excessive menstruation or childbirth complications
Causes of Anemia
2. Anemia due to decreased or faulty RBC production - Answer-~Nutritional
deficiencies: Folate, Vitamin B-12, and Iron are necessary components of RBC
production
~Sickle Cell Anemia
~Bone marrow & stem cell problems: Leukemia and lymphoma are examples
Causes of Anemia
3. Anemia due to RBC destruction "Hemolytic Anemia" - Answer-causes can be
"Intrinsic" (inherited defective RBCs) or "Extrinsic" (everything else)
~Inherited - sickle cell & thalassemia
~Stressors - RBCs destroyed by infections, drugs, snake or spider venom
~Toxins - advanced liver or kidney disease
~Autoimmune - Lupus can affect Bone marrow
~Spleen - in enlarged spleen blood moves more slowly thru, causing RBCs to become
prematurely destroyed before they get through the spleen .
Causes of Anemia
4. Other conditions associated with decreased or faulty RBCs - Answer-Advance kidney
disease - see KIDNEY CONNECTION
Hypothyroidism - causes lowered iron levels in the blood.
Chronic diseases - INFLAMMATION causes production of cytokines that then destroy
all blood cells including erythrocytes. EXAMPLES: cancer, infection, autoimmune
disorders (lupus or rheumatoid arthritis)
KIDNEY CONNECTION - Answer-Erythropoietin (made in kidneys) signals bone
marrow to make more RBCs, so if kidneys are damaged, erythropoietin is not excreted
and RBCs are not made.
Antigens - Answer-Proteins on cell surface that identify it as foreign or not. Cell specific.
Antibodies - Answer-Immunoglobulins are the bodies compliment to antigens. When
antibodies attach to antigens cells cannot reproduce. Lock and key analogy.
Apoptosis - Answer-Controlled cell death by implosion. Membrane maintains integrity,
cell contents not released into extracellular space, no inflammatory response.
Necrosis - Answer-Uncontrolled cell death. Membrane looses integrity, cell contents
released into extracellular and inflammatory response.
, What does ARDS stand for - Answer-Acute/Adult respiratory distress syndrome
How does ARDS start? - Answer-with an Acute lung injury/insult (ALI) of some type
(infection/sepsis, trauma, hypoxic event, aspiration of gastric juices/vomit, pulmonary
embolism, blood transfusion reaction, etc) that causes SEVERE LUNG
INFLAMMATION - also referred to as SIRS (Systemic Inflammatory Response
Syndrome)
In response to lung injury (ARDS)...the body will - Answer-release mediators, clotting
factors, vasodilating agents, etc. Damaging lungs further. Alveoli and surrounding
capillary bed is severely damaged and rendered useless. Lungs stop producing
surfactant, leads to atelectasis.
ARDS development and progression stages - Answer-1: First Stage - Respiratory
Alkalosis
2: Intermediate Stage - Acidosis (Resp & Met)
3: Intermediate Stage - Pulmonary Edema
4: Intermediate Stage - Blood Clotting
5: Late Stage - Respiratory Failure
ARDS: First Stage - Respiratory Alkalosis - Answer-Lungs try to compensate for
hypoxia by breathing faster. (Tachypnea - will cause hyperventilation) This causes CO2
to be removed from body.
ARDS: Intermediate Stage - Acidosis (Resp & Met) - Answer-As hypoxia worsens, lungs
are not able to maintain the fast rate of breathing. Resp Acidosis develops due to CO2
build up. Met Acidosis will develop as the acid from CO2 and breakdown of cells
increases (K+). Without O2 for metabolism, body moves from aerobic to anaerobic
metabolism - producing lactate (acid)
ARDS: Intermediate Stage - Pulmonary Edema - Answer-Combo of hypoxia and
acidosis causes damage to the epithelial wall between the alveoli and the adjacent
capillaries that forms the blood/air barrier. When membrane is damaged, fluid from the
blood is able to seep into the air sacs and drown the pt slowly. Also damaged lining is
inflamed, it starts oozing very thick exudate, which cannot be cleared out of the alveoli
ARDS: Intermediate Stage - Blood Clotting - Answer-Platelets respond to the
inflammation and tissue damage by making micro clots throughout the lung tissue. This
adds to the problem by blocking perfusion, which in turn leads to worsening hypoxia.
ARDS: Late Stage - Respiratory Failure - Answer-The continued acidosis and tissue
death ultimately cause further hypoxia, decreased cardiac output, hypotension, and
death. (About 40% of people who develop ARDS will die from complications)
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