BIOS 162 Graduate Review: Final!

December 11, 2011

• How can the disease affect organ function?• How could you test for function?• How might a patient compensate in order to

maintain organ function?• What other symptoms would you look for?

Tuberculosis

• TB infection begins when the mycobacteria reach the pulmonary alveoli, where they invade and replicate within the endosomes of alveolar macrophages.

• Tuberculosis is classified as one of the granulomatous inflammatory conditions. Macrophages, T lymphocytes, B lymphocytes, and fibroblasts are among the cells that aggregate to form granulomas, with lymphocytes surrounding the infected macrophages.

• Decreased surface area – scarring– Diffusion– V/Q mismatch

• Normal FEV1, decreased PaO2 (especially during exercise), decreased TLC

• Increased minute ventilation, oxygen• Coughing (bloody), shortness of breath, chest

pain, fever, loss of appetite, fatigue

Cystic Fibrosis

• Cystic fibrosis (CF) is caused by a defective gene which causes the body to produce abnormally thick and sticky fluid, called mucus. This mucus builds up in the breathing passages of the lungs.

• Obstructive: blocks airways• Decreased FEV1/FVC, increased FRC and RV,

decreased PA02• Increased minute ventilation• GI symptoms, infections, mucus cough

Hereditary Nephritis-Alport Syndrome

• The primary indicator of Alport syndrome is a family history of chronic glomerular disease, although it may also involve hearing or vision impairment. This syndrome affects both men and women, but men are more likely to experience chronic kidney disease and sensory loss. Men with Alport syndrome usually first show evidence of renal insufficiency while in their twenties and reach total kidney failure by age 40. Women rarely have significant renal impairment, and hearing loss may be so slight that it can be detected only through testing with special equipment. Usually men can pass the disease only to their daughters. Women can transmit the disease to either their sons or their daughters. Treatment focuses on controlling blood pressure to maintain kidney function.

• The disorder damages the tiny blood vessels in the glomeruli of the kidneys, decreasing GFR and preventing the kidney from regulating Na/H20 and removing waste

• Increased albumin, creatinine, BUN, hypertension

• Limit fluids, change diet, ACE inhibitors, angiotensin receptor blockers

• Swelling, blood in urine