Term
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Definition
| tubular covering of glomerulus in the nephron |
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Term
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Definition
| capillary supply to the nephron, filters blood |
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Definition
| low spec. gravity (dilute) urine |
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Definition
| cellular precipitate formed in tubules (tubular shaped) |
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Definition
| excess urine production/output |
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Definition
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Definition
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Term
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Definition
| excess urination at night |
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Definition
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Definition
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Definition
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Definition
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Definition
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Definition
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Definition
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Definition
| measurement of volume and flow |
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Term
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Definition
Forced Vital Capacity
max amt. air which can be inspired |
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Term
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Definition
Forced Expiratory Volume in 1 minute
volume of air which patient can exhale in 1 min |
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Term
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Definition
| Sinus tidal breathing w/10-12 sighs (1.5-2x normal tidal volume) per hour |
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Definition
| increased rate, high volume, no expiratory pause; common in DKA |
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Term
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Definition
| alternating deep and shallow breaths and regular moments of apnea; common in children and the elderly while sleeping |
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Term
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Definition
| decreased alveolar ventilation irt metabolic demands |
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Term
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Definition
| increased ventilation greater than metabolic demands; common in head injury |
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Term
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Definition
Subjective: uncomfortable breathing
Objective: SOB, increased work of breathing
Signs & Symptoms (S&S): flared nostrils (ok in children), accessory muscle use, and retraction |
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Term
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Definition
| SOB when lying flat, resolves upon sitting up, measured by pillows |
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Term
| Paroxysmal Nocturnal Dyspnea (PND) |
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Definition
| Sudden attack of dyspnea during sleep |
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Term
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Definition
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Term
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Definition
Central: slight blotchy blueness of skin, most notable in the mucosa; CAUSED BY HYPOXEMIA
Peripheral: blueness of extremities CAUSED BY vasoconstriction/poor circulation |
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Term
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Definition
| PaCO2 > 45 mmHg; often accompanied by hypoxemia |
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Term
| acute respiratory failure |
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Definition
Inadequate gas exchange
PaO2 < 50 mmHg < PaCO2
pH < 7.25 (respiratory acidosis)
Signs and symptoms are those related to hypoxemia and SOB |
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Term
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Definition
"Viral Rhinitis" caused by any of ~100 different rhinoviruses; presents with rhinorrhea, fever, myalgia, cough, headache, etc.
Major problem: weakens immune system allowing for more serious comorbidities |
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Term
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Definition
inflammation of the sinuses due to mucosal blockage, allergens, etc. most commonly an allergic reaction
presents with sinus pain, sneezing and rhinorrhea, headache, and sometimes fever |
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Term
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Definition
| sore throat, caused mostly by viruses; "strep throat" caused by streptococcus bacteria |
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Term
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Definition
Caused by the influenza virus: three major types, presents like common cold--except cough is usually non productive, also allows for comorbidities like the cold.
Best treatment is prevention: vaccine |
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Term
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Definition
A, B, and C
A: named by which H and N proteins are on surface, six different Ha's and nine different Na's (H1N1, H2N3)
B&C: H's and N's vary less |
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Term
| Lower Respiratory Tract Infection |
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Definition
acute infection/inflammation of the parenchymal lung tissue
pneumonia: both contagious and non-contagious types; affects bronchioles and alveoli |
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Term
Which groups are at increased risk for infection?
a) the elderly; b) African-americans; c) Caucasians; d) HIV; e)Asians; f)children; g) organ transplant recipients |
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Definition
| a, d, f, and g; anyone with a compromised immune system |
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Term
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Definition
Typical vs. atypical: bacterial vs. viral/fungal
Lobar vs. Broncho pneumonia (one vs. more than one lobe)
Community vs. Hospital (nosocomial) acquired
-Community: Found in community, considered community acquired if diagnosed w/in 48 hrs of admission
-Nosocomial: not present on admission |
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Term
| Pneumonia- Pathophysiology |
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Definition
-Pathogen reaches the alveoli (primary unit of gas exchange)
-Initial inflammatory response: WBC’s to the rescue--> release inflammatory mediators--> immune response: swelling, blockage, poor ventilation |
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Term
| Risk factors for Pneumonia |
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Definition
| increased virulence, decreased immune response, and a large inoculum |
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Term
| Pneumonia – Signs and Symptoms |
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Definition
Fever, chills
Productive cough (bacterial)
Non-productive cough (viral)
Fatigue
Dyspnea
Rales (crackles): fluid in lungs
Pleuritic pain: visceral pleura can be inflamed, can cause pleural friction |
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Term
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Definition
X-ray for infiltrates
Gram stain sputum
WBC count >4.8-10.8e3/mcL
Arterial Blood Gas: early resp. alkalosis; late: hypoxemia and acidosis |
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Term
| Pneumonia - Major Treatment interventions |
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Definition
Antimicrobials/virals depending on cause
Oxygen/respiration support
Hydration |
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Term
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Definition
Organism: Mycobacterium tuberculosis
Transmitted by inhalation of airborne droplets
At risk populations
Congregate settings (dorms)
S&S: fatigue, weight loss, fever, night sweats, SOB, purulent sputum, hymoptysis: bloody sputum |
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Term
| Infection pattern of Tuberculosis (4 terms) |
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Definition
-Primary: previously unexposed, unsensitized people
-Latent: immune system cell mediated, organism surrounded by granulomas (not active, localized, not transmitted)
-Milliary: bacteria moves into blood stream, disseminated, evolves in any organ/tissue (kidney, liver, brain, bone marrow); not just a pulmonary problem
Secondary: reinfection, reactivation of healed lesion |
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Term
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Definition
Tb skin test (screening)
x-ray for occlusion
sputum culture
genotyping |
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Term
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Definition
| Treat with two or more antibiotics: to combat drug resistance |
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Term
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Definition
| lack of reaction of the body's immune system to foreign bodies; occurs in the immunosuppressed (Tb skin test false negative) |
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Term
Mechanisms & Manifestations of CKD:
Sodium/Water Balance
Potassium Balance
Elimination of Urea
EPO Production
Acid-Base Balance
Vitamin D
Phosphate Elimination |
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Definition
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Term
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Definition
H. influenzae vs. parainfluenza virus
2-7 year olds vs. 3 mo. - 5 year olds
sudden vs. gradual following cold
low-pitched stridor & difficulty swallowing vs. stridor and wet/barking cough
intubation and antibiotics vs. vaporizers and oxygen |
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Term
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Definition
| • Characteristics – airway obstruction, bronchial hyperresponsiveness, airway inflammation |
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Term
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Definition
• Inflammation and fibrosis of bronchial wall
• Hypertrophied mucus glands excess mucus
– Obstructed airflow
• Loss of alveolar tissue
– Decreased surface area for gas exchange
• Loss of elastic lung fibers
– Airway collapse, obstructed exhalation, air trapping |
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Term
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Definition
[image]loss of elastic fibers in lungs
smoking decreases α1-antitrypsin activity (would keep elastase in check)
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Term
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Definition
• Airway obstruction of major and small airways
• Hypertrophy of submucousal glands - hypersecretion of mucus in large airways |
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Term
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Definition
• Emphysema
– Increase respiration to maintain oxygen levels
– Dyspnea; increased ventilatory effort
– Use accessory muscles; pursed-lip breathing
• Bronchitis
– Cannot increase respiration enough to maintain oxygen levels
– Cyanosis and polycythemia:
– Cor pulmonale: right sided heart failure, due to increased lung pressure (right side of heart pushes against said pressure) |
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Term
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Definition
| • Undissolved, detached material that occludes blood vessels of the pulmonary vasculature |
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Term
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Definition
Mostly Squamous cell and adenocarcinoma arising from the lung
squamous linked to smoking
adenocarcinoma not linked as well to smoking, more common in women |
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Term
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Definition
| http://www.thoracic.org/clinical/critical-care/clinical-education/abgs.php |
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Term
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Definition
blood is filtered through glomerulus into bowman's capsule, tubules, loop of henle; filtrate is excreted through lower urinary tract
necessary ions and water are reabsorbed in tubules, leaving nitrogenous wastes and excess water/ions to be excreted |
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Term
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Definition
| functional unit of the kidney: glomerulus (JG cells)--> bowman's capsule--> proximal tubule (macula densa)--> loop of henle--> distal tubule--> collecting duct |
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Term
| factors effecting glomerular filtration |
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Definition
| glomerular hydrostatic pressure (direct), glomerular osmotic pressure (inverse), bowman's hydrostatic pressure (inverse), and bowman's osmotic pressure (direct) |
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Term
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Definition
Sudden cessation of the function of the kidneys
Prerenal failure: severe drop in blood flow to the kidney
Intrinsic renal failure: failure of the nephron, commonly inflammation of the glomerulus (nephritis) or necrosis of the tubules (pressure change causes a nephrosis--not necessarily related to cell death)
postrenal failure: obstruction of lower urinary tract |
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Term
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Definition
• Progressive loss of renal function over months to years due to permanent loss of nephrons
ultimately irreversible, but can be slowed |
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Term
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Definition
| Based on GFR: kidney failure at <15mL/min |
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Term
| Congenital Renal Anomalies |
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Definition
Shape and Position: most common, often benign
Agenesis: non-development of organ
unilateral-okay; bilateral-dead
hypoplasia: underdevelopment
poly/cystic diseases: masses forming in different areas, often leading to chronic renal failure |
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Term
| If fetal kidney function is less than normal, what would you anticipate the volume of amniotic fluid would be (more, less) than normal? |
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Definition
| Less: fetal urine is the main constituent of amniotic fluid |
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Term
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Definition
| urinary tract infection (bacterial); usually bacteria which travel up from the external orifice of the urethra; most common nosocomial cause: Foley catheterization; a secondary comorbidity to most untreated acute renal failures due to lack of washout phenomenon |
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Term
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Definition
| the inflammation of the renal pelvis, often due to infection and implantation from the blood stream (secondary to sepsis) |
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Term
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Definition
"Kidney Stones" need nidus (often formed from mucopolysaccharides found in the extracellular matrix), and conducive environment (supersaturation of cysteine, urea, or calcium)
Citrate and Magnesium inhibit formation (requires deficiency in these) |
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Term
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Definition
| excess water volume in nephrons, build bowman's hydrostatic pressure, inhibiting filtration (lowering GFR) |
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Term
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Definition
dysfunction of the glomerulus can be:
Nephritic: due to infection, glomerulus is inflamed
This reduces GFR, damages Glomerulus (hematuria), and causes azotemia
Nephrotic: increased permeability of the glomerulus, causes all the "-urias" |
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Term
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Definition
IgE antibody-mediated allergic reaction: CD4--> B cell--> plasma cell--> IgE--> degranulation of granulocytes--> allergic reaction
I: Allergy, starts with A the 1st letter of the alphabet |
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Term
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Definition
IgG/M antibody-mediated cytotoxic reaction: phagocytosis, inflammation and damage, increased thyroid activity, and/or cellular dysfunction due to signal blockage
found in transfusion reactions
II: Cytotoxic has 2 C's (and 2 T's and 2 O's) |
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Term
| Type III Hypersensitivity |
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Definition
IgG/M mediated Complex formation (between antibodies and antigens)
Complex implants in vascular wall, activates complements, begins inflammation
SLE (lupus) is an example
III: Complex requires 3 things: antibody, antigen, and complement |
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Term
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Definition
T-cell-mediated inflammation: antigen--> presented on Antigen presenting cell--> activates CD4s--> release cytokines
DELAYED RESPONSE
IV: CD4 <--type of T cell (IV = 4) |
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Term
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Definition
| RNA-based retrovirus transmitted through contact with bodily fluids such as sexual secretions, blood, and breast milk |
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Term
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Definition
| CD4 T cells, dendritic cells, and macrophages |
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Term
| Name 4 risk factors for HIV |
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Definition
• Use of contaminated needles, sharing
• Blood transfusions prior to 1985
• Unprotected sex
• Work areas where there is potential to for blood, body fluid contamination
• Alcohol, drug abuse -> alters perception of risk
• Ulcerative, inflammatory STD’s |
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Term
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Definition
ELISA to screen (checks for enzyme)
Western blot to validate (checks for size of proteins, everything has a different combination of differently sized proteins; very accurate)
CD4 counts:
• Healthy: 800-1200/mm2
• >500: Stage 1
• <500: Stage 2
• <200: Stage 3 |
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Term
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Definition
Opportunistic infections: pneumonias, Tb, etc.
Cancers:
Lymphomas, cervical cancer |
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Term
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Definition
Lack of "self-tolerance": recognizes foreign as domestic
SLE, scleraderma, rheumatoid arthritis, myasthenia gravis, etc. |
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Term
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Definition
Rejection (Host vs. Graft): recipient immune system reacts against foreign implant
Graft vs. Host: antibodies found in donation (marrow, whole blood, etc.) react against recipient's tissues |
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Term
| His chart reports that Kyle weighs 80 kg but he reports having gained 7.00 pounds since his last visit, and your scale is broken; what is his current weight in kg? |
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Definition
| 80.0 kg + (7.00 lbs x 1 kg/2.2 lbs) = 80.0 kg + 3.18 kg = 83.2 kg |
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Term
| Posie measures 65kg, but doesn't understand the metric system and would like to know what she weighs in pounds. |
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Definition
| 65.0 kg x 2.2 kg/1 lb = 143 lbs |
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Term
| Oliver is an elderly chef, and he's forgotten YET AGAIN to measure his output at home, but his mind is still sharp and reports voiding ~48.6 oz. since his visit the day before; how much is this in mL? |
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Definition
| 48.6 oz. x 29.6 mL/1.00 oz. = 1,440 mL |
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Term
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Definition
low bp--> baroreceptors--> JG cells--> renin--> angiotensinogen--> angiotensin I--> ACE--> angiotensin II--> vasoconstriction
Angiotensin II--> adrenal cortex--> aldosterone--> sodium reabsorption in the kidneys--> water reabsorption--> increased bp
concentrated blood (increased osmolality)--> osmoreceptors--> posterior pituitary--> ADH--> kidneys--> water reabsorption--> decreased osmolality |
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