For Anatomy and Physiology

1. The conditions that led to the diagnosis of pyelonephritis are the back pain, chills, and fever. Her history of diabetes impairs the immune system which makes it more likely for her to get an infection. Her urinalysis also revealed numerous bacteria and leukocytes, in pyelonephritis, microscopic analysis of the urine virtually always shows signs of infection. This can include an excess of white blood cells and bacteria.

2. Hypoxia is the reduction of oxygen supply to a tissue below physiological levels despite adequate perfusion of the tissue by blood. The patient's oxygen saturation on room air is very low at 80% where as normal levels are greater than 94%. The diagnosis of ARDS was made from her symptoms of shortness of breath but also from the septic shock from all the bacteria in her body due to pyelonephritis. The medical history is very important in finding out if she has had prior kidney infections, ARDS often occurs along with the failure of other organ systems, such as the liver or kidneys. Cigarette smoking and heavy alcohol use may be risk factors.

3. ARDS is an acute pulmonary disorder characterized by diffuse capillary leak resulting in wet lung and a constellation of features secondary to it. This syndrome is associated with a multitude of clinical conditions which primarily damage the lung or secondarily as part of a systemic disorder. The capillary defect is produced by an interaction of inflammatory cells and mediators, including leukocytes, cytokines, oxygen radicals, complement and arachidonate metabolites, that damages the endothelium and allows fluid and proteins to leak. The lungs become stiff and less compliant, the lung volumes decrease, and minute ventilation increases as a compensatory phenomenon which leads to hypoxia.

4. The patient who is an adult female has an average lung volume of 500ml when inhaling and exhaling. Pulmonary function tests are done to diagnose certain types of lung disease such as asthma, bronchitis, emphysema and to find the cause of shortness of breath. It cannot provide a specific diagnosis, but it can distinguish between obstructive pulmonary disease involving increased airway resistance and restrictive diseases involving reduced total lung capacity.

5. In COPD, there is an increase in airway resistance, shown by a decrease in the forced expiratory volume in 1 second (FEV1) measured by spirometry. COPD is defined as a forced expiratory volume in 1 second to forced vital capacity ratio (FEV1/FVC) that is less than 0.7. The residual volume, the volume of air left in the lungs following full expiration, is often increased in COPD, as is the total lung capacity, while the vital capacity remains relatively normal. The increased total lung capacity can result in the clinical feature of a chest with a large front-to-back diameter that occurs in some individuals with COPD. Hyperinflation can also be seen on a chest x-ray as a flattening of the diaphragm.

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