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GOLJAN BLUE NOTES

CHAPTER 1 CELL INJURY Hypoxia: Inadequate oxygenation of tissue O2 content = Hb g/dL x 1.34 x SaO2 + PaO2 x 0.003 Pulse Oximeter : falsely increases SaO2 with metHb and COHb (wavelength cannot identify dyshemoglobins) Ischemia: drop in arterial blood flow OR venous outflow Hypoxemia: drop in PaO2 Increasing Alveolar PCO2 = drop in alveolar PO2 = drop in PaO2 = drop in SaO2 Ventilation defect: perfused but not ventilated, intrapulmonary shunt Perfusion defect: ventilated but not perfused, increase in dead space Diffusion defect: interstitial fibrosis, pulmonary edema Anemia: normal PaO2 and SaO2 MetHB: heme Fe3+, drop in SaO2, Rx with IV methylene blue CO poisoning: normal PaO2, drop in SaO2, Rx with O2 via nonrebreather mask High altitude: Increase in 2,3-BPG synthesis; respiratory alkalosis CO and CN inhibit cytochrome oxidase CO and CN poisoning: house fires Rx CN poisoning: amyl nitrate, thiosulfate Uncouplers: thermogenin, dinitrophenol Mitochondrial toxins: alcohol, salicylates

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