Diuretics and Renal Function Quiz
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Questions and Answers

What is the primary mechanism by which spironolactone functions as a potassium-sparing diuretic?

  • It enhances the secretion of atrial natriuretic peptide.
  • It blocks receptors for aldosterone, reducing sodium reabsorption. (correct)
  • It increases bicarbonate reabsorption in the proximal tubule.
  • It freely filters at the glomerulus but is not reabsorbed.
  • Which diuretic is primarily used to treat metabolic alkalemia by inhibiting carbonic anhydrase?

  • Diamox (correct)
  • Mannitol
  • Hydrochlorothiazide
  • Spironolactone
  • What effect does positive pressure ventilation (PPV) have on the renal system?

  • It decreases glomerular filtration rate. (correct)
  • It increases urinary output.
  • It reduces renal blood flow. (correct)
  • It enhances the secretion of atrial natriuretic peptide.
  • What is the primary function of thiazide diuretics such as hydrochlorothiazide?

    <p>Inhibit reabsorption of sodium in the distal tubule. (A)</p> Signup and view all the answers

    In which part of the nephron do osmotic diuretics like mannitol primarily act?

    <p>Proximal tubule and descending loop of Henle. (C)</p> Signup and view all the answers

    Which of the following symptoms is commonly associated with chronic renal failure?

    <p>Frequent vomiting (A)</p> Signup and view all the answers

    What happens to the release of ADH during PPV due to the change in intrathoracic pressure?

    <p>ADH release is enhanced. (C)</p> Signup and view all the answers

    Which system is activated leading to sodium and water retention during PPV?

    <p>Renin-angiotensin-aldosterone (RAA) system (C)</p> Signup and view all the answers

    What is the primary cause of epiglottitis in children?

    <p>Haemophilus influenzae type B (B)</p> Signup and view all the answers

    Which clinical sign is associated with croup?

    <p>Barking cough (B)</p> Signup and view all the answers

    What is the most common pathogen responsible for croup?

    <p>Parainfluenza type I (C)</p> Signup and view all the answers

    Which imaging finding is associated with epiglottitis?

    <p>Thumb sign (B)</p> Signup and view all the answers

    What is indicated for the treatment of croup?

    <p>Dexamethasone and Racemic epinephrine (C)</p> Signup and view all the answers

    In which condition is deoxygenated blood shunted from the right side of the heart?

    <p>Cyanotic disease (D)</p> Signup and view all the answers

    What is a common outcome of congenital heart disease?

    <p>Severe hypoxemia (C)</p> Signup and view all the answers

    Which sign is NOT typically associated with croup?

    <p>Cherry red epiglottis (B)</p> Signup and view all the answers

    What mechanism is responsible for increasing stroke volume through increased preload?

    <p>Frank-Starling mechanism (A)</p> Signup and view all the answers

    Which of the following effects does the sympathetic nervous system have during heart failure?

    <p>Stimulates systemic vasoconstriction (B)</p> Signup and view all the answers

    What is a potential disadvantage of increased systemic vascular resistance (SVR) due to compensatory mechanisms?

    <p>Increased myocardial demand (B)</p> Signup and view all the answers

    How does the renin-angiotensin mechanism affect blood volume during heart failure?

    <p>Increases blood volume through aldosterone secretion (D)</p> Signup and view all the answers

    What is the long-term consequence of myocardial hypertrophy in response to increased work demand?

    <p>Increase in contractile fibers in the myocardium (B)</p> Signup and view all the answers

    Which of the following is a characteristic finding on an echocardiogram for detecting heart failure?

    <p>Wall motion abnormalities (B)</p> Signup and view all the answers

    What is the initial treatment focus for a patient with acute shortness of breath due to heart failure?

    <p>Reducing myocardial oxygen demand (C)</p> Signup and view all the answers

    What is the role of BiPAP in acute heart failure management?

    <p>To improve intrathoracic pressure and reduce workload (A)</p> Signup and view all the answers

    What can decompensated heart failure result in when compensatory mechanisms fail?

    <p>Further reduction of cardiac output (B)</p> Signup and view all the answers

    Which diagnostic method may help identify the cause of heart failure?

    <p>Echocardiography (D)</p> Signup and view all the answers

    What type of valvular disorder is characterized by an obstruction to blood flow due to a narrowed valve?

    <p>Stenosis (A)</p> Signup and view all the answers

    Which of the following is a common clinical manifestation of valvular disorders?

    <p>Orthopnea (D)</p> Signup and view all the answers

    What is the primary type of aortic aneurysm that is most commonly observed?

    <p>Abdominal aortic aneurysm (A)</p> Signup and view all the answers

    Which diagnostic method is considered the gold standard for identifying aortic aneurysms?

    <p>CT Scan (B)</p> Signup and view all the answers

    What condition is characterized by the disorganized proliferation of myocardial cells and can lead to cardiac arrest?

    <p>Hypertrophic cardiomyopathy (C)</p> Signup and view all the answers

    What is a common symptom of an aortic aneurysm before rupture?

    <p>Strong palpable pulse in the abdomen (B)</p> Signup and view all the answers

    Which class of drugs is commonly used to manage stable aortic aneurysms by treating hypertension?

    <p>Beta-blockers (D)</p> Signup and view all the answers

    What is a primary cause of dilated cardiomyopathy?

    <p>Viral infections (D)</p> Signup and view all the answers

    Which term refers to the accumulation of fluid in the pericardial sac?

    <p>Pericardial effusion (A)</p> Signup and view all the answers

    What potential complication arises from a ruptured aortic aneurysm?

    <p>Shock (B)</p> Signup and view all the answers

    Which condition can result from an infection leading to inflammation around the heart?

    <p>Pericarditis (D)</p> Signup and view all the answers

    Which form of cardiomyopathy involves stiffened ventricular walls that may not be thickened?

    <p>Restrictive cardiomyopathy (A)</p> Signup and view all the answers

    What is a common sign of a significant aortic aneurysm rupture?

    <p>Pale skin with hypotension (D)</p> Signup and view all the answers

    What is a characteristic sign of constrictive pericarditis?

    <p>Kussmaul's sign (B)</p> Signup and view all the answers

    What is the primary management technique for cardiac tamponade?

    <p>Pericardiocentesis (A)</p> Signup and view all the answers

    In which stage of ECG changes in pericarditis is there ST elevation in all leads?

    <p>Stage I (C)</p> Signup and view all the answers

    Which of the following is NOT typically a sign of DIC?

    <p>Increased platelet count (B)</p> Signup and view all the answers

    What is the primary cause of hypovolemic shock?

    <p>Loss of blood or fluid (D)</p> Signup and view all the answers

    What is a necessary characteristic of dry drowning?

    <p>Involuntary laryngospasm (B)</p> Signup and view all the answers

    What treatment is used to remove excess fluid and prevent recurrence of effusions in pericarditis?

    <p>Pericardial window (B)</p> Signup and view all the answers

    Which shock type is characterized by widespread vasodilation?

    <p>Distributive shock (C)</p> Signup and view all the answers

    What potential complication arises from non-cardiogenic pulmonary edema due to drowning?

    <p>Frothy sputum (D)</p> Signup and view all the answers

    What is the expected lab finding in DIC?

    <p>Abnormal clotting times (D)</p> Signup and view all the answers

    Which burn degree presents with blisters and deep skin damage?

    <p>Second degree burn (B)</p> Signup and view all the answers

    What complication can result from untreated cardiogenic shock?

    <p>Organ infarction (C)</p> Signup and view all the answers

    Which type of shock is most commonly associated with septic conditions?

    <p>Distributive shock (A)</p> Signup and view all the answers

    What ECG change is noted during Stage II of pericarditis?

    <p>T wave inversion (A)</p> Signup and view all the answers

    What primarily causes coronary artery disease (CAD)?

    <p>A buildup of fatty deposits within arterial walls (D)</p> Signup and view all the answers

    What is a common risk factor for coronary artery disease?

    <p>Cholesterol levels (A)</p> Signup and view all the answers

    Which test is considered the gold standard for diagnosing coronary artery disease?

    <p>Coronary Angiography (C)</p> Signup and view all the answers

    What does myocardial ischemia indicate?

    <p>Oxygen deficiency in heart muscle (D)</p> Signup and view all the answers

    Which of the following is NOT a treatment option for coronary artery disease?

    <p>Radical mastectomy (C)</p> Signup and view all the answers

    What does the 'MONA' acronym stand for in myocardial infarction management?

    <p>Morphine, Oxygen, Nitroglycerin, Aspirin (C)</p> Signup and view all the answers

    Which characteristic differentiates STEMI from Non-STEMI myocardial infarction?

    <p>Presence of elevated ST segments on ECG (A)</p> Signup and view all the answers

    What is the primary cause of right-sided heart failure?

    <p>Chronic lung disease or cor pulmonale (D)</p> Signup and view all the answers

    What does plaque rupture in CAD lead to?

    <p>Narrowing of the lumen and potential MI (C)</p> Signup and view all the answers

    Which lifestyle change could help manage coronary artery disease?

    <p>Maintaining a healthy diet (A), Smoking cessation (D)</p> Signup and view all the answers

    What is a primary consequence of left-sided heart failure?

    <p>Pulmonary congestion (A)</p> Signup and view all the answers

    When is thrombolytic therapy most effective for treating an MI?

    <p>Within 60-90 minutes of onset (B)</p> Signup and view all the answers

    What are drug-impregnated stents used for in CAD treatment?

    <p>To reduce the risk of restenosis (D)</p> Signup and view all the answers

    What symptom is most commonly associated with myocardial ischemia?

    <p>Chest pain (D)</p> Signup and view all the answers

    Which of the following is a consequence of chronic ischemia?

    <p>Myocardial fibrosis and decreased compliance (A)</p> Signup and view all the answers

    Flashcards

    Epiglottitis Cause

    Acute bacterial infection, most commonly caused by Haemophilus influenzae type B.

    Epiglottitis Sign

    Cherry-red, swollen epiglottis, drooling, stridor.

    Croup Sign

    Steeple sign on X-ray, subglottic inflammation that narrows the airway.

    Croup Pathogen

    Parainfluenza type I, Adenovirus, RSV are common causes of croup.

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    Acyanotic Heart Disease

    Increased pulmonary blood flow, oxygenated blood is shunted from the left side of the heart.

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    Cyanotic Heart Disease

    Decreased pulmonary blood flow, deoxygenated blood flows from the right to the left side of the heart.

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    Epiglottitis Treatment

    Systemic corticosteroids plus racemic epinephrine to constrict the airway.

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    Congenital Heart Defect

    Early deformation of the heart itself or vascular structures associated with it creating a burden of workload.

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    Coronary Artery Disease (CAD)

    Narrowing of one or more coronary arteries due to fatty deposits, reducing blood flow to the heart muscle.

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    Risk factors for CAD

    High cholesterol, diabetes, high blood pressure (HTN), smoking, obesity, and stress can increase CAD risk.

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    Ischemia

    Reduced blood flow to tissue, depriving it of oxygen and nutrients.

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    Myocardial Fibrosis

    Scarring of heart muscle tissue due to chronic ischemia.

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    Plaque Rupture

    Breaking of a plaque buildup, exposing the underlying lipid core, increasing the risk of blood clot formation.

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    Myocardial Infarction (MI)

    A heart attack; death of heart muscle tissue due to complete blockage of blood flow.

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    STEMI

    ST-elevation myocardial infarction, a type of MI characterized by elevated ST segment on an electrocardiogram, needing urgent reperfusion treatment.

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    Non-STEMI

    Non-ST-elevation myocardial infarction, lower risk needing a differentiated approach.

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    Angioplasty

    Procedure using a balloon to widen a blocked artery.

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    Stenting

    Insertion of a metal tube (stent) to prevent the artery from narrowing again.

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    CABG

    Surgical procedure where a section of a blocked artery is bypassed with a graft.

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    Reperfusion therapy

    Methods to restore blood flow to a blocked coronary artery, minimizing tissue damage during a heart attack.

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    Heart failure

    Inability of the heart to pump enough blood to meet the body's needs.

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    Left-sided heart failure

    Heart's inability to adequately pump blood to the rest of the body.

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    Right-sided heart failure

    Inability of the right ventricle of the heart to effectively pump blood.

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    Valvular Disorders

    Conditions affecting the heart valves, causing either stenosis (narrowing) or incompetence (leakage), disrupting blood flow.

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    Stenosis

    Narrowing of a heart valve, obstructing blood flow due to increased resistance.

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    Incompetence

    Distortion of a heart valve, causing it to not close properly, leading to backward flow (regurgitation).

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    Stenosis Effect

    Distends (enlarges) the chamber that pumps blood through the stenotic valve.

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    Incompetence Effect

    Causes distention of the chamber before the incompetent valve due to backward blood flow.

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    Aortic Aneurysm

    An abnormal localized dilation (swelling) of the aorta, typically by 75% or more.

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    Abdominal Aortic Aneurysm

    Aneurysm located in the abdominal aorta, the most common type of aortic aneurysm.

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    Aortic Aneurysm Risk Factors

    Atherosclerosis, hypertension, Marfan syndrome, collagen-vascular disorders, and trauma increase the risk of aortic aneurysms.

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    Aortic Aneurysm Symptoms

    Often asymptomatic. Can cause back pain, strong palpable pulse in the abdomen, coughing, hoarseness, or dysphagia.

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    Aortic Aneurysm Rupture

    Life-threatening, can lead to hypotension, pale skin, altered LOC, extreme pain, dizziness/syncope, and an abdominal mass.

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    Cardiomyopathy

    A group of disorders affecting the heart muscle, impairing its ability to contract and pump blood effectively.

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    Dilated Cardiomyopathy

    Enlargement of the heart muscle, often due to genetic, infectious, or toxic causes, leading to weakened contractions.

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    Hypertrophic Cardiomyopathy

    Disorganized overgrowth of heart muscle cells, often genetically linked, causing both diastolic and systolic dysfunction.

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    Restrictive Cardiomyopathy

    Stiffening of the ventricle walls, limiting the heart's ability to fill with blood, often caused by foreign materials.

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    Pericarditis

    Inflammation of the pericardium, the sac surrounding the heart, causing chest pain, pericardial rub, and potential fluid accumulation.

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    Potassium-Sparing Diuretic

    A type of diuretic that blocks aldosterone's action in the late distal tubule and collecting duct, preventing sodium and water reabsorption. It is used to treat conditions like heart failure and liver failure.

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    Carbonic Anhydrase Inhibitor

    A diuretic that blocks the carbonic anhydrase enzyme in the proximal tubule, preventing the reabsorption of sodium and bicarbonate. Used to treat metabolic alkalemia.

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    Thiazide Diuretic

    A diuretic that blocks sodium reabsorption in the distal tubule. Also inhibits carbonic anhydrase in the proximal tubule. Used to treat mild edema and hypertension.

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    Osmotic Diuretic

    A powerful diuretic that freely passes through the glomerulus but is not reabsorbed in the tubules, pulling water out and reducing fluid buildup. Used to control intracranial pressure (ICP).

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    Chronic Renal Failure Signs

    Symptoms of chronic kidney disease include fatigue, poor appetite, itching, elevated blood urea nitrogen (BUN) and creatinine levels, anemia, sleep disturbances, dyspnea (shortness of breath), and frequent vomiting.

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    Positive Pressure Ventilation (PPV) on Renal System

    PPV can negatively affect the kidneys by reducing urinary output, glomerular filtration rate, renal blood flow, and sodium excretion.

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    PPV and ADH Release

    PPV enhances ADH release due to increased intrathoracic pressure.

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    PPV and Atrial Natriuretic Peptide (ANP)

    PPV inhibits ANP secretion due to decreased atrial filling pressure caused by increased intrathoracic pressure.

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    Constrictive Pericarditis

    A condition where the pericardium (sac surrounding the heart) becomes thickened and stiff, hindering the heart's ability to fill with blood during diastole, leading to impaired diastolic function.

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    Kussmaul's Sign

    An increase in jugular venous distention (JVD) during inspiration, a hallmark sign of constrictive pericarditis due to impaired filling of the right ventricle.

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    Pericardial Effusion

    Fluid buildup within the pericardial sac, often seen in pericarditis.

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    Cardiac Tamponade

    A life-threatening condition where fluid buildup in the pericardium compresses the heart, hindering its ability to pump blood effectively.

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    Beck's Triad

    A trio of signs indicating cardiac tamponade: hypotension, elevated JVD, and diminished heart sounds.

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    Pulsus Paradoxus

    A decrease in systolic blood pressure during inspiration, a common finding in cardiac tamponade.

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    Disseminated Intravascular Coagulation (DIC)

    A serious condition where widespread clotting occurs throughout the microvasculature, depleting clotting factors and leading to excessive bleeding.

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    Hypovolemic Shock

    A type of shock caused by a decrease in circulating blood volume due to blood or fluid loss, leading to low blood pressure.

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    Cardiogenic Shock

    Shock resulting from the heart's inability to pump blood effectively, often due to a heart attack.

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    Distributive Shock

    Shock caused by widespread vasodilation, resulting in a relative decrease in blood volume and low blood pressure.

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    Obstructive Shock

    Shock caused by an obstruction to blood flow, blocking the heart's ability to pump blood effectively.

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    Norepinephrine

    A potent vasoconstrictor used to treat septic shock, improving blood pressure and heart rate.

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    Wet Drowning

    Drowning where water enters the lungs, leading to fluid buildup and impaired gas exchange.

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    Dry Drowning

    Drowning where water doesn't enter the lungs, but laryngospasm (spasm of the voice box) obstructs airway.

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    1st Degree Burn

    A superficial burn affecting only the outer layer of skin, resulting in redness but no blisters.

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    2nd Degree Burn

    A deeper burn extending into the dermis, causing blisters and pain.

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    3rd Degree Burn

    A full-thickness burn destroying all layers of skin, resulting in charred or coagulated tissue.

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    Study Notes

    Congenital Diaphragmatic Hernia

    • Failure of posterior lateral portion of diaphragm before 8 weeks
    • Creates opening between peritoneal and pleural pressures
    • Treatment involves intubation and nitric oxide for pulmonary hypertension

    Tracheoesophageal Fistula

    • Esophagus defect connects to trachea
    • Diagnosis: inability to pass a catheter to stomach
    • Management involves ventilation, upright positioning (30°) to prevent aspiration, and frequent suctioning

    Pierre-Robin Syndrome

    • Mandibular hypoplasia (underdeveloped jaw)
    • Associated with a large tongue and short jaw
    • Management: prone positioning, nasotracheal tube, or tracheostomy

    Choanal Atresia

    • Congenital blockage/absence of nasal passages
    • May be unilateral or bilateral
    • Diagnosis: inability to pass a suction catheter
    • Management: creating a new passage, or intubation/oral airway

    Tracheomalacia and Tracheal Stenosis

    • Weak or narrowed trachea cartilage
    • Causes inspiratory stridor and dyspnea
    • Diagnosis: observed during a bronchoscopy

    Transient Tachypnea of Newborn (TTNB)

    • "Wet lung", a type of respiratory distress
    • Excess fluid in lungs, reduced lung compliance
    • Management: CPAP, heated high-flow, prone positioning, monitoring lactate

    Meconium Aspiration

    • Mixture of amniotic fluid and fetal bowel contents
    • Causes respiratory distress, inflammation, air leaks, acidosis, persistent pulmonary hypertension
    • Diagnosed with a chest X-ray showing a coarse asymmetric pattern

    Persistent Pulmonary Hypertension (PPHN)

    • Pulmonary vascular resistance remains high after birth
    • Shunting through ductus arteriosus and foramen ovale is common
    • Diagnosis confirmed via echocardiogram

    Bronchopulmonary Dysplasia (BPD)

    • Chronic lung disease in infants needing prolonged mechanical ventilation.
    • Management involves lowest FiO2 possible, Vt 4-6 ml/kg, permissive hypercapnia

    Pneumonia/Pneumonitis

    • Bacterial infection in lungs/inflammation
    • Causes: alveolar infection, pus formation, RDS
    • Leads to inflammation and fluid filling in the lungs

    Pulmonary Interstitial Emphysema (PIE)

    • Air leakage from lungs into perivascular tissues
    • Results from lung over-distention
    • Shows "bubbling" near hilar region
    • Management: minimal ventilator support, prone positioning

    Pulmonary Hypoplasia

    • Inadequate development of lungs (cells, airways)
    • Usually associated with diaphragmatic hernia
    • Common requirement for use of CPAP, prone positioning, or other respiratory support

    Hyperbilirubinemia/Jaundice

    • Breakdown of hemoglobin results in bilirubin
    • Can be either water-soluble or fat-soluble

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    Final Notes Patho PDF

    Description

    Test your knowledge on the mechanisms and effects of various diuretics and their role in renal function. This quiz covers topics such as potassium-sparing diuretics, thiazide diuretics, and the impact of positive pressure ventilation on the renal system.

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