Test 5 Clinical Applications Flashcards
stem cells taken from umbilical cord, frozen, can be used later to reconstitute the hematopoietic system in case of leukemia, chemo, or other disorder
Core blood banking:
Genetic screening of neonate:
- Blood taken at what age from where:
- Tests performed on blood test for:
- Blood taken at what age from where: heel at 24 hours of age - Tests performed on blood test for: Phenylketonuria (PKU), cystic fibrosis, lysosomal storage diseases, hypothyroidism, and sickle cell anemia. 20 - >30 tests performed
How can a immediate hypersensitivity reaction be treated?
With antihistamines (counteract mast cell release) glucocorticoids or adrenaline (if it is very severe)
Tracheotomy:
- Define:
- Reason to make one:
- Define:
surgical procedure, cut a whole in the trachea - Reason:
Allows intubation and breathing with a mechanical respirator
Sometimes they are performed just to let the person breath out of them
A hole in the trachea (usually made by a tracheotomy
Tracheostomy:
A collapse of the lung, due to air entering the pleural space is called:
Spontaneous Pneumothorax
Spontaneous Pneumothorax:
- causes:
- causes: anything which causes loss of transpulmonary pressure Puncture Cystic fibrosis lung blister rupture. Open wound
Tension pneumothorax:
A build up of air within the pleural space. Can be caused by an open chest wound.
A pneumothorax is usually restricted to one side or the other because:
Each lung is in its own pleura
Inadequate levels of surfactant babies born early is a disease known as:
Respiratory Distress Syndrome
Acute respiratory distress syndrome:
septic shock -> Inflammation -> increased capillary/alveolar permeability -> protein rich fluid within lung -> decreased compliance and surfactant production -> alveolar collapse
Cigarette smoking and FEV:
It causes FEV to decrease in individual with obstructive lung disorders faster then it should.
It also causes increased FEV reduction with age.
Asthma medication categories:
Quick acting beta 2 agonists (albuterol)
Long acting beta 2 agonists (effect lasts more than 12 hours)
Glucorticoid
Leukotrin receptor antagonists
a Leukotrin receptor antagonists used for treating asthma:
Montelukast (pill form!)
- Long term treatment
- Anemia:
- Polycythemia
- Effect on oxygen carrying capacity?
- Anemia: Low RBC - Polycythemia High RBC - Effect on oxygen carrying capacity? Think about it
Red blood cell production is promoted by:
Erythropoietin
Androgens
Hyberbaric Oxygen Therapy (HBot):
- Define:
- Treats:
- Define: 100% oxygen at 2-3 atmospheres of O2 - Treats: Decompression sickness (pressure decreases nitrogen bubble size) Carbon monoxide poisoning Gas gangrene (kill anaerobic bacteria)
Hyperbaric oxygen therapy capitalizes on which gas law?
P(1)V(1) = P(2)V(2)
Raising the pressure decreases the volume of air emboli
Ondine’s curse:
- Is also called:
- Is caused by:
- Is also called:
Congenital Central Hypoventilation Syndrome - Is caused by:
A defective gene which influences the retrotrapezoid nucleus in the medulla oblongata (which senses CO2)
Congenital Central Hypoventilation Syndrome:
- Symptoms:
- Symptoms:
Sleep apnea, sometimes fatal, but normal regulation of breathing when awake (because it is monitored in a different zone).
Hypocapnia:
- Define:
- Brain associated issues:
- Define:
Low plasma CO2, usually from hyperventilation - Brain associated issues:
CO2 is a vasodilator, without it, the brain which is primarily under metabolic control vasoconstricts, and gets inadequate blood
Hypocapnia:
- Effect on pH:
- Effect of Ca2+:
- Corresponding symptoms:
- Effect on pH: Raises it - Effect of Ca2+: Lowers it (ca2+ binds to albumin) - Corresponding symptoms: Neuromuscular irritability and muscle spasms
Hypocapnia:
- Treatment:
- Risks:
- Treatment:
hyperventilate into a bag, increases plasma CO2 - Risks:
patient may be having an asthma attack or some other issue with low oxygenation
Sudden Infant Death Syndrome (SIDS):
- Define:
- Prevention:
- Define: Unexplained death between 2 - 4 months of age - Prevention: Infants sleep on firm surfaces Infants sleep on back and not stomach
Sudden Infant Death Syndrome (SIDS):
- Speculated Cause:
- Speculated Cause:
Failure of central or peripheral chemoreceptors to detect CO2 rise.
apnea:
Temporary cessation of breathing
Obstructive sleep apnea:
- Define:
- Risk factors:
- Define: >= 15 periods of apnea during sleep - Risk factors: Obesity (major) being male
Obstructive sleep apnea:
- Cause:
- Physiological effect:
- Cause:
Collapse in oropharynx (normally held open by 20 muscles) - Physiological effect:
Low O2, high CO2.
Snoring, fatigue during day
morning headache from cerebral vasodilation
Obstructive sleep apnea:
- What is the major danger of obstructive sleep apnea?
- Treatment:
- What is the major danger of obstructive sleep apnea?
Pulmonary hypertension, right ventricular hypertrophy - Treatment:
Continuous positive airway pressure (CPAP) devices to keep oropharynx open
Carbon Monoxide Poisoning:
- Define:
- Symptoms:
- Define:
Blood carboxyhemoglobin levels over 3% in non smokers or 10% in smokers - Symptoms:
Headache, dizziness, nausea and confusion, memory loss, or cardiac injury - Treatment:
Hyperbaric Oxygen therapy
Hypocalcemic tetany:
- Define:
- Causes:
- Treatment:
- Define: Tetany due to low Ca2+ - Causes: alkaline plasma (hyperventilation) -> Ca2+ binds albumin Over production of Decreased parathyroid hormone - Treatment: breath into paper bag
Build up of bilirubin in a new born and yellowing of skin:
Physiological jaundice of the newborn:
Physiological jaundice of the newborn:
- Duration:
- Cause:
- Duration:
2 weeks - Cause:
New borns use hemoglobin F instead of A, which breaks down more quickly, producing more bilirubin
Fetal bilirubin is fat soluble and must be converted into cojugated bilirubin, the liver takes time to build up enzymes
A water soluble form of bilirubin
Conjugated bilirubin:
How is Physiological jaundice of the newborn treated?
Phototherapy. Makes bilirubin water soluble, so it can be excreted in the urine.
Acute mountain sickness:
- Define:
- Treatment:
- Define:
Neurological irritation due to swelling of pia mater. This is due to low arterial Po2 induced vasodilation, and is counteracted by hyperventilation reducing blood CO2 (which is a vasodilator) - Treatment:
NSAIDs or descending to a lower altitude
Acute mountain sickness:
- Complication at 3000 m:
- Complication at 4000 m:
- Complication at 3000 m:
High altitude pulmonary edema (producing shortness of breath) - Complication at 4000 m:
High altitude cerebral edema (confusion, mild fever, coma or death)
What type of medication stimulates short term vasodilation of lungs?
What combination can cause long term reduction in inflammation?
- Beta two andronergic agonist
- long acting Beta two andronergic agonist and a glucorticoid
Forced expiratory volume:
- is changed in what way by asthma?
- is changed in what way by asthma?
It is reduced
How was Peter’s pneumothorax treated?
Air was sucked from the pleural space, intrapleural pressure fell bellow intrapulmonary pressure, and the lungs expanded
Kidney Stones:
- Also called:
- What do they form from?
- Prevention:
- Also called: Nephrolithiasis (lith = stone) - What do they form from? Calcium phosphate or oxylate usually - Prevention: Stay hydrated (high amounts of water -> low conc. of solutes in urine -> stay in solution)
Struvite stones:
Form from ammonium phosphate in some UTI.
Uric acid stones:
Occur in people with gout
Cysteine stones:
Occur with cysteine urea
Kidney Stones:
- Treatment:
- Treatment:
Medication
Lithotripsy (blast the stone with sound waves)
Stress Urinary incontinence:
- Define:
- Cause:
- Treatment:
- Define:
Urine leakage from abdominal pressure (sneezing, coughing, laughing) - Cause:
Women’s pelvic floor no longer supports the urethra due to child birth or aging - Treatment:
Inserted mesh, additional support for the urethra
What is the most common cause of incontinence in men?
Treatments of prostate conditions
Urgency incontinence:
- Define:
- Due to:
- Is a hallmark of what?
- Define:
Detrusor muscle contracts (this is the smooth muscle of the bladder), uncontrollable urge to pee followed by peeing - Due to:
Uncontrolled contractions of detrusor muscle - Is a hallmark of what?
Overactive bladder
How is urinary incontinence diagnosed?
Urodynamic testing including:
Cystometric tests: warm waters fills bladder, pressure and and compliance (dispensability) are measured as the subject is asked when they feel the urge to pee.
Why does low Ca2+ depolarize nerve cells (as seen in hypocalcemic tetany?)
Ca2+ helps to keep Na channels closed. Once they can flow into the cell, they do. This depolarizes the cell.
