Beginning of week
•Chest Physiotherapy – consists of bronchial or postural drainage which is done by placing a patient into a position that allows drainage of mucus from the lungs
•An electric chest clapper, known as a mechanical percussor
•Exercise helps to loosen mucus and stimulates coughing to clear the mucus
•Antibiotics – lung infections plus anti-inflammatory drugs
•Medications – Bronchodilators e.g. ventolin to ease breathing
•Mucolytics which thin the mucus and reduce bronchial obstruction
•Inhaled aerosolized enzyme treatments e.g. Pulmozyme to thin the mucus by digesting cellular (genetic) material trapped in the mucus
•Pancreatic enzymes to help digestion
•High calorie diet
What are treatments for Cystic Fibrosis?
Enzyme Kinetics:
Vmax decreased
Km decreases
What is uncompetitive inhibition?
No protein
No traffic
No function
Less function
Less protein
Less stable
What are the classes of CF mutations?
- Unreasonable/unrealistic expectations, demands of medical team(s)
- depression has direct effects: poor wound healing, cardiac arrthymias, osteoporosis, disrupted sleep, greater risk of delirium
- poor adherence to medical regime
- acting out and sucidality, reactive psychosis, dissociation, denial
What are the impacts of mental health on outcome?
Pneumonia • Pleural effusion • Pulmonary Oedema/Congestive cardiac failure • Inhaled foreign body • Chest trauma • Malignancy • Assess placement of ETT/NG Tube/chest drain/CVC/pacemaker wires
What are the indications of a chest x-ray?
Salty skin • Respiratory problems • Chronic coughing • Wheezing • Bronchitis and frequent pneumonia • Thick, viscous mucus secretion in the lungs • Changes in color and amount of sputum • Good appetite but poor growth • Digestive problems with weight loss (abdominal swelling) • Clubbing of fingers and toes - thickening of the flesh under the toenails and fingernails and the nail curves downward. Vasodilation (distended blood vessels), secretion of growth factors (VEGF) are some proposed mechanisms
What are symptoms of Cystic Fibrosis?
• Uniporter – carries only one solute at a time e.g. Glut 4
• Symporter – carries 2 or more solutes simultaneously in same direction (cotransport) e.g. Na-K-2Cl Cotransporter
• Antiporter – carries 2 solutes in opposite directions (counter transport) • sodium-potassium pump brings in K+ and removes Na+ from cell • Sodium-Calcium transporter
• Any carrier type can use either facilitated diffusion or active transport
What are Membrane carriers?
Maxillary sinus
Frontal sinuses
Anterior group
Middle group
Which paranasal sinuses drain into the Middle meatus?
Patient shows:
1. Major behavioural changes
2. Affective instability
3. Increases thoughts of being controlled or lied to
p-aminobenzoic acid does not get converted to Dihydrofolic acid because this type of antibacterial drug inhibits dihydropteroate synthetase. Ultimately, this prevents tetraphydrofolic acid, purine and DNA creation.
What is the mechanism of action for Sulphonamides?
a guide RNA that detects the specific sequence in the genome and the enzyme that binds to the guide RNA and cleaves the DNA at the target site. When DNA is cleaved, it normally gets fixed with Non-Homologous End Joining (NHEJ), which adds extra insertions or deletions (indels) at the cut site. In most cases this leads to gene disruption (a knockout). To bring a specific mutation (called knock-in), a repair template DNA is also needed which becomes inserted at the cut site through Homology-Directed Repair (HDR).
What is CRISPR/Cas9?
Enzyme Kinetics
Vmax unchanged
Km increased
What is competitive inhibition?
What is the Hardy-Weinberg Equation?
Biological, Social and Psychological all work together in this model
What is the medical model/biopsychosocial model of health?
provides access to the venous system to obtain blood for most diagnostic haematological tests
What is Venepuncture?
Protection: protect underlying tissue from mechanical injury, harmful chemicals and pathogens and excessive water loss
• Sensation: Sensory stimuli are detected by specialised ___ cells. Specialised ____ tissue containing sensory nerve endings is found in the skin, eyes, ears and nose and on the tongue
• Secretion: In glands, _____ tissue is specialised to secrete specific chemical substances such as enzymes, hormones and lubricating fluids
• Absorption: Certain ____ lining the small intestine absorb nutrients from the digestion of food
• Excretion: ____ tissues in the kidney excrete waste products from the body and reabsorb needed materials from the urine. Sweat (water and ions) is also excreted from the body by ____ cells in the sweat glands
• Diffusion: Simple ____ promotes the diffusion of gases, liquids and nutrients. Because they form such a thin lining, they are ideal for the diffusion of gases (e.g. walls of capillaries and lungs)
What are functions of Epithelia cells?
Enzyme Kinetics:
Vmax decreased
Km unchanged
What is non-competitive inhibition?
the ability to make and understand information relevant to a decision and the ability to appreciate the reasonably foreseeable consequences of a decision (or lack of a decision)
What is capacity?
Penicillins
Cephalosporins
Sulphonamides
Trimethoprim
Methotrexate
Sulfamethoxazole
Cotrimoxazole
Tetracyclines
Aminoglycosides
Macrolides
What are types of Antibacterial drugs?
Indications, Considerations, Positioning and selecting vein, Equipment, Insertion technique, Withdraw Needle, Site
What are the main points of the Venepuncture Protocol?
Simple squamous
Stratified squamous
Simple cuboidal
Stratified cuboidal
Simple columnar
Stratified columnar
What are classes of Epithelial cells?
Conductive: Impairment of external & middle ear mechanisms for transmitting sounds to cochlea.
Sensorineural: Impairment of cochlear receptors or damage of the cochlear branch of VIII nerve.
What are the types of deafness?
What is power of attorney?
Dihydrofolic acid does not get converted to tetrahydrofolic acid because this type of antibacterial drug inhibits dihydrofolate reductase. Ultimately, this previents purine and DNA creation.
What is the mechanism of Trimethoprim?
Indications of CXR, Assess Details, Check Technical Factors, Assess Airway, Assess Bones, Assess Cardiac Contour, Assess Diaphragm, Check for Effusion, Assess the lung fields, Identify Fissures, Assess intestinal gas, Assess hilium, Summarize findings
What are the main points of the Chest X-Ray Interpretation Protocol?