Ф КГМУ 4/3-07/02

ПП КГМУ 4/02

KARAGANDA STATE MEDICAL UNIVERSITY

Department «Pathological physiology»

Methodological recommendation for individual work of students

under the guidance of a teacher

Topic: Pathophysiology of respiratory distress syndrome

Specialty: 5B130100 – General medicine

Discipline: PF – 23212 Pathological physiology 2

Volume of academic hours: II

Year: ІІІ

Compiled by: Asst. prof. Abikenova F.C.

Karaganda 2014
Discussed and approved
at a meeting of the department / course
Protocol № __ from ___.___. 20__yr.
Head of department _______ Zhautikova S.B.
Topic: Pathophysiology of respiratory distress syndrome
Aim: to study the causes and mechanisms of respiratory distress syndrome and peculiarities in children.

Assignments on the topic:

1. An understanding of respiratory distress syndrome and its characteristics
2. Know the main causes distress syndrome
3. Know the basic pathogenesis of respiratory distress syndrome
4. Know manifestations of respiratory distress syndrome
5. Know respiratory distress syndrome (respiratory distress syndrome) in children.

Way of conduction: consultations on the home assignments, understanding topics identified in the plan,
in the form of implementation of the practice session.

Basic questions on the topic:

1. Respiratory distress syndrome and its characteristics
2. Main reasons for distress syndrome
3. Basic pathogenesis of respiratory distress syndrome
4. Manifestation of respiratory distress syndrome
5. Respiratory distress syndrome (respiratory distress syndrome) in children.

Guide and Handout: tables and charts on the topic, test questions, situational problems.

 Literature:
Basic:
1. Патофизиология //Под ред. Новицкого В.В., Гольдберга Е.Д. – Томск: Изд-во Том. ун-та,
2006
2. Литвицкий П.Ф. Патофизиология: учебник + СД. – 4-е изд. – М., 2008. – 469 с.
3. Ефремов А.В., Самсонова Е.Н., Начаров Ю.В. Патофизиология. Основные понятия:
учебное пособие.– М., 2008.– 160 с.
4. Патофизиология: учебник в 2-х т./под ред. В.В.Новицкого, Е.Д.Гольдберга, О.И.Уразовой.
– 4-е изд. перераб. и доп. – М., 2009.
Additional:
1. Адо А.Д., Адо М.А., Пыцкий В.Н., Порядин Г.В., Владимирова Ю.А. Патологическая
физиология. // М.: Триада-Х. - 2000. - 97.
2. Нурмухамедов А.Н. Патофизиология в схемах и таблицах // Алматы.- 2003 – 110.
3. Фролова В.А., Дроздовой Г.А., Билибина Д.П. Патофизиология в схемах и таблицах
//Москва. - 2004 – 403.
4. Шанин В.Ю. Патофизиология//С-Петербург. «Элби-СПб», 2005.- 639.
5. Шанин В.Ю. Практикум патологическая физиология//«Питер», С–Петербург, 2002.- 724.
6. Зайчик А.Ш., Чурилов Л.П., Утехин В.И., Ирошников Г.П., Фокин А.С., Беляева А.В.
Введение в экспериментальную патологию.С-Петербург, 2003.- 380.
7. Рубцовенко А.В. Патологическая физиология.Москва. Медпрес-информ, 2006.- 608.
8. Зайчик А.Ш., Чурилов А.П. Механизмы развития болезней и синдромов// «Элби-СПб» -
2005.- 507.
9. Литвицкий П.Ф. Патофизиология. Учебник для вузов// «ГЭОТАР-МЕД». - 2003.-Т.1, 2.-
807.

 Control:
Questions:
1. What is respiratory distress syndrome?
2. Name main reasons for distress syndrome?
3. Explain the basic pathogenesis of respiratory distress syndrome?
4. What are the manifestations of respiratory distress syndrome?
5. How manifested respiratory distress syndrome (respiratory distress syndrome) in children?
Test questions:
1. Basic criteria for respiratory failure:
1) Anemia;
2) Cyanosis;
3) Arterial hypertension and arrhythmia;
4) Hypoxemia;
5) Dyspnea.
A. 1, 2, 4.
B. 1, 3, 5.
C. 2, 4, 5.

2. Etiological factors of respiratory distress syndrome (ARDS) in elders:

1) Pneumothorax;
2) Various types of shock;
3) Emphysema;
4) Total pneumonia;
5) Pancreatitis.
A. 1, 3, 5.
B. 1, 2, 4.
C. 2, 4, 5.

3. The main pathogenetic factors in the development of RDS Elders are:

1) reduced perfusion of the lungs;
2) Hyperventilation;
3) Hypoventilation;
4) Reduction of the diffusion of gases;
5) Increasing the diffusion of gases.
A. 1, 3, 5.
B. 1, 2, 5.
C. 1, 3, 4.

4. For respiratory distress syndrome at infants is characterized by:

1) Respiratory alkalosis;
2) Hypoxemia;
3) Hypocapnia;
4) Hypercapnia;
5) Respiratory acidosis.
A. 1, 2, 3.
B. 2, 4, 5.
C. 1, 3, 5.

5. To non-respiratory functions of the lungs include:

1) Formation of renin;
2) Air purification from mechanical impurities;
3) Synthesis of somatotropin;
4) Cleaning the blood from the fibrin clots, fat emboli;
5) Synthesis of surfactant.
A. 1, 3, 5.
B. 2, 4, 5.
C. 3, 4, 5.
Clinical task:
Premature newborn boy 1st day of life. Child from a woman of 31, somatically healthy, from 1st
pregnancy with severe preeclampsia in the III trimester, premature birth by 34 weeks. Gestation through
cesarean section in connection with the buildup of preeclampsia (increased blood pressure, increase in
proteinuria). Birth weight is 1970 g, length 43cm. 6/7 points according to Apgar score. Performed
readjustment of the upper respiratory tract, started supplemental oxygen through a mask. At birth, the
baby's condition is severe due to symptoms of respiratory failure (7 on a scale of Silverman) and
neurological symptoms as a syndrome of CNS depression.
At the age of 1 hour of life noted increase in respiratory failure. Child needs oxygen supplementation,
cools quickly.
Examination revealed reduced spontaneous motor activity, muscular hypotonia, depressed reflexes of
newborns. Skin is pale pink, with "marble" pattern. Independent breathing with severe intercostal
participation, retraction of the lower third of the sternum and the supraclavicular fossa, expiratory sounds,
respiratory rate upto 70 in 1 minute (8 points on a scale of Silverman). At an auscultation breath carried
out in all sections, uniformly weakened, and at both sides heard multiple wheezing. Heart sounds are
muffled, noises does not listen. Heart rate 170 beats / min. Abdomen is possible to palpate only by deep
palpation, little bit swollen, the lower edge of the liver is elastic, feels at a 1.0 cm beyond the costal
margin, spleen not palpable. Urination and independent stool was absent.

Questions:
1. Formulate and justify a preliminary diagnosis.
2. List the basic mechanisms of the pathogenesis of this disease.