http://www.youtube.com/watch?v=2Vv1yed_urs&feature=relatedthis a short but good you tube link on medications for cardiac conditions !-
highly rated
Sunday 31 July 2011
drugs gimme drugs !!!1
http://enotes.tripod.com/cardiacRx.htm
http://www.med.yale.edu/library/heartbk/23.pdf take info the bits you need explains what a beta blocker is etc but beware its american so watch the language !
drugs
http://www.med.yale.edu/library/heartbk/23.pdf take info the bits you need explains what a beta blocker is etc but beware its american so watch the language !
drugs
Kidney failure
in acute renal failure the assessment of this is by understanding that there is oliguria urine volume in some cases less tan 400 mls per 24 hrs.
anuria no urine passed
decreased urinary output retains certain biochemical substances in the blood urea and creatinine so these will be raised
Potassium and sodium chloride concentrations will cause sodium and water retention leading to oedema
this might lead to cardiac failure if not treated
if you cannot regulate urea and elctrolytes this leads to nausea, vomiting drowsiness confusion cardiac arrithmias rapid breathing (Kussmauls breathing) twitching ....coma
anuria no urine passed
decreased urinary output retains certain biochemical substances in the blood urea and creatinine so these will be raised
Potassium and sodium chloride concentrations will cause sodium and water retention leading to oedema
this might lead to cardiac failure if not treated
if you cannot regulate urea and elctrolytes this leads to nausea, vomiting drowsiness confusion cardiac arrithmias rapid breathing (Kussmauls breathing) twitching ....coma
The liver - functions
functions of the Liver are
1 to assist with the formation and secretion of bile
2 to store glycogen and reconvert it into glucose when blood sugar is low
it cans also convert amino acids and glycerol to glucose
3. metabolises fat the liver cells desaturate fat this means that it converts stored fat to a form of energy the liver also converts excess carbohydrate and amino acids into fat storage
4. deamination of amino acids The end products of protein digestion are amino acids which are absorbed into the portal circulation through the villi of the small intestine deamination is the removal of nitrogen portion of the amino acid the liver forms ammonia from the unwanted nitrogen portion which in turn combines dioxide to form urea.
5. production of plasma proteins
6. storage of vitamins it stores vit a B12 D E and K
7. storage of iron it is stored as Ferretin in the liver
8. production of heat
9.production of clotting factors
10. detoxification of toxic substances .
Problems for the Patient
1.confusion - coma - encephalopathy this happens due to failure of the liver to metabolise and detoxify nitrogenous substances
Action - assess neuro state the four levels of coma
1. inappropriate responses
2. drowsy sleepy
3.continually drowsy and confused
5. coma
if confusion develops restrict protein in diet as liver cannot break down and excrete the protein
ensure frequent bowel movement helps lessen protein absorption from the gut
Haemmorhage - due to clotting issues you should note any bleeding gums , after injections bruising nose bleeds or development of piles this is early signs that venous system is under pressure.
Veins in the oesophagus may become dilated
vit k and transfusion of platelets might be given
watch for blood in stools or malaena
Itching skin - causes by a build up of salts in the body
Prone to develop an infection due to liver failure
Hyperglycaemic due to the reduction in protein fat and sodium so high carbohydrate and high dextrose solutions may be used - so assess blood sugars glucose in urine careful with BM stix if lack of clotting is considered.
1 to assist with the formation and secretion of bile
2 to store glycogen and reconvert it into glucose when blood sugar is low
it cans also convert amino acids and glycerol to glucose
3. metabolises fat the liver cells desaturate fat this means that it converts stored fat to a form of energy the liver also converts excess carbohydrate and amino acids into fat storage
4. deamination of amino acids The end products of protein digestion are amino acids which are absorbed into the portal circulation through the villi of the small intestine deamination is the removal of nitrogen portion of the amino acid the liver forms ammonia from the unwanted nitrogen portion which in turn combines dioxide to form urea.
5. production of plasma proteins
6. storage of vitamins it stores vit a B12 D E and K
7. storage of iron it is stored as Ferretin in the liver
8. production of heat
9.production of clotting factors
10. detoxification of toxic substances .
Problems for the Patient
1.confusion - coma - encephalopathy this happens due to failure of the liver to metabolise and detoxify nitrogenous substances
Action - assess neuro state the four levels of coma
1. inappropriate responses
2. drowsy sleepy
3.continually drowsy and confused
5. coma
if confusion develops restrict protein in diet as liver cannot break down and excrete the protein
ensure frequent bowel movement helps lessen protein absorption from the gut
Haemmorhage - due to clotting issues you should note any bleeding gums , after injections bruising nose bleeds or development of piles this is early signs that venous system is under pressure.
Veins in the oesophagus may become dilated
vit k and transfusion of platelets might be given
watch for blood in stools or malaena
Itching skin - causes by a build up of salts in the body
Prone to develop an infection due to liver failure
Hyperglycaemic due to the reduction in protein fat and sodium so high carbohydrate and high dextrose solutions may be used - so assess blood sugars glucose in urine careful with BM stix if lack of clotting is considered.
Wednesday 27 July 2011
Monday 18 July 2011
Sunday 17 July 2011
Biochem results liver
Biochemistry and clotting
Biochemistry
Biochemistry values usually are to do with the fluid balance in your body and its ability to use electrolytes (substances that provide cells with energy) such as sodium, potassium, calcium, phosphate, magnesium and glucose.
Kidney function is also represented in this test. In advanced liver failure the kidney function can be badly affected. Urea is the end product of protein usage by the body. Creatinine is the end product of metabolism in the body. Both of these values will rise with worsening kidney function.
ClottingAs the liver is involved in clotting, it is standard procedure to have clotting studies done when any ‘invasive’ procedure is planned such as biopsy, surgical procedures and operations. A clotting profile is made to assess your risk of bleeding. If your risk for bleeding is very high, your procedure/surgery may be postponed until a later date.
Values and substances involved in clotting include:
Prothrombin time (PT): This test measures the time taken for a clot to form in a blood sample. This is compared against values in healthy people and is an important value for indicating the clotting ability of your blood, as influenced by the presence or lack of vitamin K. The prothrombin time will take longer as a result of deficiencies in vitamin K.
INR (international normalised ratio): As the chemicals used to perform the PT test may vary between laboratories, the INR is a calculation the doctors use to allow for any changes when results from different laboratories are compared. This is an important consideration when you have been prescribed blood-thinning products such as warfarin.
APTR (activated partial thromboplastin time ratio): The APTR is the time taken for thromboplastin to convert into thrombin.
Fibrinogen: This is another substance in the blood that helps clotting by producing fibrin strands. Platelets stick to the fibrin strands to form a plug that prevents bleeding. The presence of drugs and poisons in your body can also alter the clotting pathway (normal course of coagulation) of the liver. This may the case if you are receiving medications such as aspirin, clopidogrel or warfarin.
The presence of drugs and poisons in your body can also alter the clotting pathway (normal course of coagulation) of the liver. This may the case if you are receiving medications such as aspirin, clopidogrel or warfarin.
Biochemistry values usually are to do with the fluid balance in your body and its ability to use electrolytes (substances that provide cells with energy) such as sodium, potassium, calcium, phosphate, magnesium and glucose.
Kidney function is also represented in this test. In advanced liver failure the kidney function can be badly affected. Urea is the end product of protein usage by the body. Creatinine is the end product of metabolism in the body. Both of these values will rise with worsening kidney function.
ClottingAs the liver is involved in clotting, it is standard procedure to have clotting studies done when any ‘invasive’ procedure is planned such as biopsy, surgical procedures and operations. A clotting profile is made to assess your risk of bleeding. If your risk for bleeding is very high, your procedure/surgery may be postponed until a later date.
Values and substances involved in clotting include:
Prothrombin time (PT): This test measures the time taken for a clot to form in a blood sample. This is compared against values in healthy people and is an important value for indicating the clotting ability of your blood, as influenced by the presence or lack of vitamin K. The prothrombin time will take longer as a result of deficiencies in vitamin K.
INR (international normalised ratio): As the chemicals used to perform the PT test may vary between laboratories, the INR is a calculation the doctors use to allow for any changes when results from different laboratories are compared. This is an important consideration when you have been prescribed blood-thinning products such as warfarin.
APTR (activated partial thromboplastin time ratio): The APTR is the time taken for thromboplastin to convert into thrombin.
Fibrinogen: This is another substance in the blood that helps clotting by producing fibrin strands. Platelets stick to the fibrin strands to form a plug that prevents bleeding. The presence of drugs and poisons in your body can also alter the clotting pathway (normal course of coagulation) of the liver. This may the case if you are receiving medications such as aspirin, clopidogrel or warfarin.
The presence of drugs and poisons in your body can also alter the clotting pathway (normal course of coagulation) of the liver. This may the case if you are receiving medications such as aspirin, clopidogrel or warfarin.
The Liver
System: Digestive
Location: Under your diaphragm, more to the right side of your body
Physical description:Wedge-shaped, spongy organ
Function: To get rid of toxins, to regulate your blood sugar levels and to produce bile
Location: Under your diaphragm, more to the right side of your body
Physical description:Wedge-shaped, spongy organ
Function: To get rid of toxins, to regulate your blood sugar levels and to produce bile
Largest internal organ
Your liver is your largest internal organ. A big blood vessel, called the portal vein, carries nutrient-rich blood from your small intestine directly to your liver.
Chemical processing factory
Hepatic cells make up about 60 percent of your liver tissue. These specialised liver cells carry out more chemical processes than any other group of cells in your body. They change most of the nutrients you consume into forms your body cells can use. They
- Convert sugars and store and release them as needed, thereby regulating your blood sugar level
- Break down fats and produce cholesterol
- Remove ammonia from your body and produce blood proteins, including blood clotting factors
Other functions of your hepatic cells are to
- Detoxify drugs and alcohol
- Produce bile, which breaks down fats in the food your eat
Security guard
A second important group of liver cells are the Kupffer cells. They
- Remove damaged red blood cells
- Destroy microbes and cell debris
Essential for life
Because your liver fulfils so many vital functions, you would die within 24 hours if it stopped working. A common sign of a damaged liver is jaundice, a yellowness of your eyes and skin. This happens when bilirubin, a yellow breakdown product of your red blood cells, builds up in your blood.
The liver
A brief summary of the liver’s functions follows, but remember there are more than 500 functions:
- processing digested food from the intestine
- controlling levels of fats, amino acids and glucose in the blood
- combating infections in the body
- clearing the blood of particles and infections including bacteria
- neutralising and destroying drugs and toxins
- manufacturing bile
- storing iron, vitamins and other essential chemicals
- breaking down food and turning it into energy
- manufacturing, breaking down and regulating numerous hormones including sex hormones
- making enzymes and proteins which are responsible for most chemical reactions in the body, for example those involved in blood clotting and repair of damaged tissues.
Some of the most important functions include:
Producing quick energy
One of your liver’s most important functions is to break down food and convert it into energy when you need it. Carbohydrates such as bread and potatoes from our diet are broken down to glucose and stored mainly in the liver and muscles as glycogen. When energy is required in an emergency the liver rapidly converts its store of glycogen back into glucose ready for the body to use.
Your liver also helps the body to get rid of waste products. Waste products which are not excreted by your kidneys are removed from the blood by the liver. Some of them pass into the duodenum and then into the bowel via the bile ducts.
People with liver damage may sometimes lose the ability to control glucose concentration in the blood and need a regular supply of sugar.
Fighting infections
Your liver plays a vital role in fighting infections, particularly infections arising in the bowel. It does this by mobilising part of your body’s defence mechanism called the macrophage system. The liver contains over half of the body’s supply of macrophages, known as Kuppfer cells, which literally destroy any bacteria that they come into contact with.
If the liver is damaged in any way its ability to fight infections is impaired.
Producing quick energy
One of your liver’s most important functions is to break down food and convert it into energy when you need it. Carbohydrates such as bread and potatoes from our diet are broken down to glucose and stored mainly in the liver and muscles as glycogen. When energy is required in an emergency the liver rapidly converts its store of glycogen back into glucose ready for the body to use.
Your liver also helps the body to get rid of waste products. Waste products which are not excreted by your kidneys are removed from the blood by the liver. Some of them pass into the duodenum and then into the bowel via the bile ducts.
People with liver damage may sometimes lose the ability to control glucose concentration in the blood and need a regular supply of sugar.
Fighting infections
Your liver plays a vital role in fighting infections, particularly infections arising in the bowel. It does this by mobilising part of your body’s defence mechanism called the macrophage system. The liver contains over half of the body’s supply of macrophages, known as Kuppfer cells, which literally destroy any bacteria that they come into contact with.
If the liver is damaged in any way its ability to fight infections is impaired.
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