Hypercapnia and its relationship with acid-base balance
Hypercapnia is an increased PaCO₂ (>45 mmHg) that causes respiratory acidosis by increasing carbonic acid and lowering blood pH.
Respiratory alkalosis and its related arterial gas changes in PaCO₂ and HCO₃⁻
↑ pH, ↓ PaCO₂, and ↓ HCO₃⁻ if compensation occurs.
Differentiate compensated metabolic acidosis, decompensated metabolic acidosis, compensated respiratory acidosis, and decompensated respiratory acidosis
Compensated metabolic acidosis: ↓ HCO₃⁻, ↓ PaCO₂, pH near normal
Decompensated metabolic acidosis: ↓ HCO₃⁻, normal PaCO₂, ↓ pH
Compensated respiratory acidosis: ↑ PaCO₂, ↑ HCO₃⁻, pH near normal
Decompensated respiratory acidosis: ↑ PaCO₂, normal HCO₃⁻, ↓ pH.
Clinical significance of producing yellowish-green, cloudy, thick sputum
Suggests a bacterial respiratory infection such as pneumonia or bronchitis.
What is orthopnea?
Difficulty breathing while lying flat that is relieved by sitting upright.
Laryngotracheobronchitis (etiology and affected patient population)
Usually caused by parainfluenza virus; most commonly affects children 6 months to 3 years old.
How does severe hypoxia develop with pneumonia?
Alveoli fill with fluid and inflammatory exudate, preventing adequate oxygen exchange.
The basic pathophysiology of cystic fibrosis
A mutation in the CFTR gene causes defective chloride transport, producing thick, sticky mucus.
Persistent thick mucus in the bronchioles of a child with cystic fibrosis may cause what?
Airway obstruction, recurrent infections, bronchiectasis, atelectasis, and respiratory failure.
During an acute asthma attack, how does respiratory obstruction occur?
Bronchospasm, airway inflammation, mucosal edema, and increased mucus production narrow the airways.
Hormonal imbalances in Addison's disease
Decreased cortisol and aldosterone.
Why does glycosuria occur in patients with diabetes?
Blood glucose exceeds the kidney's renal threshold, causing glucose to spill into the urine.
Which medical condition may cause immunosuppression?
HIV/AIDS, leukemia, chemotherapy, long-term corticosteroid therapy, and severe malnutrition.
Which acid-base imbalance is associated with the early stage of vomiting?
Metabolic alkalosis.
Common signs of acute gastritis
Epigastric pain, nausea, vomiting, loss of appetite, bloating, and possible hematemesis.
Sequelae from chronic bleeding of gastric carcinoma
Iron-deficiency anemia.
The most common type of hepatitis transmitted by blood transfusion
Hepatitis C.
Why can malnutrition develop in children with celiac disease?
Damage to the intestinal villi causes nutrient malabsorption.
Stool characteristics of ulcerative colitis and Crohn's disease
Ulcerative colitis: bloody, mucus-filled diarrhea
Crohn's disease: chronic diarrhea, usually non-bloody.
Anemia associated with ulcerative colitis
Iron-deficiency anemia from chronic blood loss.
Blood pH and bicarbonate changes with prolonged diarrhea (dehydration and acidosis present)
↓ pH and ↓ HCO₃⁻ (metabolic acidosis).
The components in a urine sample
Water, urea, creatinine, uric acid, electrolytes, and metabolic waste products.
Long-term effects of chronic infection or inflammation of the kidneys
Renal scarring, chronic kidney disease, hypertension, and renal failure.
Presentation of a patient with obstruction of the ureter by a renal calculus
Severe flank pain radiating to the groin, hematuria, nausea, vomiting, and restlessness.
Nephrosclerosis can lead to what further damages or morbidities?
Chronic kidney disease, renal failure, and hypertension.
Why do patients with chronic renal failure always have a weak skeletal system?
Reduced vitamin D activation causes hypocalcemia and renal osteodystrophy.
Why does severe pain occur with endometriosis?
Ectopic endometrial tissue bleeds during menstruation, causing inflammation, adhesions, and nerve irritation.
Common complication of leiomyoma
Heavy menstrual bleeding (menorrhagia) leading to anemia.
Bleeding between menstrual periods
Metrorrhagia.
Which factor provides the basis for grading newly diagnosed malignant tumors?
The degree of differentiation of the tumor cells.
Paraneoplastic syndrome
Signs and symptoms caused by tumor-produced hormones or immune responses rather than direct tumor growth.
Reasons for staging a malignant tumor at the time of diagnosis
To determine the extent of disease, prognosis, and appropriate treatment.
Why does ovarian cancer usually have a poor prognosis?
It is usually diagnosed at an advanced stage because early symptoms are vague or absent.
Which drugs are cell-cycle specific antimitotics that act on cells in the M stage (mitosis)?
Vinca alkaloids (vincristine, vinblastine) and taxanes (paclitaxel).
Aging-related body changes
Loss of muscle mass, decreased bone density, reduced organ function, thinner skin, and slower healing.
How can the risk of osteoporosis related to aging be reduced?
Weight-bearing exercise, adequate calcium and vitamin D, avoiding smoking, limiting alcohol, and fall prevention.
The reasons for improved function of the heart and brain during a stress response
Epinephrine and norepinephrine increase heart rate, blood pressure, and blood flow to the heart and brain.
Three stages in the stress response
Alarm, Resistance, and Exhaustion.
Lead poisoning
Causes anemia, abdominal pain, neurologic impairment, kidney damage, and developmental delays in children.
Bites and stings can cause disease in three ways
Venom effects, allergic reactions (anaphylaxis), and transmission of infectious organisms.
Peritoneal dialysis and hemodialysis
Peritoneal dialysis uses the peritoneal membrane as the filter
Hemodialysis uses an external dialysis machine to filter the blood.
Pancreatitis and its cause
Inflammation of the pancreas, most commonly caused by gallstones and alcohol abuse.
Goiter and its possible causes
Enlargement of the thyroid caused by iodine deficiency, Graves disease, Hashimoto thyroiditis, or thyroid nodules.
Wilms tumor
A malignant kidney tumor that primarily affects children under 5 years old.
Poststreptococcal glomerulonephritis
Immune-mediated inflammation of the glomeruli occurring after a Group A Streptococcus infection, causing hematuria, edema, hypertension, and decreased urine output.