fuck my life

secondary pediatric hypertension

structural changes of kidneys/vessels, coarctation of the aorta

patent ductus arteriosus

duct does not close after birth, interventions with device closure, can develop LHF

atrial septal defect

hole between atria, atrial dilation leads to conductivity issues, A-fib and arrhythmia, can develop RHF, intervention with closure device

ventricular septal defect

opening between ventricular septum, most common congenital heart defect, causes mixing of oxygenated and deoxygenated blood, can lead to pulmonary hypertension causing localized vasoconstriction, eisenmenger syndrome if unrepaired

tetralogy of fallot

most common cyanotic heart defect, causes ventricular septal defect, shift of aorta, right ventricular hypertrophy, and narrowing of pulmonary valve

transposition of great arteries

arteries attached to ventricles, cyanotic, need surgery within first 2-3 weeks of life

coarctation of aorta

narrowing of aorta, increase in after load, hypertension, decreased pulses in lower extremities, intervention via ballooning

respiratory distress syndrome

decreased surfactant and smaller alveoli collapse, leads to atelectasis and hypoxia, can cause pulmonary hypertension, decreased perfusion, increased pulmonary capillary permeability, and pulmonary vascular constriction

day 1 RDS

breathing worsens and requires more support

day 2 RDS

remarkably stable on adequate support

day 3 RDS

resolution noted with diuresis

bronchopulmonary dysplasia

chronic lung disorder in preterm infants, lung function improves with growth, inflammatory and fibroproliferative stages, hypercapnia, rapid shallow breathing with chest retractions

croup

causes inflamed vocal cords and narrowed trachea leading to hoarseness, barking cough, SOB, cool air helps with swelling (misty shower)

acute epiglottis

inflamed epiglottis leading to narrowed airway, typically caused by strep throat, tripod position, inspiratory/expiratory stridor, nasal flaring, muscle retraction

acute bronchiolitis

lower airway infection due to RSV, produces inflammatory obstructions of small airways, rapid shallow breathing with retractions, nonproductive cough, diminished appetite

cystic fibrosis

autosomal recessive chromosome 7 mutation, affects chloride channels causing thick mucus secretions in respiratory, pancreatic, reproductive, and sweat gland systems, causes GI symptoms, sputum production, persistent cough, dyspnea, recurrent/severe pneumonia

osmoreceptors

stimulation causes thirst and ADH release

baroreceptors

sense stretch, stimulate sympathetic response and ADH release

diabetes insipidius

deficiency in ADH or decreased response to ADH, inability to concentrate urine, hypertonic dehydration, neurogenic and nephrogenic types

syndrome of inappropriate antidiuretic hormone

failure of negative feedback, ADH secretion continues despite decreased serum osmolality, fluid retention and dilution hyponatremia, caused by tumors, CNS disorders, and drugs

causes of edema formation

increased capillary permeability, lymph obstruction, increased capillary hydrostatic pressure, decreased capillary oncotic pressure

hyponatremia

hypotonic from dilution of bloodstream or hypertonic from osmotic shift from ICF to ECF with hyperglycemia, causes muscle cramps, weaknesses, confusion, lethargy, headache, increased risk for seizure activity

hypernatremia

hypertonicity of ECF and intracellular dehydration caused by disproportionate loss of water in relation to sodium, results in thirst, low urine output, high specific gravity, weak thready pulse, hypotension, dry sticky mucus membrane, muscle twitching, seizure activity

hypokalemia

caused by diets and EDs, symptoms don’t start until K is below 3, causes excitability, paraesthesia, no bowel sounds, vomitting, polyuria, treatment is to increase K intake

hyperkalemia

caused by acidosis, causes weakness, paraesthesia, peaked T waves, dyspnea, diarrhea, cramps, in severe cases causes muscle weakness, lethal arrhythmias and cardiac arrest, difficult to initiate muscle contraction

hypoparathyroidism

deficient PTH secretion that causes low serum and ionized calcium

hyperparathyroidism

increased PTH secretion, primary and secondary, causes high calcium levels and renal osteodystrophy

hypocalcemia

causes increased excitability, paraesthesia, muscle spasms, hyperactive reflexes, hypotension, chronic skeletal fractures

hypercalcemia

can occur in chronically ill bed bound patients, causes decreased neural excitability and muscle function, lethargy, behavioral changes, N/V, constipation, high output, renal calculi, treated with rehydration and drugs depending on cause

hypophosphatemia

characterized by musculoskeletal symptoms

hyperphosphatemia

characterized by cardiac arrhythmias

hypomagnesemia

same symptoms as hypocalcemia, increased neuromuscular excitability

hypermagnesemia

renal insufficiency of failure, causes lethargy, hyporeflexia, muscle weakness, confusion, hypotension, cardiac arrhythmias

acid

dissociate and release H ion, volatile and nonvolatile

base

accept H+ ion

metabolic acidosis

caused by production of metabolic acids, decreased renal function, increased bicarbonate losses, decreased perfusion, results in weakness, fatigue, peripheral vasodilation, N/V, compensate with increased respiration and acidic urine with increased ammonia in urine

metabolic alkalosis

caused by IV infusion excess, over ingestion of antacids, loss of fixed acid, fluid depletion, results in confusion, hyperactive reflexes, hypotension, arrhythmias, compensate with hypoventilation

respiratory acidosis

hypoventilation, increased carbon dioxide production, results in headache, confusion, stupor, compensate with acid in urine

respiratory alkalosis

hyperventilation, causes lightheadedness, panic, tingling, numbness, sweating, palpations, dyspnea, compensate with alkaline urine

achalasia

lower esophageal sphincter fails to relax, causes inflammation and aspiration

GERD

persistent reflex creating inflammatory response, can be caused by weak esophageal sphincter, lifestyle, causes mucosal injury, heartburn, hoarse voice, can develop ulcers and esophageal strictures

acute gastritis

injury to protective mucosal barrier, can cause vague abdominal discomfort, N/V, hematemenesis, self-limiting

chronic gastritis

H.pylori, chronic autoimmune, can lead to pernicious anemia, slow onset, antibodies to GI cells, chemical gastropathy

H. pylori gastritis

gram negative rods in stomach causing inflammation, secrete urease to make stomach more alkaline

peptic ulcer disease

ulcerative disorder of upper GI tract, caused bu increased acid and pectin production, healing periods and excaberations, pain, complications with hemorrhage, perforation, outlet obstruction

Crohn’s disease

characterized by skip lesions, cobblestone appearance, affect all bowel layers, granulomatous inflammatory response, periods of excaberations and remissions where lumen narrows and overtime bowel wall thickens and becomes inflexible, complications with fistulas

ulcerative colitis

lesions that work upwards from rectum, pseudo polyp formation, relapsing disorder, complications with toxic megacolon and increased risk of colon cancer

diverticulosis

diverticula/outpouchings of mucosa without inflammation, change in bowel habits

diverticulitis

inflammation of diverticula, pain and tenderness in LLQ, N/V, fever, complications with perforations, obstructions, abcess and fistula formation

acute intestinal obstruction

mechanical or nonmechanical, cause distention and edema, pain, fluid and electrolyte imbalance, diarrhea, constipation

peritonitis

inflammation of peritoneum, can be caused by bacterial invasion, true ulcer, perforated bowel, trauma, cause boardlike abdomen, hypoventilation causing atelectasis

gallbladder disease

impaired bile storage

cholelithiasis

gallstones

cholecystitis

inflammation from gallstones, cause colicky pain in RUQ, N/V, bile backup

chronic pancreatitis

progressive destruction with fibrotic replacement, usually from alcohol abuse but can be autoimmune or idiopathic, causes loss of endocrine and exocrine functions, fatty stools, weight loss, can develop diabetes

acute pancreatitis

auto digestion of pancreatic tissue, massive immune response, obstruction of bile duct, massive vasodilation, severe pain in epigastric region, N/V but do not feel better with vomiting, complications with breakdown of pancreatic tissue and abcesses

causes of liver failure

autoimmune hepatitis, intrahepatic, viral hepatitis, drug induced liver injury, cirrhosis

hepatitis a

fecal-oral, can be transmitted via anal sex, does not cause chronic hepatitis

hepatitis b

blood borne and sexual, usually asymptomatic, can lead to liver failure

hepatitis c

blood borne and sexual, usually asymptomatic, can lead to liver failure, large cause of hepatocellular cancer, no vaccine

acute fulminant hepatitis

acute hepatic insufficiency, sometimes viral caused, no history of liver injury and goes into liver failure, high mortality

liver failure symptoms

usually asymptomatic until far advanced, causes portal hypertension, weight loss, weakness, hepatomegaly, jaundice, pain in RUQ, fetter hepaticus, bleeding issues, sexual dysfunction

portal hypertension

nodules affecting flow cause backup, shunting of blood leads to development of collateral channels, cause varices, ascites

renal calculi

kidney stones, stones can be calcium, struvite, uric acid, or cystine, cause pain, N/V, hematuria, stones pass spontaneously, treatment via prevention

acute renal failure

rapid decline in kidney function, cause azotemia and decreased GFR

chronic renal failure

permanent loss of nephrons

dietary management in renal failure

decrease phosphorus, potassium required when GFR falls

azotemia

accumulation of nitrogenous waste

uremia

manifestation of kidney failure due to organic waste in blood

BUN

measures nitrogenous wastes from urea, protein byproduct

creatinine

waste product of muscle metabolism excreted by kidneys

hypervolemia

too much fluid in vascular space

ascites

fluid accumulation in peritoneal space