results in chloride ion channel problem: defective chloride ion secretion with excessive sodium and water absorption
What are the manifestations of CF?
thick & viscid respiratory tract secretions
micro-environment protects microbial agents
defective mucociliary clearance
neutrophil influx with release of elastase & inflammatory mediators
chronic airway obstruction and bacterial infection; development of chronic bronchitis, bronchiectasis, respiratory failure
T/F: CF is more common in Asians.
Cystic fibrosis is less common in other ethnic groups, affecting about 1 in 17,000 African Americans and 1 in 31,000 Asian Americans
Why are CF pt's skinny?
Thick and sticky mucous blocks ducts in the pancreas and causes malnutrition of the patient
Patho of CF?
What is another name for RDS?
Hyaline membrane disease
What is the result of RDS on the respiratory system?
deficiency in alveolar surface area for gas exchange
results in atelectasis, shunting, persistence of fetal circulation
Describe a hyaline membrane
composed of cellular debris, red blood cells, neutrophils, and macrophages. Appears as amorphous material, lining or filling the alveolar spaces and blocking gas exchange
When does RDS begin?
shortly after birth
S&S for RDS?
tachypnea, chest wall retractions, expiratory grunting, flaring of the nostrils, cyanosis, hypercarbia, prolonged apnic periods, ventilatory failure
How long is the clinical course for RDS?
2 to 3 days.
Day 2-may be stable
Day 3- resolution
What is a clinical sign that RDS is resolving?
What is the most common single cause of death in the first month of life?
Treatment for RDS could include:
maternal glucocorticoid administration
surfactant to infant via ET tube
inhaled nitric oxide
What causes RDS?
developmental insufficiency of surfactant production and structural immaturity in the lung
When do type II pneumocytes mature?
23-28 weeks gestation
type II cells secrete surfactant
Is it possible to have RDS in a term infant?
Yes, it can also result from a genetic problem with the production of surfactant
T/F: RDS is less likely in babies delivered by C-section due to less stress on the baby during birth.
False. The stess is thought to help with glucocorticoids which help lung maturation
What is the key presenting factor in compartment syndrome?
Pain out of proportion to physical findings
What is compartment syndrome?
Increased pressure in muscle compartment that leads to muscle and nerve damage
T/F: Pathologic fractures do not occur with normal activities, but increased stress can cause bones to break more easily.
False. Pathologic fractures can be caused by normal activities.
What is the most common metabolic disease?
T/F: The patho of osteoporosis involves osteoblast activity > osteoclast activity.
OsteoBlasts Build bone.
OsteoClasts Cut bone.
So, in osteoporosis, osteoclast activity is > osteoblast activity
Which med is antiosteoclastic?
Fosamax cuts the cutting!
Which med is pro-osteoblastic?
Forteo builds that bone fort!
Which hip is most often involved in developmental dysplasia of the hip?
Which gender is more likely to have developmental dysplasia of the hip?
Females (80% of cases)
T/F: The first born is at greatest risk of developmental dysplasia of the hip.
T/F: Hip formation is not completed until 24 weeks gestation.
False, it is largely complete by 11 weeks
What are some conditions associated with developmental dysplasia of the hip?
oligohydramnios (low amniotic fluid)
Which type of birth increases the risk for developmental dysplasia of the hip?
Osteoporosis is a skeletal disorder characterized by loss of bone mass and deterioration of the architecture of ________ bone with a subsequent increase in bone fragility and susceptibility to fractures
What types of things cause osteoporosis?
T/F: a low protein diet increases your risk of osteoporosis
False. High protein diet is a risk factor
What are some risk factors for osteoporosis?
Small bone structure
Smoking, alcohol, caffeine
T/F: RA usually has a gradual onset.
Is RDS more of a dead space or shunt problem?
T/F: MODS is easy to treat if diagnosed early.
False. Prevention is more valuable, as it is hard to reverse.
"UNCONTROLLED inflammatory response"
What is the most important cell contributing to inflammation?
Why is it so hard to increase the PO2 in ARDS?
diffusion impairment (hyaline membrane)
Can ARDS develop in babies?
How long does it take for CK to become elevated after an MI?
When does the peak CK level occur?
18-24 hours after the MI, then it gradually returns to baseline
When is troponin detectable in serum after MI?
T/F: Troponin returns to baseline levels 2 days after the MI.
False. It remains elevated at low levels for 5-7 days
When damaged cells release potassium, it contributes to decreased
What type of HF does Paget's disease produce?
High output HF
What type of HF does throtoxicosis produce? (high vs. low)
High output HF
Conditions that cause AV shunt cause which type of HF? (high vs. low)
Ischemic heart diseases results in _______ output HF. (high vs. low)
Cardiomyopathy results in _______ output HF. (high vs. low)
Sepsis causes which type of HF? (high vs. low)
Where do fatty streaks form?
between the endothelium and internal elastic lamina
What do fatty streaks contain?
atherogenic lipoproteins and macrophage foam cells
What is the fibrous cap made of?
layers of smooth muscle and connective tissue matrix
Where is the autonomic control center for the cardiac function and blood pressure located?
bilaterally in the medulla oblongata
What does the vasomotor center control?
sympathetic-mediated acceleration of heart rate and blood vessel tone