Bronchial asthma: Symptoms, Cause, Treatment and More

BRONCHIAL ASTHMA :

 Definition

Asthma is a chronic inflammatory disease of airway caused by allergic response of bronchi resulting in reversible narrowing of airway due to bronchoconstriction (spasm) congestion and thickening of walls all of bronchi and accumulation of mucus.

Causes / Etiology :-

1. Environmental factors

_ Chenge in temperature mostly cold air.

_ Change in humidity _ dry air.

2. Atmospheric pollutants

_ Cigarette

_ industrial smoke 

_ ozone

_ sulphur dioxide

_ formaldehyde.

3. Allergen inhalation

Food treated with sulphate, beer, wine ,etc

4. Medication

_ NSAIDS

_ Beta blockers

5. Stress/ emotional upset

6. strong odour and perfumes

Risk factors :-

_ Family history

_ History of allergen

_ Low birth weight

_ Urban living

_ Regular use of NSAIDS

_ Passive smoking 

_ Obesity

Types of Asthma

1. Extrinsic (Allergic asthma)

When asthma cause by allergen such as paint ,house dust, pollan, food preservatives etc is known as allergic asthma.

Allergic asthma most commonly seen in seasonal environment.

2. Intrinsic (non allergic asthma)

It is caused by sympathetic and parasympathetic response of the body .

Other types of Asthma

1.mixed asthma

2. Cough variant asthma

3. Exercise induce asthma

Clinical manifestations

_ Cough 

_ Chest tightness

_ Dyspnoea

_ Wheezing

_ Prolonged expiration

_ Hypoxemia

_ Ronchi(sounds during inspiration)

Diagnostic evaluation

_ History collection

_ Physical examination

_ Spirometry

_ ABG (Arterial blood gas analysis)

_ Chest x-ray

_ Auscultation of breath sounds (wheezing sounds)

Complications

_ Respiratory failure

_ Pneumonia

_ Cardiac arrest

_ Atelectasis

_ Status Asthmatics 

MANAGEMENT

Medical management

1. Bronchodilators

_ Salbutamol

_ Albuterol

_ Formoterol

_ Terbutaline

2. Xanthine derivatives :

_ Theophylline

_ Deriphylline.

_ Aminophylline

3. Anticholinergie :

_ Ipratropium

_ Atropine sulphate (Nebulizer).

4. Corticosteroids : 

_ Methylprednisolone

_ Betamethasone.

5. Leukotriene receptor antagonist :

_ Montelukast

_ Zafirlukast.

6. Mast cell stabilizers (stop activities of mast cells.) :

_ Cromolyn sodium.

Nursing management

1. Assess the patient’s respiratory status by monitoring the severity of the symptoms.

2. Assess for breath sounds.

3. Assess the patient’s peak flow.

4. Assess the level of oxygen saturation through the pulse oximeter.

5. Monitor the patient’s vital signs.

By : @ummedsaini_

Lung Abscess: Symptoms, Causes, Diagnosis, Treatment

LUNG ABSCESS 

What is lung abscess :-

A lung abscess is a pus-filled cavity in your lung surrounded by inflamed tissue. It usually results from breathing bacteria that normally live in your mouth or throat into the lungs, leading to an infection.

Lung abscess is the localised necrotic lesion of the lung containing person material and from activity. 

Causes :-

Primary: A primary lung abscess stems from an extension of a condition involving the lung itself.

Secondary: Lung abscesses may occur secondarily as the result of a condition outside of the lungs spreading to the lungs.

** "The most common cause of a lung abscess is aspiration of anaerobic bacteria (bacteria that live without oxygen) from the mouth." **

Risk factors :-

_ Drug overdose

_ Alcoholism

_ Patient is having NG tube

_ Pneumonia

_ general anaesthesia

_ infectious agent

_ anaerobic bacilli

Pathophysiology :-

     Due to any etiological factor

                         ⬇️

  Infections agents gets in to the lungs

                         ⬇️

             Abscess formation

Clinical manifestation  / Sign & Symptoms :-

_ Pleuritic pain

_ weight loss

_ sweating

_ cough

_ chills

_ increased pulse rate 

_ fever

_ dull chest pain

Diagnostic evaluation :-

_ history collection

_ physical examination 

_ chest X Ray

_ bronchoscopy

_ sputum test

_ CT scan of the chest

Complications :-

Empyema: An abscess may rupture into the pleural cavity, the space between the membranes that line the lungs. When this occurs, the condition is often treated differently.

Bronchopleural fistula: A fistula (abnormal passageway) may develop between a bronchus and the pleural cavity.

Management :-

Medical management

_ administer antimicrobial therapy

_ chest physiotherapy

_ postural drainage should be given

_ bronchodialators (for dilate bronchi)

_ mucolytics (to liquefie secretion) mostly penicillin with metronidazole used

Nursing management 

1. Administer antimicrobial as     prescribed

2. assist patient with painful area during coughing deep breathing to more effective and less traumatic coughing

3. Provide medication to control the pain

4. maintain comfort position provide fowler or semifowler position to patient to promote maximal inspiration

5. Assist with respiratory treatment.

By : @ummedsaini_

Shock, Classification, Cause and Treatment

SHOCK

Shock is defined as failure of the circulatory system to maintain adequate perfusion of vital organs.

Shock is a life-threatening medical condition as a result of insufficient blood flow throughout the body.

* Medical shock is different than emotional or psychological shock.

Classification of the shock :-

1. Cardiogenic shock occurs due to

heart problems, such as valve disorder, heart attack or heart failure.

2. Hypovolemic shock occurs due to internal or external bleeding, diarrhea, chronic vomiting, dehydration or severe burns.

3. Distributive shock is a medical condition in which abnormal distribution of blood flow in the smallest blood vessels results in inadequate supply of blood to the body's tissues and organs.

It is further classified into:-

Anaphylactic shock occurs due to the severe allergic reaction. Septic shock occurs due to E. coli or other infection.

Neurogenic shock occurs due to a spinal injury, hypoglycemia.

Septic shock occur due to the when bacteria release endotoxins

Septic shock are most common cause by gram negative bacteria

Causes of Shock :-

• Excessive blood loss

• Heart failure or heart attack

• Severe allergic reactions

• Burns

• Dehydration

• Blood infection

. Poisoning

Sign and Symptoms of Shock :-

_ Chest pain

_ Confusion

_ Anxiety/ restlessness

_ Bluish fingernails and lips

_ Enlarged pupils

_ low or no urine output

_ Nausea and vomiting

_ Rapid, weak pulse

_ Rapid, shallow breathing

_ Unconscious

_ Pale, clammy and cool skin

_ Dizziness

Diagnosis :-

• Blood tests: A sample of blood is examined to evaluate blood infection, significant blood loss, or an overdose of medication or drug.

.Imaging tests: 

_ ultrasound

_ X-ray

_ CT scan

_ MRI 

Treatment :-

Medications to narrow the blood vessels in case of cardiogenic shock

Antibiotics to cure the infection in case of septic shock

Antihistamines and Adrenaline for anaphylactic shock

Corticosteroids to treat neurogenic and anaphylactic shock

Prevention of shock :-

Maintain a healthy lifestyle: 

Eat a well-balanced diet and exercise regularly to avoid heart diseases.

Prevent injuries: 

Wear protective gears while driving, playing sports, or working with dangerous equipment to prevent injuries.

Drink plenty of water:

Keep yourself hydrated to prevent dehydration. 

By : @ummedsaini_

Atherosclerosis / arteriosclerosis Cause and Symptoms

Atherosclerosis / Arteriosclerosis

Watch full video

Definition

Arteriosclerosis is the thickening and hardening and loss of elasticity of the walls of arteries.

Risk factor  / etiology  / cause :-

_ Hypertension

_ age 

_ family history 

_ smoking

_ alcoholism 

_ deposition of fat /cholesterol

_ diabetes mellitus

_ lack of exercise

Sign and symptoms

_ Shortness of breath dyspnea

_ Chest pain

_ Dysrhythmia

_ Fatigue

_ confused 

_ muscles weakness

_ Visionless

_ kidney fail

_  hypertension

Diagnostic evaluation

_ CT scan

_ MRI (magnetic resonance imaging)

_ ECG (electrocardiography)

_ CBC

_ Chest X -Ray

Management

1. Medical management

_ beta blocker drugs 

_ calcium channel blockers

_ diuretics

_ vasodilators 

_ antiplatelet drugs

_ pain relief drugs

2. Surgical management

_ CABG

_Coronary stand

_ Angioplasty :- a procedure to restore blood flow through the artery

Nursing management

_ Regular check up of blood pressure

_ Restrict the high self diet

_ Restrict the high cholesterol diet

_ Quit smoking and alcoholism

_ Encourage the patient for exercise

_ Take healthy diet for keeping heart healthy.

By : @ummedsaini_

HEART ATTACK (myocardial infarction)

Heart Attack 

 ( myocardial infarction)

Heart attack is a coronary heart disease in which death of myocardial tissue due to prolonged decrease of O2 supply because of insufficient blood flow through the coronary arteries.

Others name of heart attack :- 

_ Acute myocardial infarction

_ Acute coronary syndrome

_ Acute coronary accusing

Causes / Risk factor / Etiology :-

The most common cause of heart attack is coronary thrombosis.

Other causes :-

_ obesity

_ aorta inflammation

_ cocaine addiction

_ smoking (nikottin)

_ sedentary lifestyle

_ alkohal

_ old age

_ atherosclerosis

_ less physical activity

_ family history of heart disease

_ coronary artery disease

_ hypercholesterolemia

Pathophysiology :-

Due to etiology factor (coronary artery disease)

                 ⬇️

   Decrease blood supply to the heart

                 ⬇️

     Myocardial ischemia

                 ⬇️

    Decrease cardiac output

                ⬇️

Increase O2 peripheral tissue damage of blood

               ⬇️

Stimulation sympathetic receptor

               ⬇️

Increased workload of heart

               ⬇️

   Myocardial infarction

       (Heart  Attack)

Clinical manifestation / Sign  & Symptoms :-

1. Sudden arrest chest pain, pain located in substernal region.

2. Pain is pressing and squeezing in nature

3. Pain lasts for 15 minute or more

4. Patient feel cold

5. Palpitation

6. Dysphonia

7. Weakness

8. Fatigue

9. Nausea and vomiting

10. Patient may have anxiety confusion and restlessness.

Diagnostic evaluation :-

_ urine test

_ blood test

_ ECG (electrocardiography)

_ chest X Ray

_ cardiac enzyme level

_ radionuclide imaging

Management :-

1. Medical management :- 

 O2 therapy

Analgesics :-To relief the pain 

_ morphine

_ pethidine

Calcium channel blockers :-

_ Verapamil (Calan, Verelan)

_ Nifedipine (Adalat CC, Procardia)

_ Isradipine.

_ Nicardipine.

Beta blockers drug :-

These drugs reduce blood pressure heart rate and myocardial contractility

_ Acebutolol (Sectral)

_ Atenolol (Tenormin)

Thrombolytic agent :- these drugs which are used to dissolve the thrombus.

_ urokinase

_ streptokinase

2. Surgical management :-

1. Coronary bypass surgery

2. PTCA ( percutaneous transluminal coronary angioplasty )

3. Coronary stand

3. Nursing management :-

_ assess the vital sign of the patient

_ nurse should we provide safe and comfortable position

_ nurse should be give prescribed medication of patient

_ nurse give psychological support of the patient

_ nurse should we provide health education

_ nurses should be maintain record and report of the patient. 

By : @ummedsaini_

PNEUMONIA TYPES, CAUSE & SYMPTOMS

Pneumonia

Introduction :-

pneumonia is the inflammation of the lungs parenchyma characterized by consolidation of the affected part.

Mostly are due to infection by bacteria, virus, fungi, bacteria like organism.

Definition :-

Pneumonia is an inflammatory process of lungs Parenchyma usually associated with in marked increase in interstitial and alveolar fluid.

Etiology :-

1. Bacterial infection -

  (A) gram positive bacteria 

       __ streptococcus pneumoniae

       __ streptococcus aureus

  (B) gram negative bacteria

       __ anaerobic bacteria

       __ human influenza

2. Viral infection -

         __ influenza virus

         __ adenovirus

         __ para-influenza virus

3. Fungal infection -

        __ candida albicans

        __ histoplasmosis

Types of pneumonia :-

Pneumonia mostly divided into 4 main types :-

 

1. Segmental pneumonia :- Only in one small segmental lobe of lungs.

2. Bilateral pneumonia :- Both side segmental logo of lungs are affected.

3. Labour pneumonia :- Complete lobe affected.

4. Broncho pneumonia :- Patchy like formation in the lungs.

Pathophysiology :-

  Due to etiological factors

                     ⬇️

Microorganism enter into the body

                       ⬇️

     Inflammation in alveoli

                       ⬇️

  Mast cell activate and release       histamine prostaglandin cytokinin

                        ⬇️

  Due to cytokinase release fluid shift         to extracellular space

                         ⬇️

          Alveoli filled with fluid

                           ⬇️

                  Consolidation

                             ⬇️

       Decrease O2 saturation in body

                             ⬇️

                       Hypoxemia

                             ⬇️

                       Pneumonia

Risk factors :-

Key of risk factors :-

A- Air pollution

B- Bed rest for long time

C- chronic lung disease

D- Diabitic mallitus

E- endotracheal intubation

F- fully day smoking

G- general anaesthesia

H- Hiv

I- immunosuppressive therapy

Other risk factors such as :-

A. Head injury e

B. Diabetes mellitus

C. General anaesthesia

D. Inhalation of chemical gases

E. Drug overdose F. Heart disease

G. Lungs disease

H. Renal disease

Sign &  Symptoms / clinical manifestation :-

_ Chills

_ Pleuritic pain

_ Cough e

_ Hemoptysis (cough with blood)

_ Fatigue

_Cyanosis (skin colour changes)

_Headache

_Low 02 saturation

_Rapid pulse

_Sweating.   etc.

Diagnostic evaluation :-

_ History collection

_ Physical examination

_ Sputum for culture and sensitive

_ Chest X-Ray

_ Bronchoscopy

_ ABG analysis

_ Montex test

Management :-

1. Medical management :-

Prevention of pneumonia by vaccination.

Antibiotics :-

_ Erythromycin

_ Cephalosporin (syrup)

_ Amikacin (drug of choice)

_ Ceftriaxone

Bronchodialators :-

_ Salbutamol (cough syrup)

_ Levo salbutamol

_ Terbutaline

Analgesics :-

_ Nimesulide

_ Paracetamol

Long acting bronchodialators :-

_ Salmeterol

_ Clenbuterol

_ Formoterol

2. Nursing management :-

_ Analgesics and antipyretics

_ Chest physiotherapy

_ Intravenous fluid if indicated

_ Oxygen supplementation

_ Positioning of the patient to         minimise aspiration risk

_ Respiratory therapy including treatment with bronchodilators

_ Sectioning and bronchial hygiene

_ Ventilation with low tidal volume in patients requiring mechanical ventilation secondary to bilateral pneumonia or acute respiratory distress syndrome

_ Systemic support may include proper hydration, nutrition and mobilization.

By : @ummedsaini_

COPD (CHRONIC OBSTRUCTIVE PULMONARY DISEASE)

What is COPD ?

* COPD - CHRONIC OBSTRUCTIVE PULMONARY DISEASE

COPD refers to disease that produced obstruction of air flow. They are chronic bronchitis, emphysema and bronchial asthma

Other name of COPD :-

1 Chronic obstructive lung disease (COLD)

2 Chronic airflow limitation (CAL)

3 Chronic lower respiratory disease(CLRD)

Etiology / Risk factors :-

- Environment

- work place

- air pollution

- Cigarette smoking

- air pollution

- chemical forms

- dust

Pathophysiology :-

Due to any logical factors of COPD

                         ⬇️

Affect ciliary cleaning mechanism of respiratory tract.

                         ⬇️

Air flow is obstructed and air becomes trapped behind the obstruction

                          ⬇️

 Alveoli greatly distant and long           capacity decreased

                          ⬇️

  Increase production and                        accumulation of the mucus

                          ⬇️

      Produce more infection

                          ⬇️

            Damage to lungs

                          ⬇️

                       COPD

Clinical manifestation / sign and symptoms :-

- respiratory insufficiency

- fatigue

- tachypnea

- prolong expiration

- chronic cough

- sputum production

- weight loss

- tightness of chest

- pitting peripheral edema

Treatment :-

1. Medical management :-

- lungs transplantations

- oxygen therapy

- surgery

- corticosteroids

- bronchodilators

- vaccine may also be effective

- smoking cessation, if appropriate.

2. Nursing management :-

- assessment

- improving breathing pattern

- air way clearance

- improve active tolerance

- monitoring and managing complications.

By : @ummedsaini_

𝐒𝐭𝐫𝐮𝐜𝐭𝐮𝐫𝐞 𝐚𝐧𝐝 𝐟𝐮𝐧𝐜𝐭𝐢𝐨𝐧 𝐨𝐟 𝐭𝐡𝐞 𝐇𝐞𝐚𝐫𝐭

𝙎𝙩𝙧𝙪𝙘𝙩𝙪𝙧𝙚 𝙤𝙛 𝙩𝙝𝙚 𝙃𝙚𝙖𝙧𝙩

The heart is divided into the left and right side by partitions called septa (singular septum).

The interatrial septum separates the two upper chambers, called atria (from atri/o, meaning "upper chambers").

The interventricular septum separates the two lower chambers, called ventricles (from ventricul/o, meaning "lower chamber).

𝙏𝙝𝙚 𝙃𝙚𝙖𝙧𝙩 𝘾𝙤𝙣𝙨𝙞𝙨𝙩𝙨 𝙤𝙛 𝙁𝙤𝙪𝙧 𝘾𝙚𝙡𝙡 𝙇𝙖𝙮𝙚𝙧𝙨:

The endocardium (from endo- + cardi/o +ium, meaning "inner layer of the heart") is formed by endothelial cells, and it lines the interior of the heart chambers and valves.

 The myocardium (from my/o + cardi/o + -ium, meaning "heart muscle") is the muscular middle layer of the heart that consists ofheart muscle cells. 

The epicardium (from epi- + cardi/o + -ium, meaning "outer layer of the heart") is formed by epithelial cells, and forms the outer cell layer of the heart.

The pericardium (from peri- + cardi/o +-ium, meaning "surrounding the heart") is a membranous sac that surrounds the heart. It consist of two layers called the visceral pericardium (adheres to the epicardium) and parietal pericardium (the outer coat). The space between these two layers is called pericardial cavity and it contains pericardial fluid.

𝙃𝙚𝙖𝙧𝙩 𝘾𝙝𝙖𝙢𝙗𝙚𝙧𝙨 𝙖𝙣𝙙 𝙑𝙖𝙡𝙫𝙚𝙨

The human heart has four chambers, which are responsible for pumping blood and maintaining blood circulation throughout the body. 

The four chambers are named:

The right atrium

The left atrium

The right ventricle

The left ventricle

Blood is only pumped to one direction. Four heart valves ensure that blood does not flow backward within the heart.

𝙏𝙝𝙚 𝙁𝙤𝙪𝙧 𝙃𝙚𝙖𝙧𝙩 𝙑𝙖𝙡𝙫𝙚𝙨 𝙖𝙧𝙚 𝙉𝙖𝙢𝙚𝙙:

*• The tricuspid valve (from tri- + cuspid, meaning "having threepoints") located between right atrium and ventricle.

* The pulmonary valve (from pulmon/o, meaning "lungs") located between right ventricle and pulmonary artery. Also called semilunarvalve.

*• The mitral valve, also called bicuspid valve ( from bi-+ cuspid, meaning "having two points") located between left atrium and ventricle.

*• The aortic valve located between left ventricle and aorta. The tricuspid and bicuspid valves are also called atrioventricular valves (meaning "located between the atrium and ventricle").

The pulmonary artery will deliver the deoxygenated blood to the lungs, where gas exchange occurs.

Oxygen is taken from the air into the blood (now called oxygenated blood), while carbon dioxide is expelled from the blood into the air. The oxygenated blood returns to the left side of the heart via the pulmonary veins.

The oxygenated blood enters the left atrium.

The left atrium pumps blood into the left ventricle. The mitral valve prevents blood from flowing backward into the left atrium.

The left ventricle pumps the blood into the aorta and systemic circulation. The oxygenated blood is delivered everywhere in the body (besides the lungs).

𝗙𝘂𝗻𝗰𝘁𝗶𝗼𝗻 𝗼𝗳 𝘁𝗵𝗲 𝗛𝗲𝗮𝗿𝘁

The heart functions to circulate blood around the body. The right and left side of the heart pump blood into two different circulations.

The right side pumps deoxygenated (from de- + oxygenated, meaning

"without oxygen") blood into the pulmonary circulation, while the

left side pumps oxygenated blood into the systemic circulation. The right atrium receives deoxygenated blood from the body tissues via the superior (from super- meaning "above") and inferior (meaning below) vena cava (from ven/o meaning "vein").

The blood enters the right atrium, which pumps the blood into the right ventricle. The tricuspid valve prevents blood from flowing backward into the right atrium. The right ventricle pumps the blood into the pulmonary artery via the pulmonary valve.

𝘽𝙡𝙤𝙤𝙙 𝘾𝙞𝙧𝙘𝙪𝙡𝙖𝙩𝙞𝙤𝙣

Blood circulates around the body via two distinct pathways; the pulmonary circulation and the systemic circulation.

Together they create a closed pathways that keep the deoxygenated and oxygenated blood separated.

𝙋𝙪𝙡𝙢𝙤𝙣𝙖𝙧𝙮 𝘾𝙞𝙧𝙘𝙪𝙡𝙖𝙩𝙞𝙤𝙣

Pulmonary circulation begins at the right ventricle, where the deoxygenated blood from the body tissues is pumped into the pulmonary arteries and to the lungs.

In the lungs, the blood exchanges carbon dioxide (waste product of cellular respiration) to oxygen.

The oxygenated blood them travels back to the heart and the left atrium, via the pulmonary vein.

𝙎𝙮𝙨𝙩𝙚𝙢𝙞𝙘 𝘾𝙞𝙧𝙘𝙪𝙞𝙩

The systemic circulation begins at the left ventricle that pumps oxygenated blood into the aorta.

Aorta branches out into smaller arteries, which carry the oxygenated

blood to the rest of the body (with the exception of lungs).

Oxygen is delivered to the body tissues and exchanged to carbon dioxide. The now deoxygenated blood is carried back to the heart and the right atrium via veins.

𝘼𝙧𝙩𝙚𝙧𝙞𝙚𝙨 𝙫𝙨 𝙑𝙚𝙞𝙣𝙨

The blood vessels that carry blood AWAY from heart are called arteries.

The blood vessels that carry blood TOWARD the heart are called veins.

Only in systemic circulation arteries carry oxygenated blood, while in the pulmonary circulation arteries carry deoxygenated blood.

𝗖𝗼𝗻𝘁𝗿𝗮𝗰𝘁𝗶𝗼𝗻 𝗼𝗳 𝘁𝗵𝗲 𝗛𝗲𝗮𝗿𝘁

The contraction of the muscular wall of the heart chambers, called myocardium generates the force to pump blood.

The heart contraction is divided into two phases: systole (meaning "contraction") and diastole (meaning "relaxation").

Blood is pumped from the chambers during a contraction phase. The heart chambers are filled with blood during a relaxation phase.

𝙊𝙣𝙚 𝙧𝙤𝙪𝙣𝙙 𝙤𝙛 𝙝𝙚𝙖𝙧𝙩 𝙘𝙤𝙣𝙩𝙧𝙖𝙘𝙩𝙞𝙤𝙣𝙨 𝙘𝙖𝙣 𝙗𝙚 𝙙𝙞𝙫𝙞𝙙𝙚𝙙 𝙞𝙣𝙩𝙤 𝙩𝙝𝙚 𝙛𝙤𝙡𝙡𝙤𝙬𝙞𝙣𝙜 𝙥𝙝𝙖𝙨𝙚𝙨:

Relaxation phase → Blood flows from the atria into the ventricles passively via open atrioventricular valves.

The atrial systole → Contraction of atria. Pumps the rest of the blood into the ventricles.

The ventricular systole → Contraction of the ventricles. Forces blood into the pulmonary and systemic circulation. (During the ventricular systole, the atria relax and begin to fill with blood arriving from vena cava or the pulmonary veins.

Ventricular diastole → The ventricles and atria are relaxed.

𝗦𝗶𝗻𝗼𝗮𝘁𝗿𝗶𝗮𝗹 (𝗦𝗔) 𝗡𝗼𝗱𝗲

Myocardium contracts after it receives an electrical impulse generated by a specialized tissue located within the right atrium.

This is called the sinoatrial node (SA node), also called the pacemaker of the

heart. The SA node is a bundle of neurons that triggers the contraction of

the atria during the cardiac cycle.

The electrical currents next reach the ventricles, which contract after the atria. The SA node initiates approximately 75 electrical impulses each minute, with

variation between individuals' age and general health

𝗔𝘁𝗿𝗶𝗼𝘃𝗲𝗻𝘁𝗿𝗶𝗰𝘂𝗹𝗮𝗿 𝗻𝗼𝗱𝗲 (𝗔𝗩 𝗻𝗼𝗱𝗲)

This small mass of neuromuscular tissue is situated in the wall of the atrial septum near the atrioventricular valves. Normally, the AV node merely transmits the electrical signals from the atria into the ventricles. There is a delay here; the electrical signal takes 0.1 of a second to pass through into the ventricles. This allows the atria to finish contracting before the ventricles start.

The AV node also has a secondary pacemaker function and takes over this role if there is a problem with the SA node itself, or with the transmission of impulses from the atria. Its intrinsic firing rate, however, is slower than that set by the SA node (40-60 beats per minute)

𝗧𝗵𝗲 𝗣𝘂𝗿𝗸𝗶𝗻𝗷𝗲 𝗙𝗶𝗯𝗲𝗿𝘀

The Purkinje fibers are cells in the inner ventricle walls, just beneath the endocardium. These fibers run between the ventricles to the apex (bottom) of the heart. The Purkinje fibers play a crucial role in the cardiac cycle.

When an electrical stimulus leaves the AV node, it travels via the bundle of His and branches to the Purkinje fibers. These fibers then carry the impulse through the inner wall of each ventricle. This causes the ventricles to contract after the atria contract.

The ventricle contraction forces blood from the right ventricle to the lungs (pulmonary circulation) and from the left ventricle to the body (systemic circulation).

These three elements generate a healthy heart rhythm known as sinus rhythm. The rhythm, or contraction of the heart pumps blood throughout the body. In roughly a minute's time, blood travels from the heart to the body and back.

By : @ummedsaini_

𝙨𝙪𝙥𝙚𝙧𝙛𝙞𝙘𝙞𝙖𝙡 𝙠𝙣𝙤𝙬𝙡𝙚𝙙𝙜𝙚 𝙖𝙗𝙤𝙪𝙩 𝙤𝙪𝙧 𝙗𝙤𝙙𝙮

𝙨𝙪𝙥𝙚𝙧𝙛𝙞𝙘𝙞𝙖𝙡 𝙠𝙣𝙤𝙬𝙡𝙚𝙙𝙜𝙚 𝙖𝙗𝙤𝙪𝙩 𝙤𝙪𝙧 𝙗𝙤𝙙𝙮

1. Number of bones - 206

2. Number of muscles - 639

3. Number of kidneys - 2

4. Number of milk teeth - 20

5. Number of ribs - 24 (12 pairs)

6. Number of chambers in the heart - 4

7. Largest artery. Aorta Normal Blood pressure - 120/80

8. Ph of blood - 7.4

9. Number of vertebrae in the spine - 33

10. Number of vertebrae in the Neck - 7

11. No. of bones in middle Ear-6

12. Number of bones in Face - 14 

13. Number of bones in Skull - 22

14. Number of bones in Chest - 25

15. Number of bones in Arms -6

16. Number of bones in each human ear - 3

17. Number of muscles in the human arm - 72

18. Number of pumps in heart - 2

19. Largest organ - Skin

20. Largest gland - Liver

21. Smallest cell - Blood cell

22. Biggest cell - Egg cell (ovum)

23. Smallest bone - Stapes

24. First transplanted organ - Heart 

25. Average length of small Intestine - 7 m

26. Average length of large intestine - 1.5 m

27. Average weight of new born baby - 2.6

28. Pulse rate in one minute - 72 limes

29. Body Temperature - 36.90 °C (98.40 °F)

30. Average blood volume. 4-5 liters

31. Average life of RBC - 120 days

32. Pregnancy period - 280 days

33. Number of bones in human foot - 33

34. Number of bones in each wrist - 8

35. Number of bones in hand - 27

36. Largest endocrine gland - Thyroid

37. Largest lymphatic organ - Spleen

38. Largest cell - Nerve cell

By : @ummedsaini_

@nursing_education

𝘿𝙍𝙐𝙂𝙎 𝙏𝙤 𝘼𝙑𝙊𝙄𝘿 𝘿𝙪𝙧𝙞𝙣𝙜 𝙋𝙍𝙀𝙂𝙉𝘼𝙉𝘾𝙔

* DRUGS To AVOID During PREGNANCY *

1) 𝐀𝐧𝐭𝐢𝐛𝐢𝐨𝐭𝐢𝐜𝐬 :

▫Fluoroquinolones : (Ciprofloxacin, Ofloxacin, Levofloxacin, And Norfloxacin)

▫Sulfonamides : (Sulfasalazine And Trimethoprim - Sulfamethoxazole)

▫Tetracyclines

▫Streptomycin

▫Nitrofurantoin

** Abnormalities Caused :

Possibility of Bone And Joint Abnormalities. 

(Seen Only In animals). 

2) 𝐀𝐧𝐭𝐢𝐜𝐨𝐧𝐯𝐮𝐥𝐬𝐚𝐧𝐭𝐬 :

▪Carbamazepine

▪Phenobarbital

▪Phenytoin

▪Valproate

** Abnormalities Caused :

Bleeding Problems In The Newborn. To

This Problem Can be Prevented By Taking Vitamin K Orally 30 Days Before Delivery.

Cause Risk Of Birth Defects, Including Neural Tube Defects. 

(Such As Spina Bifida)

Valproate Cause Some (1%) Risk Of Birth Defects, Including Neural Tube Defects. 

(Such As Meningomyelocele),

Cleft Palate, And 

Defects of Face, The Heart, Skull, Limbs and Spine. 

 3) 𝐀𝐧𝐭𝐢𝐡𝐲𝐩𝐞𝐫𝐭𝐞𝐧𝐬𝐢𝐯𝐞𝐬 :

 a) Angiotensin - Converting Enzyme (ACE) Inhibitors :

▪Captopril

▪Benazepril

▪Fosinopril

▪Enalapril

▪Lisinopril

▪Quinapril

▪Ramipril

▪Trandolapril

▪Perindopril

** Abnormalities Caused :

Serious Injury To The Fetus,

May Cause Kidney Damage In The Fetus,

Reduce Amniotic Fluid,

Also Cause Defects Of Lungs, Face and Limbs.

 b) Calcium Channel Blockers :

▫Isradipine

▫Nisoldipine

▫Amlodipine

▫Verapamil

▫Nifedipine (Sustained - Release Only)

▫Diltiazem(Sustained - Release Only)

▫Nicardipine

▫Felodipine

** Abnormalities Caused :

Fluid Retention in the Ankles,

Dizziness,

Headache,

Flushing,

Heartburn,

Tachycardia and

Enlarged Gums. 

Verapamil Also Causes Constipation.

 c) Beta Blockers :

▫Atenolol

▫Bisoprolol

▫Metoprolol

▫Acebutolol

▫Nadolol

▫Penbutolol

▫Propranolol

▫Betaxolol

▫Carteolol

▫Timolol

▫Nebivolol

▫Pindolol

** Problems Caused :

Slow Growth Rate In The Fetus,

Low Level Of Blood Sugar And Low Heart Rate.

 d) Thiazide Diuretics :

▫Chlorothiazide

▫Bendroflumethiazide

▫Hydroflumethiazide

▫Chlorthalidone

▫Methyclothiazide

▫Metolazone

▫Indapamide

▫Hydrochlorothiazide

** Problems Caused :

Decrease In The Level Of Oxygen, Potassium Sodium,

Decrease In Number Of Platelets In The Fetus,

Inadequate Growth Before Birth.

 4) 𝐀𝐧𝐭𝐢𝐚𝐧𝐱𝐢𝐞𝐭𝐲 𝐃𝐫𝐮𝐠𝐬 :

▪Lithium

** Abnormalities Caused :

Poor Feeding, 

Lethargy,

Reduced Muscle Tone,

Nephrogenic Diabetes Insipidus In The Newborn and

Underactivity Of The Thyroid Gland.

 5) 𝐍𝐨𝐧 𝐒𝐭𝐞𝐫𝐨𝐢𝐝𝐚𝐥 𝐀𝐧𝐭𝐢 - 𝐈𝐧𝐟𝐥𝐚𝐦𝐦𝐚𝐭𝐨𝐫𝐲 𝐃𝐫𝐮𝐠𝐬 (𝐍𝐒𝐀𝐈𝐃𝐬) :

▪Naproxen

▪Ibuprofen

▪Aspirin and other Salicylate

** Problems Or Abnormalities Caused:

When Taken In Large Doses,

Probably Miscarriages During The First Trimester,

A Delay Within The Begin Of Labor,

Premature Closing Of The Connection Between The Aorta And Artery To The Lungs (Ductus Arteriosus),

Jaundice,

Necrotizing Enterocolitis (Damage To The Liner Of The Intestine), And (Occasionally)

Brain Injury Within The Foetus And Bleeding Issues Within The Woman Throughout And After Delivery And / Or Within The Newborn When The Medication Is Taken Late In Pregnancy,

A Reduction In The Amount Of Amniotic Fluid. 

 6) 𝐒𝐞𝐱 𝐇𝐨𝐫𝐦𝐨𝐧𝐞𝐬 :

Synthetic Progestins

(But Not The Low Doses Used In Oral Contraceptives)

▫Danazol

When Synthetic Progestin And Danazol Are Taken In The early Stages Of Pregnancy, Masculinization Of A Female Fetus’s Genitals, Sometimes Requiring Surgery For Correction. 

▫Diethylstilbestrol (DES)

Abnormalities Of The Penis In Sons,

Abnormalities Of The Uterus,

An Increased Risk Of Vaginal Cancer,

Menstrual Problems, and

Complications During Pregnancy In Daughters.

 7) 𝐕𝐚𝐜𝐜𝐢𝐧𝐞𝐬 :

Vaccines for Polio, Measles, Mumps or Yellow Fever. 

These Vaccines Causes Potential Infection Of The Placenta And Developing Fetus.

Vaccine For Chickenpox (Varicella) And Rubella.

This Is Associated With Unknow Risks.

8) 𝐃𝐫𝐮𝐠𝐬 𝐔𝐬𝐞𝐝 𝐈𝐧 𝐒𝐤𝐢𝐧 𝐓𝐫𝐞𝐚𝐭𝐦𝐞𝐧𝐭 :

▫Isotretinoin

▫Etretinate

** Problems Caused :

Both Drugs, 

Birth defects, Such As

Small Ears,

Heart Defects, and Hydrocephalus.

While Isotretinoin Also Cause Intellectual Disability And Risk of Miscarriage.

9) 𝐎𝐫𝐚𝐥 𝐀𝐧𝐭𝐢 𝐃𝐢𝐚𝐛𝐞𝐭𝐢𝐜𝐬 :

▫Metformin

▫Glyburide

▫Tolbutamide

By : @ummedsaini_

@nursing_education

𝑺𝒐𝒎𝒆 𝑴𝒆𝒅𝒊𝒄𝒂𝒍 𝑨𝒃𝒃𝒓𝒆𝒗𝒊𝒂𝒕𝒊𝒐𝒏𝒔

𝑺𝒐𝒎𝒆 𝑴𝒆𝒅𝒊𝒄𝒂𝒍 𝑨𝒃𝒃𝒓𝒆𝒗𝒊𝒂𝒕𝒊𝒐𝒏𝒔

🇦​​​​​

ALP : : alkaline phosphatase

ALT : alanine aminotransferase

AST : :aspartate aminotransferase 

AIDS : acquired immunodeficiency syndrome. 

AKA : alcoholic ketoacidosis 

ALL : acute lymphoblastic leukaemia 

AMI : acute myocardial infarction 

ARF : acute renal failure 

AF : : atrial fibrillation

🇧​​​​​

BT : : bleeding time

🇨​​​​​

CBC: :complete blood count 

CP: :complete picture of blood

CXR: : X-ray chest (PA view)

CT : : clotting time

CABG: coronary artery bypass graft 

CAH: congenital adrenal hyperplasia 

CCF: congestive cardiac failure 

CF: cystic fibrosis

CHD: coronary heart disease 

CNS: central nervous system 

COPD: chronic obstructive pulmonary disease 

CPAP: continuous positive airways pressure 

CRF: chronic renal failure 

CSF: cerebrospinal fluid 

CT: computer mography 

CVA: cerebrovascular accident (stroke) 

CVD: cardiovascular disease 

CCK: :cholecystokinin 

Ca : : calcium

🇩​​​​​

DM:diabetes mellitus 

DKA: diabetic ketoacidosis 

DU: duodenal ulcer 

DVT: deep vein thrombosis 

🇪​​​​​

ECG: electrocardiography/ or cardiogram 

EEG: electroencephalogram 

ESR: erythrocyte sedimentation rate 

ESRD: end-stage renal disease 

🇫​​​​​

FPG: fasting plasma glucose 

🇬​​​​​

GIT: gastrointestinal tract 

GU: gastric ulcer 

GvHD: graft versus host disease 

GGT: :gamma glutamyl transpeptidase

GGT: : gamma glutamile transpeptidase

GTT: : glucose tolerance test

🇭​​​​​

HTN : : high/ blood pressure,@hyper tension 

HAV: hepatitis A virus 

HBV: hepatitis B virus 

Hcg: human chorionic gonadotrophin

HAV : : hepatitis A virus

HBV @ HBs Ag hepatitise B antigen

HCV hepatitis: C virus 

HIV: human immunodeficiency virus 

HNA: heparin neutralising activity 

🇮​​​​​

INR: : international normalized ratio/rate

IFG: impaired fasting glucose 

IGT : impaired glucose tolerance 

IHD: ischaemic heart disease 

Ig: immunoglobulin 

IM: intramuscular 

INR: international normalized ratio 

ITU: intensive therapy unit 

IV: intravenous 

IVU: intravenous urogram 

ICH: intracranial haemorrhage 

IDA: iron deficiency anaemia 

IDDM: insulin dependent (type 1)

🇰​​​​​

K: : potassium 

KUB: kidney, ureter, bladder (x-ray)/ U-S

🇱​​​​​

LFT : liver function test

LDH: : lactae dehydrogenase

LBBB: left bundle branch block 

LCM: left costal margin 

LFTs: liver function tests 

LIF: left iliac fossa 

LUQ: left upper quadrant 

LVF: left ventricular failure 

LVH: left ventricular hypertrophy 

🇲​​​​​

MC&S: microscopy, culture & sensitivity 

MCH: mean cell haemoglobin 

MI: myocardial infarction 

Min: minutes 

MPD: myeloproliferative disease 

MRI : magnetic resonance imaging 

MS : multiple sclerosis or mass spectroscopy 

🇳​​​​​

Na: : sodium 

NaCl: sodium chloride 

🇴​​​​​

OA : osteo arthritis  

OCP: oral contraceptive pill 

🇵​​​​​

PT: : prothrombing time

PT : :pregnancy test (by urine)

PACWP; pulmonary artery capillary wedge pressure 

PAD: peripheral arterial disease 

PaO2: partial pressure of O2 in arterial blood 

PB: peripheral blood 

PBC : primary biliary cirrhosis 

PCI: percutaneous coronary intervention 

PCL: plasma cell leukaemia 

PE: pulmonary embolism 

PR: per rectum 

PV : : per vagina 

PV: plasma volume

🇷​​​​​

RA : : rheumatoid arthritis

RAS: renal angiotensin system or renal artery stenosis 

RBBB: right bundle branch block 

RBCs: red blood cells 

RCC: red blood cell count 

Rh: Rhesus (monkey)

RIF: right iliac fossa 

RUQ: right upper quadrant 

🇸​​​​​

SGOT : : serum glutamic oxaloacetic transaminase

SGPT : : serum glutamic pyruvic transaminase

SC: subcutaneous 

SDH: subdural haemorrhage 

SOB: shortness of breath 

SM: smooth muscle 

SVC : superior vena cava 

SVCO: superior vena caval obstruction 

SXR: skull x-ray 

🇹​​​​​

TLC : : total leukocytes count

T°: temperature 

t1/2: half-life 

T4: thyroxine 

TA: temporal arteritis 

TB: tuberculosis 

TFT: thyroid function test 

TIAs: transient ischaemic attacks 

TPO: thyroid peroxidase 

TRAB: thyrotropin receptor antibodies 

TSH : thyroid-stimulating hormone 

TT: thrombin time 

🇺​​​​​

u/U: units 

UC: ulcerative colitis 

U&E: urea and electrolytes 

UCE: : urea creatinine & electrolytes 

URTI: upper respiratory tract infection 

UTI: urinary tract infection 

USS: ultrasound scan 

🇻​​​​​

VIII: C factor VIII clotting activity 

VIP: vasoactive intestinal peptide 

Vit K: vitamin K 

VSD: ventricular septal defect 

🇼​​​​​

WBC: :white blood cell

By : @ummedsaini_

                               @nursing_education

How to take care of your (internal) body parts...?

⏩TAKE CARE OF YOUR (INTERNAL) BODY PARTS/ORGANS.

1) The STOMACH is injured when you do not have breakfast in the morning.

(2) KIDNEYS are injured when you do not even drink 10 glasses of water in 24 hours.

(3) The GALLBLADDER is injured when you do not even sleep until 11 o'clock and do not wake up to the sunrise.

(4) The SMALL INTESTINE is injured when you eat cold and stale food.

(5)The LARGE INTESTINES are injured when you eat more fried and spicy food.

(6) The LUNGS are injured when you breathe in smoke, dirt and polluted environment of cigarettes and bidi.

(7) The LIVER is injured when you eat heavy fried food, junk, and fast food.

(8) The HEART is injured when you eat your meal with more salt and cholesterol.

(9) The PANCREAS is injured when you eat more sweet because of the taste and freely available.

(10) The EYES are injured when you work in the light of mobile and computer screen in the dark.

(11) The BRAIN is injured when you start thinking negative thoughts.

Take care of the parts of your body and do not scar them.

All these parts are not available in the market. Those available are very expensive and probably cannot be adjusted in your body.

Pls take care of your body, not everything is a spiritual....

So, keep your body parts HEALTHY.

By : @ummedsaini_

                               @nursing_education

Lab Test🧫🧪

*Medical and Nursing Lab.DiagnosticTest*

1. AdomTest- Scoliosis

2. Allen test- ABG Analysis

3. Aldehyde test- Leprosy

4. Phosphate test- Pasteurization

5. Patch Test- AllergicReaction

6. Tourniquet Test- Dengue

7. Urea BreathTest- H.Pylori

8. Schick test- Diphtheria

9. Dick Test- Scarlet Fever

10. Rothers test- Acetone in Urine

11. Hey Test- Bile Salt in Urine

12. Smith test- Bile Pigment in Urine

13. Benedict Test- Glucose in urine

14. KveimTest- Sarcoidosis

15. Rinne & Webber test- Hearing

16. Direct Coomb test- Hemolytic Anemia

17. IschiaraTest- Color Vision test

18. Snellen Chart Test- Distance Vision

19. Confrontation Test- Central and Peripheral Vision

20. Jegar's type Card test- Near Vision

22. SchilingTest- Vitamin B12 Absorption

23. HistamineTest-Leprosy

24. RollerOverTest- Pre-Eclampsia

25. Fern Test or Nitrizine Test- leakage of Amniotic fluid

26. VDRLTest- Syphilis

27.VMA(VanellylMandelicAcid)- Pheochromocytoma

28. GlucoseToleranceTest-DiabetesMellitus

29. Glycosylated Hemoglobin/Hb1AC Test- DiabetesMellitus

30. WaterDeprivation Test- Diabetes Insipidus

31. Treadmill/StressTest-HeartFunction

32. TripleTest- DownSyndrome

33. D-DimerTest-measuring Clot formation(DVT,P

E,DIC)

34. TrendelenburgTest- VericoseVein

35. Phallen/TinnelTest- Carpal Tunnel Syndrome

36. Gold QuntiFeronTest- Tuberculosis

37. BangleTest- Protein Energy Malnutrition

38. TensilonTest- MyastheniaGravis

39. Romberg Test- Neurological Function/balance or gait

40. KneeKissTest- Meningitis in Children

41. Tzank Test- Herpes Genital or Vericella

42. FrieTest- Lymphogranuloma inguinale

43. WidalTest-Typhoid(on2ndweek)

44. Weilfelix test-Typhoidfever

45. BonnyTest/MarshallTest- Stress Incontinence

46. Binnet Test- IntelligenceQuotient

47. SweatChlorideTest- Cystic fibrosis

48. HangingDropTest- Cholera

49. Paul bunnel Test- EpstienBarrVirus

50. ShakeTest/BubbleTest- Surfactant and fetal Lungs maturity

51. RubinTest- Patency of FallopianTube

52. TapeTest- PinWorm

53. OrthoTolidinTest- Check Chlorine in Water

54. DexaScan- Bone Metabolic Disease(eg.Oste

oporosis)

55. Heel to Shin Test-Body Coordination Test

56. HaloTest- CSF Leakage

57. Dexamethasone Suppression Test- ACTH or Pituitary/Adrenal gland tumor

58. Arthrocentesis- Joint inflammation and Infection

59. Holter Monitoring- 24HourECG Monitoring in Dysrhythmia

60. PulmonaryFunctionTest- measure lung volume and Capacity (By-Spirometer)

61. SGOT&SGPT AST/ALT-LiverFunctionTest

62. PAP’sSmear- Cancer of cervix

63. Creatinine Clearance Test- estimation of GFR

64. Wood's Light Examination- Superficial Infection of Skin

65. Burrow Ink Test- Scabies/The Itch

66. BradenScale-to Measure integrity of Bed Sore

#CancerDiagnosticTest :-

■ CA15-3–BreastCancer

■ CA19-9– GIT (Pancreatic,LiverCancer)

■ CA125–OvarianCancer

#AIDSDiagnosticTest :-

■ ELISA Test- Screening for HIV

■ Western Blot Test- Confirmative Test for HIV

■ CD4Count- Predictor Of HIV (<200)

■ P24 Antigen Assay Test- Indicates Active HIV Replication or seen in

Pregnancy & children's

By : @ummedsaini_

@nursing_education

MUST KNOW NUMBERS

MUST KNOW NUMBERS

BP: 

Systolic 90-140 mmHg

Diastolic 60-90 mmHg

HTN systolic > 140

Hypotension systolic <90

Pulse Pressure: > 40

syst. - diast.

MAP: 70-100 *at least 60 to perfuse

tissue

         syst. + (diast. x2)

                  3

HR: 60-100, brady <60, tachy >100

Temp: 36.5-37.5/97-99

LOC: awake + alert, lethargic,

obtunded, comatose

Pain: 0-10

Blood Glucose: 4-7 mmol/L /80-120

mg/dL

Stroke Volume: 60-80 mL per

contraction

Cardiac Output = SV x HR

Troponin: specific to myocardial

infarction

BNP: indicates heart failure 

Arterial Norms: PaCO2 35-45

Newborn Vital Signs: HR 120-160, RR 30-60, SBP 50-70 mmHg, T 36.5

37.5

LABS:

K+: 3.5-5.0

Na+: 135-145

Ca+: 8.5-10.5

CI: 80-100

Mg+: 1.5-2.5

BUN: 7-20 mg/dL

Creat: 0.7-1.3

RBC: 4-6 million; (low anemia, high= polycythemia)

Hgb: 12-16 g (female), 14-18 g (male)

WBC: 5-10 K

Platelets: 150-400K

PTT: 20-36 seconds

If on heparin: 1.5-2.5x normal

INR: 0.9-1.8

2-3, if on warfarin

Parkland Formula: 4 mL x BSA (% of body burned) x kg

@nursing_education

                                    By : @ummedsaini_

IMMUNOGLOBULINS(Ig) IMPORTANT POINTS

💥IMMUNOGLOBULINS IMPORTANT POINTS 

1. Ig that crosses the placenta ........... Ig G .

2. Ig present in milk .......... Ig G and Ig A

3. Ig in sero-mucinous glands ............Ig G and Ig A

4. Ig in primary immune response..............Ig M

5. Ig in secondary immune response.........Ig G

6. Ig with maximum molecular weight .............Ig M

7. Ig with maximum sedimentation rate .........Ig M

8. Ig with minimum sedimentation coefficient ........Ig G

9. Blood group antibodies belong to which type of immunoglobulins ....Ig M

10. Rheumatoid factor belongs to which type of immunoglobulins ............Ig M ( antibody against Fc fragment of Ig G )

11. Immunoglobulin that is heat labile ..........Ig E .

12. Immunoglobulin mediating the prausnitz kustner reaction ...........Ig E

13. Ig appearing first in life..........Ig M

14. homocytotropism is seen in which Ig..............Ig E .

15. Ig with maximum serum concentration ........... Ig G

16. Ig with minimum serum concentration ............Ig E

17. Ig with longest half life ........... Ig G

18. Ig with shortest half life .............Ig E

19. Ig with maximum synthesis per day ...........Ig A

20. Ig with minimum synthesis per day ............Ig E

21. Ig responsible for hypersensitivity pneumonitis .........Ig G

22. binary exposure to an antigen results in sudden increase in..........Ig G

23. Ig to fix complements via classical pathway.......... Ig G1 and Ig M

24. Ig to fix complements via alternate pathway ........Ig A , Ig D , Ig G

By : @ummedsaini_

Nursing Education's