Question

Critical Thinking questions:

1.   A traveler, in excellent physical condition, is takin a trip to Andes Mountain in South America. Once climbing up to the high, she fined herself breathing rapidly. What happen to her and why? Explain.

2.   Upon placement of endotracheal tube (ET) into anaesthetized patient, the resident noticed that the air sounds were coming from epigastric region rather than from the lungs. What went wrong?

3.   What is the difference between pneumonia and pneumonitis?

4.   What is bronchogenic carcinoma? Provide detailed explanation.

Case Study:

25-years old college student as involved in a very heavy car accident. Arriving at the scene, the EMT personnel observe that: she was cyanotic and apneic (not breathing); her pulse was fast and thread, her head was tilt at peculiar angle as if she is having fracture at C₂ vertebra.

Questions:

1.   What is the connection between her head position and her cessation of breathing?

2.   Explain to your best her cyanosis.

3.   What is pneumothorax and why would in cause of R lung to collapse? Why not the left one?

4.   Doctor inserts a chest tube into the R intrapleural cavity and hooks it up to suction. How might this alleviate the pneumothorax?

Case Study 1:

A young 27-yeals old male patient had surgery on his R hand. The complete blood count (CBC) done indicates: very low total leukocyte count and low proportion of lymphocytes. One day after surgery, he complains of pain on his R injured ring finger. Observations indicates: the finger and dorsum are red, warm, and edematous, red streaks radiating proximally on the R forearm. High dosage of antibiotics was prescribed, and personnel was advised to have gloves and gown for his protection (known as reverse protection).

Questions:

1.   What is the connection between low level of lymphocytes, antibiotic treatment and reverse isolation? Why is important for him NOT to move his affected arm?

2.   Provide the best statement that explains the presence of red streaks in his forearm.

3.   Do you predict that his recovery will be uneventful or problematic? Why?

Case Study 2:

Mr. Smith is 52-yeaars old patient diagnosed 18 years ago with aggressive form of multiple sclerosis (MS). Back to the hospital, his doctor offer him one. Drug that will release steam cells from his bone marrow (collected from his blood), two. Antibodies against his T-lymphocytes. These procedures were offer to him in order to avoid problems such as transplant rejection.

Questions:

1.   What type of transplanted organ (aka graft) would it be if he receive someone bone marrow? On the other hand, what type of graft would be if he receive his own bone marrow?

2.   What are MHC proteins (class I or class II and what is the difference between the two classes)?

The nurse explain to Mr. Smith that a bone marrow transplant from another donor could result in destroying his own immune cells. Provide your best explanation for this statement

Answer 1

Ans1: Our lungs regulates the breathing process, for proper and normal breathing the pressure of air has to be higher outside of body. But at high altitudes, the outside air pressure is lower than it is inside lungs, which makes it more difficult to pull in the thinner air and for veins to pump oxygen throughout the body.When we breathe in air at sea level, the atmospheric pressure of about 14.7 pounds per square inch (1.04 kg. per cm.²) causes oxygen to easily pass through selectively permeable lung membranes into the blood. At high altitudes, the lower air pressure makes it more difficult for oxygen to enter our vascular systems. This is the same reason why people have breathing problems when they reach at the higher altitude.

Ans2: ET insertion is a common procedure performed by residents and nursing staff to access the stomach. Although an apparently simple procedure, it is associated with technical difficulties and complications if proper care is not taken during insertion. But sometimes while this procedure air gets entrapped in the pipe which causes problem. In this kind of situation immediately X-ray should be done and pipe should be removed.

Ans3: Pneumonia and pneumonitis are two serious respiratory infections, which if not treated early on, can lead to life-threatening consequences. The biggest difference between pneumonia and pneumonitis is that pneumonia is caused by an infection and pneumonitis can be caused by other factors aside from infections. The cause of pneumonia can be bacteria, virus, fungus., whereas for pneumonitis cause can be inhalation of toxic gases, gastric fluid, vomiting etc.

Ans4: Bronchogenic carcinoma is a malignant neoplasm of the lung arising from the epithelium of the bronchus or bronchiole. Bronchogenic carcinomas begin as a small focus of atypical epithelial cells within the bronchial mucosa. The lesion starts to increase and spread all over the mucosa, which makes difficulty in breathing problem, mainly this is a slow process but once it starts to grow, it becomes like a tumor. The neoplasm is composed of malignant squamous cells which may vary in degree of differentiation from tumor to tumor and the lesion progresses, the atypia becomes frankly malignant and the neoplasm grows in size. The neoplasm may grow into the bronchial lumen, along the mucosa or into the bronchial wall and adjacent lung parenchyma.