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Volume of air inspired or expired during a normal respiration.
Tidal Volume: 500mls
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Amount of air that can be inspired forcefully after the tidal volume. Above and beyond the tidal volume (500ml)
Inspiratory Reserve Volume: 3000ml
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The amount of air that can be forcefully expired after expiration of normal tidal volume
Expiratory Reserve Volume: 1100ml
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The amount of air still in the lungs after most forceful expiration
Residual Volume: 1200ml
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Functional Residual Capacity
- 2300ml
- Expiratory reserve volume (1100ml) + Inspiratory reserve volume (1200ml)
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Inspiratory capacity
- 3500ml
- Tidal + Inspiratory reserve
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Vital capacity
- 4600ml
- Tidal, inspiratory reserve, expiratory reserve
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Forced Vital Capacity 1 (FVC1)
How much and quickly you can inspire and expire
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Forced Expiratory Volume 1.0
Amount of air that you can expire in 1 second
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Total lung capacity
5800ml
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PO2 level for clinical hypoxia
PO2 of 60 = 88-90 saturation
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Exercise, acidosis, increased temp all shift the oxygen disassociation curve to the _______
RIGHT
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Main form of CO2 in the blood
bicarbonate
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peripheral PO2 at rest
40mm Hg or 75% saturation
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COPD effect on FVC FEV
- Increased time required for FVC
- Decreased FEV
- Decreased FVC ratio
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Impaired surfactant production--> difficulty re-inflating Alveoli
Acute Respiratory disease Syndrome (ARDS)
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What type of hypersensitivity if the cause of asthma symptoms
type 1
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how do B2 stimulators work
Sympathetic stimulation increase synthesis of cAMP which relaxes smooth muscle, stimulate mucociliary escalator, inhibits mast cell degranulation
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Venous PO2 of alveoli and RBC in pulmonary capillary network
- Alveoli PO2 = 104mmHg
- RBC PO2 = 40mmHg
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Venous CO2 pressure in alveoli and RBC
- PCO2 Alveoli = 40mmHg
- PCO2 RBC = 45mmHg
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Pneumotaxic Center
- Located in the pons
- Inhibits inspiratory center activity
- Inhibits Apneustic center
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Keeps inspiratory center in rhythm, located in the pons
Apneustic Center
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Central chemo receptors respond to changes in what
- Mainly CO2
- located in the medulla
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what do peripheral respiratory chemoreceptors respond to
PO2 less than 60mmHg
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inflammatory edema and spasm of the larynx
Croup
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Child sits with mouth open and chin thrust forward (Classic presentation)
Epiglottitis
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What microorganism causes epiglottitis
Hemophilus Influenza Type B
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most common cause of bronchiolotitis
Respiratory syncytial virus (RSV)
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Pulmonary fibrosis secondary to environmental exposure
Pneumoconiosis
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Pneumoconiosis secondary to cotton dust
Byssinosis (Brown-Lung disease)
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-
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pH=7.62
pCO2= 48 mmHg
PHCO3= 45
Metabolic Alkalosis with respiratory compensation
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Pericardial effusion associated with bleeding into space (e.g., TB, purulent organism, neoplasm)
Hemopericardium
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Pericardial effusion caused by inflammation of the pericardium, infectious organism, suppurative exudate
Purulent Pericarditis
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Rapid smothering of the heart by pericardial effusion which may end in heart failure
Cardiac Tamponade
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most common type of pericarditis
Acute fibrinous pericarditis
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What type of pain is associated with pericarditis
Sharp localized pain that is more pronounced when breathing
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What causes the first heart sound, when
Rising pressure in the in ventricles due to initial part of contraction early in systole
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What are the normal stroke volume and ejection fraction
Normal stroke volume is around 70ml which is around 60% ejection fraction
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What does systemic blood pressure measure?
cardiac output X peripheral vascular resistance
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What are the five phases of ventricular action potential
- 0 = Depolarization (+30mv)
- 1 = Repolarization (K leaks out slowly)
- 2 = Plateau (K leaks out, Ca leaks in)
- 3 = Rapid repolarization (K rushes out)
- 4 = Resting Membrane potential (-90 mv)
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Mobitz type II (wenckebach)
AV nodal block with repeating patterns of elgated PR interval with a drop QRS
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Resistance to ejection from left ventricle
After Load occurs in early systole
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what determines preload
end diastolic volume
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What is Frank Starling's Law
- End-diastolic volume stretches the cardiac muscle fibers, which in turn develop tension for contraction. (2.2-2.4micrometers optimal)
- Causes an increased preload and increase cardiac output
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drop in BP causes a excitatory signal to the cardio control center which increases heart rate causing an increase in BP
Baroreceptor Reflex
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most common cause of bacterial endocarditis
Streptococcus viridans
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mitral and tricuspid regurgitation
occurs during systole
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aortic and pulmonary regurgitation
occur during diastole
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regurgitation taht causes widening of pulse pressure.
aortic valve failing does not allow for peripheral bp to be maintained
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obstruction of aortic flow causing a decrease in stroke volume, decrease in systolic BP
Aortic valve stenosis
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primary cause of aortic valve regurgitation
rheumatic fever
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In what type of heart failure is pulmonary capillary wedge pressure elevated
Left sided (pressure backs up into lungs from lack of output from left ventricle
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how does hypertrophic cardiomyopathy affect the heart?
if asymetrical it will cause obstruction during systole
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how do beta blockers work
decrease O2 consumption by decreasing heart rate
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what type of cardiomyopathy is caused by amyloidosis
Restrictive cardiomyopathy
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what type of ECG wave abnormality can be seen with hypertension
Large R wave
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accounts for 58% of the proteins in the blood
Albumins
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normal percentage of neutrophils
65%
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normal percentage of lymphocytes
20-25%
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88% neutrophils due to acute inflammation causes what kind of shift
shift to the right
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normocytic anemias
- Sickle cell anemia
- Spherocytosis
- G-6-PD
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Microcytic anemias
- Thalassemias (abnormal a or b hemoglobins)
- Iron Deficiency
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Macrocytic anemias
- Pernicious anemia (B12/Intrinsic Factor)
- Folic Acid Deficiency
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What type of hemophilia is caused by a defect of factor VIII
Type A
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hemophilia caused by defect in factor IX
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Hemophilia caused by a defect in the factor that stabilizes factor VIII
Von Wildenbrand Disease
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