Pathophysiology Final Exam Study Guide Modules 1-10

Module 1 Chapter 2 I. General Adaptation Syndrome and Allostasis a. Alarm Stage: Fight-or-Flight response due to stressful stimuli. b. Resistance Stage: Nervous & Endocrine systems returning the body to homeostasis c. Exhaustion Stage: Point where bofy can no longer return to homeostasis Chapter 24 II. Body Fluid Homeostasis: Pertains to water within the body and the particles dissolved in it. i. Fluid Distribution: Occurs through osmosis, water moves to higher osmolality, cell membranes permeable to water, not elec￾trolytes. ii. Extracellular Fluid: OUTSIDE THE CELL 1. 1/3 BODY FLUID IN ADULTS 2. Infants have more extracellular fluid as compared to intracel￾lular iii.Intracellular Fluid: INSIDE THE CELL 1. 2/3 BODY FLUID IN ADULTS III. Fluid Imbalances a. Volume Deficit i. Etiology: Caused by removal of a sodium-containing fluid from the body ii. Clinical Manifestations:Sudden weight loss, postural blood pres￾sure decrease with concurrent increased heart rate, flat neck veins, lightheadedness, dizziness, syncope, oliguria, decreased skin tur￾got, dryness of oral mucus membranes, hard stools, soft sunken eyeballs, lonitudinal furrows in the tongue 1. INFANTS: fontanel may be sunken, neck veins are not reli￾ably assessed in infants b. Volume Excess i. Etiology: Amount of extracellular fluid is abnormally increased, vascular and intersitial areas have too much fluid ii. Clinical Manifestations: 1. Circulatory Overload: Bounding pulse, neck vein distention in upright position, crackles in dependent portions of lungs, dyspnea, orthopnea 2. Sudden Weight Gain: A sensitive measure of extracellular fluid 3. INFANT: Bulging fontanel, assessment of neck veins is not effective in infants 4. Edema 5. ADVANCED: Frothy sputum of pulmonary edema IV. Body Fluid Concentration a. Hyponatremia: Serum Sodium conentration below the lower limit of normal i. Clinical Manifestations: 1. Mild Central Nervous System Dysfunction: Malaise, anorexia, nausea, vommiting, headache 2. Severe Central Nervous System Dysfunction: Confusion, lethargy, seizures, coma, fatal cerebral herniation b. Hypernatremia: Serum sodium concentration above upper limit of normal i. Etiology/Causes: Gain of more salt than water, loss of more water than salt c. Interstitial Fluid Volume i. Edema: V. Electrolyte Imbalances a. Serum Potassium i. Hypokalemia: decreased potassium ion concentration in extracellular fluid 1. Etiology: a. Decreased Intake: Usually in conditions that cause a decreased oral intake b. Shift into the cell from extracellular fluid c. Increased Excretion: Renal, through feces, Sweat, GI Tract (Emesis, diarrhea) Diuretics ii. Hyperkalemia: Rise of serum potassium levels above 5 MEQ/L 1. Clinical Manifestations: a. Early, Mild: Intesional Cramping, Diarrhea b. Late, More severe: Musclue weakness: (Ascending, beginning in lower extremities) Cardiac Dysrhythmias, even cardiac arrest b. Serum Calcium i. Clinical manifestations: 1. HYPOa. Clinical Manifestations: i. Hyperexcitability of Neuromuscular cells: possitive trousseau sign, positive chvostek sign (not reliable in infants), parethesias, muscle twitching and cramping, hyperactive reflexes, carpal spasm, pedal spasm, tetany, laryngospasm, seizures, cardiac dyshythmias 2. HYPER-