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ACUTE GLOMERULONEPHRITIS Group A Beta hemolytic strep Antigen- antibody reaction Deposition of antigen- antibody in the glomerulus Activation

ion of complement system Inflammatory response in the glomeruli Increase capillary permeability and cell proliferation Leakage of protein, increase number of erythrocytes Cell proliferation Interfere with filtration Decreased GFR and retention of fluid and wastes Impaired blood Flow Edema Decreased blood flow Increased rennin A1 to A2 hematuria, albuminuria

Decreased urine output

VC Increased TPR Increased BP

Aldosterone Increased Na+ and H2O retention Increased blood volume Increased BP

NEPHROTIC SYNDROME Intrinsic renal disease that affects the glomerulu Damaged glomerular capillary membrane Proteinuria Hypoalbuminemia Decreased binding sites Decreased saturated fats Increased proteins Lipoprotein in the liver Decresed oncotic pressure Generalized Edema Hypovolemia Decreased GFR Activation

of RAAS SNS stimulation Increased aldosterone retention NaCl & H2O retention Generalized edema Ascites Edema in dependent areas (sacrum, ankle, hands) Pulmonary edema, pleural Effusion, diaphragmatic Compromise Dyspnea Fatigue Edema in the eyes (periobital)

URINARY TRACT INFECTION Diet Habit Gender Hygiene Intake of salty urinary retention shorter urethra poor hygiene Foods traps bacteria in bladder Easy access to bacteria Serve as reservoir For bacterial growth Accumulation of E.coli in the urinary tract E.coli adhesive to the columnar cells of the urinary tract Release of chemincal mediators of inflammation Dysuria Frequency Nocturia Fever Chills Nausea & abdominal Vomiting & flank Pain

Antibiotic therapy: Ciprofloxacin Ampicillin Cephalosphorins Meds with azodyes -avoid alcohol, caffeine, and spicy foods -drink cranking juices -drink plenty of h2O -take pain relievers

PYELONEPHRITIS Presence of bacteria in the bladder Ascending of bacteria to the kidney Adheres and colonize the urinary tract Increased bactreria in the urinary tract Obstruction in the urinary tract Inflammation in the kidney Increased susceptibility to infection of the kidney Presence of bacterial infection in the urine Systemic Symptoms Pyuria Dysuria Hematuria Abdominal pain

MAJOR BURNS Cell Lysis hemolysis hyperthermia Increased Capillary permeability Possible Loss of skin inhalation barrier injury thermo regulation inflammatory problems response

hemoglobin/ myoglobin Na+ h2O & in the urine protein shifts from intravascular to interstitial spaces Decreased circulatory blood Volume up to 50% Burns shock Massive stress response SNS activation Adrenal aortic hormones and Catecholamides release Peripheral Tachycardia Vasoconstriction Increased after Load Decreased Cardiac output Hyperglycemia increased catabolism risk of metabolism curling (after burn ulcer shock resolves)

ACHALASIA Neurodegenerative disorders Gastric carcinoma Infiltrates the esophagus lymphoma Chagas disease Viral infection Eosinophilic gastroenteritis

Loss of intramuscular neurons Failure of esophageal sphincter to relax Ineffective peristalsis of the distal esophagus Incomplete relaxation of the gastrophageal junction Dilation of esophagus Dysphagia Chest pain Heart burn Prolonged distention of the esophagus Regurgitation of food

-Administer nitrates and long acting nitrate to relieve pain -Ca+ channel blockers to manage diffuse spasm - Esophagonytomy may be necessary if the pain becomes intolerable -esophageal heller myotomy if none of the conservative approach is successful in managing symptoms -eat slowly and drink meals with fluid -frequent feeding and soft diet to decrease esophageal pressure and irritation

HIATAL HERNIA Obesity, pregnancy, ascites, aging Increased intra abdominal pressure Muscle weakness in esophageal hiatus Esophageal support loosens Low pressure in the thorax Reflux, regurgitation and motor dysfunction Heart burn Fullness after eating Difficulty of Breathing Chest pain

-semi-fowlers position -recline one hour after eating -administer pain relievers -xray -barium swallow -flouroscopy