This document outlines a lecture on acid-base disorders given by Dr. Raneem AlSayed. The learning objectives are to recognize normal acid-base regulation and relationships, outline causes of respiratory acidosis, respiratory alkalosis, metabolic acidosis, and metabolic alkalosis. The content will cover physiology of acid-base balance, case studies of different disorders, and the roles of lungs, kidneys, and buffer systems in regulation. Key concepts to be discussed are the pH scale, clinically significant acid-base pairs, respiratory versus renal regulation, and approaches to analyzing arterial blood gases.
This presentation discuss about acid-base-gas normal ratio and its indication in relation to varying abnormal level and how to manage it. This includes clinical analysis practice.
This presentation discuss about acid-base-gas normal ratio and its indication in relation to varying abnormal level and how to manage it. This includes clinical analysis practice.
The normal ranges for arterial blood gas values
Approach to arterial blood gas interpretation
Arterial blood gas abnormalities in special circumstances
The normal ranges for arterial blood gas values
Approach to arterial blood gas interpretation
Arterial blood gas abnormalities in special circumstances
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Telegram: bmksupplier
signal: +85264872720
threema: TUD4A6YC
You can contact me on Telegram or Threema
Communicate promptly and reply
Free of customs clearance, Double Clearance 100% pass delivery to USA, Canada, Spain, Germany, Netherland, Poland, Italy, Sweden, UK, Czech Republic, Australia, Mexico, Russia, Ukraine, Kazakhstan.Door to door service
Hot Selling Organic intermediates
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
2. LEARNING OBJECTIVES:
By the end of this lecture, you should be able to:
Recognize normal acid base regulation
Recognize the clinical acid-base relationship.
Outline the causes of respiratory acidosis
Outline the causes of respiratory alkalosis
Outline the causes of metabolic acidosis
Outline the causes of metabolic alkalosis
Discuss the role of the kidney in handling the HCO3.
3. Content of the lecture:
Physiology of acid base balance.
Case of respiratory acidosis (chest).
Case of metabolic acidosis (Diabetic keto acidosis , renal tubular acidosis)
Example of metabolic alkalosis
Example of respiratory alkalosis
4.
5. "POTENTIAL OF HYDROGEN" (PH)
The acidity or alkalinity of a solution is measured as
pH.
The more acidic a solution, the lower the pH.
The more alkaline a solution , the higher the pH.
Water has a pH of 7 and is neutral.
The pH of arterial blood is normally between 7.35
and 7.45
6. BUFFER SYSTEMS
"Ability of weak acid and its corresponding base to
resist change in pH of a solution upon adding a strong acid
or base"
Regulate pH by binding or releasing Hydrogen
Most important buffer system:
Bicarbonate-Carbonic Acid Buffer System
(Blood Buffer systems act instantaneously and thus
constitute the body’s first line of defense against acid-base
imbalance)
8. RESPIRATORY REGULATION
Lungs
help regulated acid-base balance by eliminating or retaining carbon dioxide
pH may be regulated by altering the rate and depth of respirations
changes in pH are rapid,
occurring within minutes
normal CO2 level
35 to 45 mm Hg
9. RENAL REGULATION
Kidneys
the long-term regulator of acid-base balance
slower to respond
may take hours or days to correct pH
kidneys maintain balance by excreting or conserving bicarbonate and hydrogen ions
normal bicarbonate level
22 to 26 mEq/L.
17. ASSESSING OXYGENATION
Normal value for arterial blood gas 80-100mmHg
Normal value for venous blood gas 40mmHg
Normal SaO2
Arterial: 97%
Venous: 75%
18. IMPORTANT POINTS FOR ASSESSING
TISSUE OXYGENATION
This is the O2 that’s really available at the tissue level.
Is the Hb normal?
Low Hb means the ability of the blood to carry the O2 to the tissues is decreased
Is perfusion normal?
Low perfusion means the blood isn’t even getting to the tissues
19. RESPIRATORY ALKALOSIS
min. Vent. pCo2 & pH
Most common causes
Response to hypoxemia
Response to acute metabolic acidosis
CNS malfunction
Correct underlying cause
Rarely life-threatening
20. METABOLIC ACIDOSIS
Causes
High anion gap = Na - (Cl + HC03)(eg.LA)
Normal-anion gap (Hyperchloremic)
Treatment
Correction of underlying cause
Administer bicarbonate for life-threatening acidosis
21. METABOLIC ALKALOSIS
Usually results from excess acid losses
Causes
Loss of gastric juices
Diuretic therapy
Adrenal cortical hormone excess
Hepatic coma(hyper ammonemia )
Administration of exogenous base
Almost always accompanied by low K+
Treatment
22. Highly acidic, pH =1.0
Secretes HCO3
-
pH varies from
4.0 to 8.0
Vomiting:
Loss of H+
leading to
alkalosis
Diarrhea:
Loss of HCO3
-
leading to
acidosis
Gastrointestinal losses can create acid-base disturbances
23. APPROACH TO ABG
Check serum pH –
Acidemia or Alkalemia ?
Check PCO2
–
Is disturbance respiratory or metabolic ?
Is respiratory disturbance acute ?? Change in pH= -0.08 x (d Pco2/10)
Is respiratory disturbance non acute ?? Bicarb change = 1-5 x (d Pco2/10)
24. APPROACH TO ABG
Check PaO2 ?? -Good guide to patient course.. Not important with regard to Oxygen
Delivery..
SaO2 - 90 % acceptable for Oxygen delivery.
26. Case 1;
12 year old diabetic presents with Kussmaul breathing
pH : 7.05
pCO2: 12 mmHg
pO2: 108 mmHg
HCO3: 5 mEq/L
BE: -30 mEq/L
Severe partly compensated metabolic acidosis without hypoxemia due to ketoacidosis
27. Case 2;
9 year old w/hx of asthma, audibly wheezing x 1 week, has not slept in 2 nights;
presents sitting up and Using acessory muscles to breath w/audible wheezes
pH: 7.51
pCO2: 25 mmHg
pO2 55 mmHg
HCO3: 22 mEq/L
BE: -2 mEq/L
Uncompensated respiratory alkalosis with severe hypoxia due to asthma exacerbation
28. If the previous child was untreated or came later:
pH: 7.28
pCO2: 55 mmHg
pO2 35 mmHg
HCO3: 28 mEq/L
BE: +6 mEq/L
Partially compensated respiratory acidosis with severe hypoxia due to asthma exacerbation
29. Case 3;
7 year old post op presenting with chills, fever and hypotension
pH: 7.25
pCO2: 32 mmHg
pO2: 55 mmHg
HCO3: 10 mEq/L
BE: -15 mEq/L
Uncompensated metabolic acidosis due to low perfusion state and hypoxia causing
increased lactic acid
30. Case 4
A 6 year old girl with severe gastroenteritis is admitted to the
hospital for fluid rehydration, and is noted to have a high [HCO3
-]
on hospital day #2. An ABG is ordered:
ABG: pH 7.47 Chem : Na+ 130
PCO2 46 K+ 3.2
HCO3
- 32 Cl- 86
PO2 96 HCO3
- 33
Urine pH: 5.8
Hypokalemic hypocholiremic metabolic alkalosis