NURS 5315 FINAL EXAM
Anion gap 3-10 normal osmol gap is < 10 mOsm/kg
elevated = etoh
Dehydration triggers renin
Cirrhosis increases oncotic pressure HF decreases it.
Elevated serum osmolality pulls potassium
Thiazide diuretics cause metabolic alkalosis due to aldosterone stimulating reabsorption of Na and bicarb in proximal tubule.
ACIDOSIS = hyperkalemia
Crohn’s active IL-4. IL-4 is associated with inflammation.
Diapedesis is adherence seen with WBC
Innate immunity is 1st line. intact mucosal
Hemolytic anemia of a newborn is an anamnestic immune response due to 2nd from the mother.
Flu and infection are cytokine release
Mycobacterium avium is acid fast bacteria super thick cell wall long haul antibiotics to break through.
Adults with sickle cell are greater risk for pneumococcal due to asplenia.
Sickle cell hypotonic
PTT for hemarthrosis
Child bearing age is iron deficit Hodgkin’s lymphoma Reed Sternberg cells weight loss night sweats older, enlarged mass on right side of neck. Leukemia causes thrombocytopenia
Pulmonary resistance equal to adults at 8 weeks. Afib causes atrial kick loss which results in lack of cardiac output which can lead to syncope.
Aortic stenosis can cause pulmonary edema. During surgery hypertrophy is not acute.
Community acquire pneumonia comes from streptococcus pneumoniae.
Hypovolemic shock due to diarrhea causes pyruvate to produce lactic acid.
Croup = parainfluenza virus
Factor V Leiden Mutation = PE due to hypercoagulable.
COPD = low FEV1
Subdural hematoma takes weeks to develop, seen in elderly who fall.
Fontanels do not close until 18mo.
Cerebral palsy 2nd to injury or abnormal brain development, hemorrhage during birth can cause this.
Cerebellum = lack of coordination.
Subarachnoid can cause irritation to meninges due to contact with pia.
Decrease cerebral blood flow and glucose metabolism can lead to depression because of 5ht.
Addison’s hypo everything lack of aldosterone and cortisol
Increased ADH leads to SIADH
Rhabdomyolysis may be triggered by influenza or medications such as statins. GFR best to check out renal functions
Prolonged hypotension can lead to acute tubular necrosis due to lack of oxygen
Granulocytes are the phils (neutrophils, basophils, eosinophils). Granulocytes granulate. Neutro infection, baso and eosino are parasite or allergy.
Macrophages – monocytes (eat things). Mast Cells have histamine and when touched it is released with chemotaxins (attractant scent).
Prostaglandins = pain and clotting
Leukotrienes are the leukocyte whispers and stimulate hypothalamus.
Complement system – immune response
Kinin system – pain and blood vessels
Leukocytes – IL-1, TNF
NK cells – IL-2
Mast and eosinophils – IL-4 and IL-5
Monocytes and granulocytes – CSF
Cytokines – interleukins – communicate with wbc and are released by macrophage and lymphocytes.
TNF – released by macrophage – fever and pyrogen.
Active Immunity and Cell mediated immunity are T cell Related.
Adaptive immunity and humoral immunity are B cell mediated.
Agglutination – gluing bacteria together to slow them down.
IgG- 2nd line of defense
IgM – 1st up to 10 days
IgA – mucous
IgE- allergic reaction
HLA and MHC are same they present the antigen for memory.
Haplotypes – transplanted cells.
SLE – ANA test
RA – presence of ACPA, RF, and CRP levels.
Staph – gram +, A is upper, B is vaginal and lower
Ecoli – Gram –
Antigenic drift – rapid mutation, Flu and RNA viruses.
Antigenic Shift – gene switching (recombination) species switching. Takes 3 days roughly.
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