study group for aspiring pce,npte students

hi meenakshi nice to see you again, ill add to you in my group when you will regularly reply to us, and will regular in group studies.

hi friends the topics from my side are,

1. chronic bronchitis
2. Atelectasis
3. Nuclear imaging techniques for chest diagnosis.

hi swapnil i am happy that you are working hard to make your group members regular in their studies. that is what the real work of a good leader is.

a salute to you buddy:hat

i promise ill cooperate you and will be regular from now

anisha my questions for you as follows

1. differentiate between emphysema and chronic bronchytis?2. can the dilated alvioli be regenerated again?
3. does smoking direcly relates with bhronchytis?

thanks for the answers above swapnil
just one question- can you explain MET's and how you'd use it to determine an exercise programme for an individual?...please,
jess

hey guys.....just some research i found regarding physiotherapy and CF, which id like to share with you and also something to think about!
Thought id put it in bullet points, hence easier to read.

CF research

*antibiotic-mediated reduction in sputum bacterial density improves lung function more than bronchodilators and physio.
*conventional physio is labour-intensive, time consuming, expensive and not frequently available. instead, hidh frequency chest compression (hfcc) usues an inflatable vest linked to an air-pulsed delivery system which can be used as an alternative. it is equally safe when used in acute pulmonary axaccerbations in CF patients.
*....although there is little immediate functional improvement when conventional physio is used on a regualr basis, a 3 week period without conventional methods leads to a worsening of functional status.
*vigorous cough sessions are better than postural drainage and manual techniques alone.
*aerobic training and upper body strength training has shown to increase physical work capacity for children with CF.

...ponder away.....

jess

topics include:
valve stenosis and regurgitation
ARDS
respiratory failure

jess

Hi Ms. Handa

I just went thru ur study group and m interested in joining.
I hope im not too late.
Can u pls let me know how to proceed..

regards
sunil turlapati

hi myself chaitanya frm lucknow but studying final yr in PT.
may i know abt u ?

urrr ok guys....hope this isnt boring the hell outa you since im nt getting any quesyions you all must be awesome physios!!! 8:smokin

ok topics for you include:
1. PVD
2. INPATIENT CARDIAC REHAB
3. OUTPATIENT EXERCISE PRESCRIPTION

oh and also i've been meaning to ask u guys one thing.
i was wondering if someone could shed some BRIGHT light on these key points for respiratory patients:
respiratory acidosis
respiratory alkalosis
metabolic acidosis
metabolic alkalosis
....as well as the compensating mechanisms!

(this bit ALWAYS does my head in!)

suggestions welcome

jess

Jess

Are you studing all that stuff for the practical exam?!!!

nope the written...why?

jess

Hi,

I m a Bach holder in Physio. I want to join the group. Can you let me know the topics ur preparing at this time. I would lik to give PCE and NPTE exams.

Is there any limt on the no. of attempts for the above exams.

when is the gropu coming online for chat.....

Thank You,
regards
sunil turlapati

for jess

jess you asked for met. i hope im not confused with abrreviation if so than re reply.

MET :stands for a metabolic equivalent. a met is defined as the oygen consumed(9mili liters) per kilograms of body weight per minute(ml/kg).it is equal to approx 3.5ml/kg per minute square.

ARDS: it stands for acute respiratory distress syndrome. it is one of the leading pathologies of respiratory system.

a brief overview to ards is

it can be caused by peumonia,sepsis,smoking,aspiration,major trauma burns.

inflamation is caused at alveolar epithilium and pulmonary capillaries.pulmonary capillaries become more permeable allowing plasma and blood to leak into the interstitial and alveolar spaces, while at same time the capillaries get blocked with cellular debris and fibres. the lungs become heavy,stiff and water logged and alvioli collapse.this leads to ventillation/perfusion mismatch and hypoxaemia and patients normally require mechanical ventilatory support to achieve adequate gas exchange.
symtoms usually develop with in 24 to 48 hrs after the origianl injury or illness,but can develop 5-10 days later.

CAN IN THIS WHOLE GROUP GIVE PHYSIO MANAGEMENT OF ARDS


VALVE STENOSIS:

SIGNS:EJECTION systolic murmer
slow rising carotid pulse,redused pulse pressure
left ventricular hypertrophy,thrusting left ventricle
signs of left ventricular failure

symtoms:
exertional dysnoea
angina
pulmonary syncope
sudden death

possible investigations:
ECG(LEFT VENTRCULAR HYPERTROPHY LBBB)
CHEST RADIOGRAPH
DOPPLER
ECHO

MANAGEMENT include aortic baloon valvoplsty but of no long term value for elderly patients

for jess

mitral regurgitation:

it causes gradual dilation of the left atrium with little increase in pressure and therefore relativly few symptoms

causes:
mitral vave prolapse
dilatation of the mitral valve ring
damage to valve cusps and chordae
damage to papillary muscle.
myocardial infarction

respiratory failure:
it is broadly defined as an inability of the respiratory system to maintain blood gas valves with in normal ranges.these are of two types:
type I(hypoxaemic respiratory failure)
a decreased pao2(hypoxalmia) with a normal or low paco2 due to inadequate gas exchange.causes induced pneumonia,emphysema,fibrosing.alveolitis,sever asthma and adult respiratory distress syndrome.

typeII(ventilatory failure)
a decreased pao2 with an increased paco2(hypercapnia) caused by hyperventilation. causes include neuromuscular disorders like muscular dystrophy etc. drug related respiratory drive depressions an increase to chest wall

questions for anisha's topics

1.compare atelectesis of entire lung,right upperlobe,right middle lobe and left upper lobe with each other.
2.discuss radiographic changes seen during lung or lobar collapse.
3.about nuclear imaging tech no queries from my side anisha please difine some by your self

meenakshi smoking is one of the leading factor of major respiratory disorders,

in case of chronic bhronchytis or emphysema also it plays a major role. what was you really wanted to ask with your question?

for physiopati,chaitanyamohansuri,sunnyphysio

if you want to join the group join the current topic and reply regularly

u will get password after some time for password oriented room

wow i was begining to think everyone had vanished!....thanks for the detailed replies however the ards, valve regurgitation and resp failure stuff you kindly added, was actually th topics that i'd prepared. if you were simply adding more info- then thats great. but i hope you didnt think that i'd asked all those questions!!!! much appreciate the METs info. (the question which i asked help with)...all is well knowing what it is...but how can 'we' use it in a clinical setting??

jess

MY TOPICS FOR TODAY ARE

1.SEPSIS
2.LUNG TUBERCULOSIS
3.HAEMOPHILIA

RESPIRATORY acidosis:-
repiratory acidosis occurs when paco2 is elevated.paco2 rises when elemination of carbon dioxide and may occur for variety of reasons.

respiratory alkalosis:
respiratory alkalosis occurs when paco2 is decreased and indicates alveolar hyperventilation. the normal regulation of ventilation can be overridden by a variety of disorders as well as by voluntary control.

metabolic acidosis:
it can be produced by the addition of H+ OR THE loss of hco3-.it can result from an ability to encrete the dietry h+ load or from an acute increase in the h+ load, because of the addition of h+ or the loss of hco3-. acute increases in h+ load can overwhelm the renal excretory capacity,resulting in h+ retention and hence metabolic acidosis.

metabolic alkalosis:
metabolic alkalosis is characterised by a decrease in {h+} and an increase in plasma{hco3-}. a compensatory increase in paco2 is produced by a decreased in va.

jess ipd rehabilitation is not a topic.it is a whole subject to be discussed in 100 of seperations{ex.postural drainage for ipd}

jess the topic which we upload is not only for us its for all so if anything you have read is not always likly to be read by others so dont get annoyed. i promise if ill get some more information in the relevent topics ill send always.


moreover other members will also give some more to us keep waiting
gud bye

thanks very much for the reply. just nice to read it in a different context.
of course i understand that inpatient rehab offers such detail, however my mistake but maybe i didnt type clearly. what i meant to imply were simply general guidelines and initial therapy goals (both short term and long term) from which then we could discuss more in depth therapy. what i was initially thinking of were just simple goals we would need to think about whilst treating the patient in an acute setting for example, functional ADLs, rom, strengthening, patient education, risk factor modification ect ect.

apologises for the mix up in understanding!

hiiiiiii physios
can ny1 tell me about lumber stenosis----wat can we do 4 a patient with lumbar stenosis.

There are many forms of lumbar spinal stenosis. The most common is degenerative stenosis, occurring in virtually the entire adult population as a result of the natural process of aging. The posture of patients with lumbar spinal stenosis while walking is typically bent forward, or, kyphotic. Patients will sometimes describe how they can walk for longer periods in a store only by leaning forward supported by a shopping cart. Extension of the spine will often provoke symptoms while flexion will relieve them. Thus, many patients will stop walking, and bend over or squat to relieve their pain. The patients may only be able to walk a few hundred meters but may be able to ride a bicycle for several kilometers.

While some patients experience a rapid decline in physical function and a rapid increase in symptom severity, for many more, the process of becoming disabled from lumbar spinal stenosis is a slow one.

Conservative treatment typically consists of bedrest and controlled physical activity, physiotherapy, anti-inflammatory drugs, epidural steroid injections and the use of a lumbar corset. While some patients are able to obtain some relief from symptoms with these measures, many others do not. The most common surgical procedure for stenosis is a decompressive laminectomy sometimes accompanied by fusion.


Exercises that encourage lumbar flexion and flattening of the lumbar lordotic curve can be of a clinical benefit to patients suffering from lumbar spinal stenosis. An exercise program must be used 4 to 5 times a week to be beneficial, and any early signs of improvement are observed 4 to 6 weeks after the program has begun. (Nagler, W, Hausen, HS. 'Conservative management of lumbar spinal stenosis. Identifying patients likely to do well without surgery.' Postgraduate Medicine 1998; 103 (4): 69-88)

thanx jaishindia

hey guys,
im going to be in london for a few days so apologies if i dnt reply to your messages!
jess

best of jny jess, i hope this is an professional trip

hello,
im back now and would be happy to answer any qs u had earlier or now! did i miss anything drastic??
jess

hi,

could you please tell me some more about sepsis and how it affects patients and rehab?
jess

could you please define some nuclear imaging techniques which physios are used to seeing.

thanks jess

pulmonary oedema/ effusion
pneumothorax
pneumonia


my topics!!!

is everyone ok with these topics? or were there any questions? happy to help

hey guys, i was wondering if i could get some help or rather discuss some things in a different way. it always helps to know how others describe things.
ok these were my questions;

functional residual capacity with regards to inward and outward elastic recoil?? im getting a little muddle with these.

pressure gradients with regards to intrapleural pressure ect during breathing...

oh and also can anyone suggest why one uses chest drains post pneumothorax even after aspiration? if a pneumothorax is an accumulation of air...then whats the chest drain for??

thanks
jess

i prepared more topics...if anyones interested

fibrosing alveolitis
lung ca
copd

so what is the 1st subject?? what we are going to talk about???

see all...!!!

hello friends,
i am heartly sorry to all of you for not being present for so long. these days of my life went drastically, i got infected by chicken pocks and when i got recovered i again got virul, i hope my situation is clear to you. ill try to come back with same spirit with in two three dayz

hi,

this is just a little off the topic but has anyone considered or know ppl who have taken the npte preparation course or rather the IER Exam Preparation Course? apparently its a two day course which concentrates on the whole exax and applied techniques ect.

any info is welcome
thanks

hello friends,
im back after a long gap.You all are requested to continue again with the same zeal.

swapnil

hello jess,
i have never heard about such course which could be commenced injust two dayz.as soon you get any new information plz do inform us.