Sinus infections
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Transcript Sinus infections
Gilead -Topics in
Human Pathophysiology
Fall 2010
Drug Safety and Public Health
Gas exchange
Protection
Speech
Compression of abdomen and spine
stiffening
Acid-Base balance
Flu (example H1N1)
Asthma
Cystic fibrosis (and accompanying infections)
Pulmonary aspergillosis
Pneumonia
•
Cause
– Influenza virus
•
Symptoms
– Fever
– Sore throat
– Cough
– Body aches
– Headache
– Chills
– Fatigue
– Vomiting and diarrhea
Susceptible populations
Antivirals for influenza – Tamiflu
(oseltamivir), Relenza (zanamivir), peramivir
Complications
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Pneumonia and respiratory failure
Bronchitis
Ear infections
Sinus infections
Inherited disorder causing a defect in a cell
membrane Cl- channel
Causes thick sticky mucus buildup in airways
and ducts of pancreas, etc.
Shortens lifespan because of pneumonia,
malnutrition, etc.
Fungal lung infection
Common with AIDs patients and cystic
fibrosis patients
Treated with Ambisome (amphoterocin B),
one of several antifungals, alters fungal cell
permeability
http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijid/vol
6n1/aspergillosis.xml
Fluid buildup in lung alveoli
Thickens respiratory interface, interrupting
diffusion of gases
Caused by a wide variety of microorganisms
including bacteria, aspergillus and
pneumocystis fungi, influenza virus (Tamiflu),
cytomegalovirus (Vistide)
• Cayston® (aztreonam) for
Pseudomonas aeruginosa
• Tamiflu for influenza viruses
• Ambisome for aspergillus fungus
• Vistide for cytomegalovirus
Chest X-ray
Pulmonary function tests
Sputum cultures
Pulse oximetry
Arterial Blood Gases (ABGs)
http://www.med-ed.virginia.edu/courses/rad/cxr/pathology3chest.html
Sputum Culture
•Patient donates a
sputum sample
•It is cultured with
various media to
determine causative
agent of lung infection
Pulse Oximetry
•Measures arterial
hemoglobin oxygen
saturation
•Normal is > 95%
•Indicator of effectiveness
of respiratory interface and
gas diffusion
pH
PCO2
PO2
O2 Saturation
HCO3-
Renal Pathophysiology
Kidneys maintain homeostasis
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Maintain water balance
Regulate salt balance
Maintain acid-base balance and blood pH
Control production of red blood cells
Activate an inactive form of vitamin D
Figure 15.2
Normal Kidney Anatomy
The nephron is the functional unit of the kidney
Figure 15.6
Overview of Nephron Actions
Nephron Actions
• Filtration
• Reabsorption
• Secretion
Figure 15.4
Glomerular Apparatus
The glomerular capillaries filter the blood.
Glomerular filtration rate is an indicator of kidney
health.
Tubules reabsorb nonwastes, and secrete wastes, allow
urine to be concentrated, control electrolyte balance.
Figure 25.16
Kidney Disorders
Acute Renal Failure
• Causes:
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Decreased blood flow to kidneys
Large kidney stones
Infections
Burns
Severe injuries
Toxic drugs and or chemicals (antivirals, especially
anti-HIV drugs)
• Tubule damage is typical and signs include
problems with reabsorption and secretion and
thus changes in serum electrolytes
• Can be reversed by eliminating the cause
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From: radiology.rsna.org/ content/242/1/175/F5.expansion
Acute Renal Failure
Signs & symptoms
– Oliguria or anuria
– Swelling / edema
– Mental status changes
Tests
– Urinalysis
– Serum creatinine
– blood urea nitrogen
(BUN)
– serum potassium
– Kidney ultrasound or Xray to rule out
obstructions to urine
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Kidney Disorders
Chronic Renal Failure - End Stage Renal Disease
(ESRD)
• Generally caused by long term damage to nephrons reducing
GFR and urine output
• Risks include hypertension, diabetes mellitus, untreated acute
renal failure
• Increased leakage through glomerulus leads to
– Proteinuria- proteins in urine
– Hematuria – blood in urine
– Azotemia – excess nitrogen containing compounds in
blood
– Edema
– Hypertension
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Kidneys maintain homeostasis
•
•
•
•
•
Maintain water balance
Regulate salt balance
Maintain acid-base balance and blood pH
Control production of red blood cells
Activate an inactive form of vitamin D
Stages of Chronic Kidney Disease (ESRF)
Stage
1
Normal or
increased GFR
90mL/min or above
Some evidence of kidney damage
(microalbuminuria/proteinuria, hematuria, or histologic
changes) Asymptomatic
Stage
2
GFR 60-90 mL/min
Kidney damage with mild decrease in GFR
Asymptomatic
Stage
3
GFR 30-59 mL/min
Kidney damage with moderate decrease in GFR
Asymptomatic, may have anemia
Stage
4
GFR 15-29 mL/min
Kidney damage with severe decrease in GFR
Hyperkalemia
Anemia
Stage
5
GFR <15 mL/min
Kidney failure;
renal replacement therapy needed to sustain life
Uremia, platelet dysfunction, encephalopathy, peripheral
neuropathy, anorexia, nausea and vomiting, pericarditis,
pruritus, lethargy and increased somnolence)
Metabolic acidosis
Protein catabolism
Renal bone disease
Sodium & water retentionedema, pulmonary hypertension,
systolic hypertension
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Treatment for Renal Failure
• Control the underlying cause, i.e. diabetes,
HTN, drug therapy
• Controlled fluid intake
• Diet
• rhEPO
• Kidney Transplant
• Dialysis
Dialysis Treatment
Review of Clinical Tests for Renal Injury
• Complete medical and medication history
• Complete physical examination
• Microscopic exam---clues in the urine sediment (eg.
hematuria)
• Urinalysis---any protein, WBCs, blood?
• BUN/creatinine, electrolytes, GFR, quantitative
protein, urine serum/potassium
• Renal ultrasound
• Renal biopsy
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