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Body fluid compartments
Movement of water between body compartments
Acid-base disturbances: Pathology review
Diabetes insipidus and SIADH: Pathology review
Electrolyte disturbances: Pathology review
Renal failure: Pathology review
Acyanotic congenital heart defects: Pathology review
Adrenal masses: Pathology review
Bacterial and viral skin infections: Pathology review
Bone tumors: Pathology review
Coagulation disorders: Pathology review
Congenital neurological disorders: Pathology review
Cyanotic congenital heart defects: Pathology review
Extrinsic hemolytic normocytic anemia: Pathology review
Eye conditions: Inflammation, infections and trauma: Pathology review
Eye conditions: Refractive errors, lens disorders and glaucoma: Pathology review
Headaches: Pathology review
Intrinsic hemolytic normocytic anemia: Pathology review
Leukemias: Pathology review
Lymphomas: Pathology review
Macrocytic anemia: Pathology review
Microcytic anemia: Pathology review
Mixed platelet and coagulation disorders: Pathology review
Nasal, oral and pharyngeal diseases: Pathology review
Nephritic syndromes: Pathology review
Nephrotic syndromes: Pathology review
Non-hemolytic normocytic anemia: Pathology review
Pediatric brain tumors: Pathology review
Pediatric musculoskeletal disorders: Pathology review
Platelet disorders: Pathology review
Renal and urinary tract masses: Pathology review
Seizures: Pathology review
Viral exanthems of childhood: Pathology review
Adrenal insufficiency: Pathology review
Central nervous system infections: Pathology review
Childhood and early-onset psychological disorders: Pathology review
Congenital gastrointestinal disorders: Pathology review
Diabetes mellitus: Pathology review
Environmental and chemical toxicities: Pathology review
Gastrointestinal bleeding: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Inflammatory bowel disease: Pathology review
Medication overdoses and toxicities: Pathology review
Obstructive lung diseases: Pathology review
Pneumonia: Pathology review
Psychiatric emergencies: Pathology review
Shock: Pathology review
Supraventricular arrhythmias: Pathology review
Traumatic brain injury: Pathology review
Ventricular arrhythmias: Pathology review
Congenital TORCH infections: Pathology review
Jaundice: Pathology review
Respiratory distress syndrome: Pathology review
Autosomal trisomies: Pathology review
Cystic fibrosis: Pathology review
Disorders of sex chromosomes: Pathology review
HIV and AIDS: Pathology review
Miscellaneous genetic disorders: Pathology review
Papulosquamous and inflammatory skin disorders: Pathology review
Anxiety disorders, phobias and stress-related disorders: Pathology Review
Developmental and learning disorders: Pathology review
Eating disorders: Pathology review
Mood disorders: Pathology review
Pharmacodynamics: Agonist, partial agonist and antagonist
Pharmacodynamics: Desensitization and tolerance
Pharmacodynamics: Drug-receptor interactions
Pharmacokinetics: Drug absorption and distribution
Pharmacokinetics: Drug elimination and clearance
Pharmacokinetics: Drug metabolism
Androgens and antiandrogens
Estrogens and antiestrogens
Miscellaneous cell wall synthesis inhibitors
Protein synthesis inhibitors: Tetracyclines
Cell wall synthesis inhibitors: Penicillins
Antihistamines for allergies
Non-steroidal anti-inflammatory drugs
Antimetabolites: Sulfonamides and trimethoprim
Cell wall synthesis inhibitors: Cephalosporins
DNA synthesis inhibitors: Fluoroquinolones
DNA synthesis inhibitors: Metronidazole
Miscellaneous protein synthesis inhibitors
Protein synthesis inhibitors: Aminoglycosides
Bronchodilators: Beta 2-agonists and muscarinic antagonists
Bronchodilators: Leukotriene antagonists and methylxanthines
Pulmonary corticosteroids and mast cell inhibitors
Anticonvulsants and anxiolytics: Barbiturates
Anticonvulsants and anxiolytics: Benzodiazepines
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Acute Respiratory Distress Syndrome (ARDS) Assessment
Acute Respiratory Distress Syndrome (ARDS) Interventions
Neonatal Respiratory Distress Syndrome
Two people are admitted to the emergency department.
Mike, a 55-year-old man, presents with shortness of breath, high fever, and cough.
A chest x-ray was ordered and it showed a right lower lobe infiltrate, which is suggestive of pneumonia.
He was then started on IV antibiotics but the following day Mike became hypoxic and hypotensive.
Because his hypotension didn’t improve despite intubation, IV fluids, and vasopressors, he is diagnosed with septic shock.
Next, a repeat x-ray detected newly-developed bilateral alveolar opacities, heart echography ruled out heart failure, and arterial blood gas analysis revealed a PF ratio of 109 milligrams Mercury.
Then there was Dona, an infant delivered by cesarean section at 36 weeks’ gestational age, with an Apgar score of 9 at birth.
A few hours after delivery, she develops tachypnea, chest wall retractions with nasal flaring, and tachycardia.
Aside from increased work of breathing, her physical examination findings are normal.
A chest x-ray was ordered and it showed diffuse reticulogranular ground glass appearance with air bronchograms.
Now, both people are in respiratory distress.
But first, a bit of physiology.
Normally, when you breathe in, the air reaches the alveoli, which are made up of two types of pneumocytes.
First, type I pneumocytes are thin, and have a large surface area that that facilitate gas exchange.
More important for the exams are the type II pneumocytes, which are smaller, thicker and have the ability to proliferate in response to lung injury.
They are in charge of making a fluid called surfactant which contains various phospholipids.
Respiratory distress syndrome (RDS) is a respiratory condition in which the alveoli collapse due to the deficiency of the surface-active substance called surfactant. Collapsed alveoli make it difficult to breathe and get enough oxygen. Acute respiratory distress syndrome happens when inflammation causes diffuse alveolar injury and pulmonary edema. This edema can wash away the surfactant coating the alveoli to the point where it causes the alveoli to collapse. There is also neonatal respiratory distress syndrome, which mostly affects premature infants, whose lungs are not fully developed and lack enough surfactant.
Symptoms of respiratory distress syndrome include rapid breathing, grunting, and flaring of the nostrils while breathing, as well as cyanosis (bluish color of the skin) and difficulty feeding. All forms of respiratory distress can lead to respiratory failure and death if not treated promptly. Treatment includes providing respiratory support, and administering surfactants, especially in neonatal respiratory syndrome. The use of corticosteroids before delivery may also be considered to improve lung function in some cases.
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