hypoglycemia pathophys - ANSlow glucose->adrenal medulla knows and releases
adrenaline->liver releases glycogen which is converted into glucose to increase BGL
if block in adrenaline or liver cant convert glycogen into glucose (AKA BETA BLOCKERS)
then CVS s/s wont occur
DKA s/s - ANSonly in insulin dependent diabetics
,BGL 400-900
dehydrated (4-6L lost)
No circulating insulin
+acidosis b/c body breaks down fat into ketones
Kussmaul (inc rate depth to blow off c02)
DKA and HHNK treatment - ANSinsulin gtt
IVF (more for HHNK)
NS 1st- to hydrate vascular compartment
1/2NS to hydrate cell
D51/2NS to prevent hypoglycemia
**for every decrease in pH by 0.1, K+increases by 0.6
HHNK vulnerable population - ANSOLD AGE (pancrease gets tired)
diet controlled diabetics
people on TPN (gets 80% glucose IV->pancreatic fatigue
pancreatitis
HHNK s/s - ANSBGL 1000-2000
Severe dehydration (6-8L lost)
+insulin (prevents breakdown of fat)
No acidosis (baby breaths)
somogyi phenomenon - ANSRapid decrease in serum glucose, usually at night, that generates
the release of glucose-elevating hormones that manifests as an elevated glucose level in the
morning.
dehydration is not a component of this
NPH peak - ANS6-10 hrs
Pancreatitits - ANSobstruction of pancreatic ducts
gallstones
infection
alcoholism
drug toxicity (cyclosporines, steroids, thiazides, tetracyclines)
trauma
s/s of pancreatitis - ANShypocalcemia (pancreas uses Ca+ to break down its fatty organ self)
HHNK
increase amylase levels
l sided pleural effusion
L atelectasis
B rales
ARDS (panc releases phosfolipase A=>lungs =>eats alveoli=> no surfactant production
GI obstructions - ANSsmall bowel: small distention, diarrhea, n/v
large bowel: large distention
how fast is blood filtered through the liver? - ANS1500cc blood/min
Kupper cells - ANSdetoxify blood in liver
Liver - ANScreates bile
synthesis amino acicds
makes albumin, PT, Fibrinogen
converts glucose into glycogen
converts NH3 into urea
How does ascitis happen? - ANSLiver produces albumin, and with decreased
albumin=>decrease in oncotic pressure=>fluid shift to interstitial compartments
hepatic encephalopathy (high ammonia) - ANSdecrease in K+ levels (kidneys hold onto K
and NH3)
increase in BUN (breaks down NH3)
increase proteins (GIB's release NH3)
increase in acids (metabolic acidosis=>low BP, ringers lactate=>lactate=>bicarb by liver
with ESLD, lactate cant be converted to bicarb, so the kidneys convert it to lactic acid instead
Complication of Neomycin Therapy - ANSvitamin deficiency
its not systematically absorbed, stays in the gut in order to destroy bacteria (makes vitamins
and releases NH3)
bilirubin (conjugated or unconjugated) - ANSunconjugated/indirect bili goes to liver to be
'married' and once it leaves the liver, its conjugated/direct bili and then goes to gall bladder
if indirect is high=>liver problem (hepatic failure, liver disease)
if direct is high=>gall bladder problem/biliary tract disease
Kehr's sign - ANSl shoulder pain.
fingers under left rib cage results in neck pain
RUPTURED SPLEEN
Normal GFR - ANS125ml/min or 180L/day
Creatnine clearance reflects GFR-it evaluates the ability of the kidney to filter a waste
product (creatnine) that is neither absorbed nor secreted
What causes excretion of Na+ and H20 and retention of K+? - ANSACE Inhibitors
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Layer. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $10.49. You're not tied to anything after your purchase.
