DISORDERS OF VENTILATION AND GAS EXCHANGE CASE STUDY

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LESSON: Disorders of Ventilation and Gas Exchange
Assignment: Disorders of Ventilation and Gas Exchange Case Study
Guidelines; Complete the Case Study below
Emmanuel Case Study
Emmanuel and his mother live in an urban community housing complex. The building is worn down and dirty from the urban dust, cockroaches, and mold. Emmanuel is 5 years of age and has suffered from asthma for the last 2 years. One evening, his mother poured him some milk and put him to bed. Shortly afterward, Emmanuel woke up wheezing and coughing. As he gasped for air, he became more and more anxious. His mother ran for his inhaler, but he was too upset and restless to use it. Emmanuelâ€s skin became moist with sweat, and as he began to tire, his wheezing became quieter. His mother called 911 and waited anxiously for the ambulance to arrive.
1. Emmanuel uses a corticosteroid inhaler for the management of his asthma. What is the mechanism of action of this drug? How is its action different from the β2-agonist inhalants?

2. Why does someone with severe asthma become physically fatigued during a prolonged attack? What are the physiological events that occur during an attack?

3. One of the complications of respiratory fatigue is the development of hypercapnia. How does the body compensate for an increase in CO2? What are the effects of hypercapnia on the central nervous system?

NOTE TO WRITER: PLEASE DO NOT USE QUOTED MATERIAL BECAUSE IT IS CONSIDERED PLAGIARISM.

NOTE TO WRITER: Linked is a PDF copy of the book being used in the class. The book has to be one of the references. The chapters being used this lesson is Chapter 29 “Structure and Function of the Respiratory System” Chapter 31 “Disorders of Ventilation and Gas Exchange”.

Norris, T. L., & Lalchandani, R. (2019). Porthâ€s pathophysiology: Concepts of altered health states (10th ed.). Wolters Kluwer.

file:///Users/jowusu/Downloads/Porth%E2%80%99s%20Pathophysiology_%20Concepts%20of%20Altered%20Health%20States.pdf

ALSO TO WRITER: This is a pathophysiology class so use more background information on the cellular level of the topic being discussed. Avoid cryptic information and use more of the course content and the chapter of the book which apply to the topic to complete the discussion.

FOR EXAMPLE THIS IS A QUOTE FROM THE INSTRUCTER THAT I WANT THE WRITER TO PAY ATTENTION TO WHEN COMPLETING THE DISCUSSION “As was described in the previous course announcement, there is an expectation of graduate level work in BIO PATHO. Simply using your textbook in forum and case study answers IS NOT adequate (that effort will not earn you an A in this class; and the syllabus clearly says that is inappropriate). A minimum of four sources need to be cited. Background information should ALWAYS be provided. For example, suppose the question leads you to diagnose that a person has hypertension, and you tell me all the evil consequences of hypertension and what the patient better do to reverse the many adverse effects of hypertension. Great. What is blood pressure to begin with? What is it normally? What regulates blood pressure? What can predispose someone to hypertension? What are modifiable and non-modifiable risk factors for hypertension? What will hypertension do in the short-term? Long-term? This is appropriate background information. Students putting in the effort to do this by providing background content in exceptional forum post or case study answers will be rewarded during grading.”

I WILL ASLO ATTACH THE POWERPOINTS FOR THIS LESSON TO SERVES AS A GUIDE.

file:///Users/jowusu/Downloads/Porth%E2%80%99s%20Pathophysiology_%20Concepts%20of%20Altered%20Health%20States.pdf

ALSO NOTE TO WRITER: BELOW IS THE LEARNING OUTCOMES FOR THIS LESSON. LET THIS BE A GUIDE WHEN COMPLETING THIS ASSIGNMENT

• Disorders of Ventilation and Gas Exchange
o Use your knowledge of the Fick equation to describe pathological conditions that reduce pulmonary diffusing capacity by increasing membrane thickness and decreasing surface area, or from disorders that alter ventilation
o Understand the relationship between cardiac output and ventilation, and the relate these terms to the zonal distribution of ventilation (V) and blood flow (Q)
• Shunts and Dead Space
o Compare and contrast physiologic and anatomic shunts, and understand that cardiac defects can cause shunting of blood
o Use your understanding of pulmonary volumes and capacities to describe clinically how pulmonary function tests can be used to diagnose obstructive or restrictive lung disorders
o Compare and contrast anatomic, alveolar, and physiologic dead space, and understand how these may be altered in disease states
• Breathing Patterns
o Define a number of breathing patterns including eupnea, dyspnea, sigh breaths, Kussmaul respirations, labored breathing, restricted breathing, Cheyne-Stokes breathing, hypoventilation, and hyperventilation
• Low Blood Oxygen or High Blood Carbon Dioxide levels
o Define the terms hypoxemia and hypercapnia
o List five generalized ways that hypoxemia can result (for example, decreased inspired oxygen). In addition, you should be able to describe conditions or diseases that produce each of the five ways that hypoxemia can occur
o Describe the four ways that cellular hypoxia is produced
o In each case of cellular hypoxia, the student should be able to determine if oxygen therapy would be useful as a treatment option
• Pulmonary Disorders
o Understand the clinical importance of the Alveolar (A) and arterial (a) gradients, and describe pathological conditions that result in elevated A-a gradients
o Describe why carbon monoxide exposure causes significant pathological problems
o Describe how pulmonary edema occurs, and how it is generally prevented
o Compare and contrast bronchiectasis and bronchiolitis
o Define the terms pleural effusion, empyema, and pleurisy
o Compare and contrast open, tension, and spontaneous pneumothorax
• Obstructive and Restrictive Pulmonary Disorders
o Describe the three lung obstructive conditions, and realize that these conditions result in reducing oxygen diffusion by reducing airway diameter and/or surface area
o List and understand the four causative conditions that lead to lung restrictive diseases, and understand that these conditions reduce gas exchange by increasing the diffusing distance by thickening the pulmonary membrane (interstitial fibrosis) or reducing the amount of air that can be brought into the lung (pneumothorax, scoliosis, multiple sclerosis)
• Pulmonary Vascular Diseases
o Describe the four conditions that are classified as pulmonary vascular diseases

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