-
increased A-a gradient
hypoxemia of pulmonary origin
-
normal A-a gradient
hypoxemia of extra-pulmonary origin
-
Pao2
=%02(713)-arterial Pco2/0.8
-
-
Hypoxemia+increased A-a gradient
- ventilation
- perfusion
- diffusion defects;
- right-to-left cardiac shunts
-
Hypoxemia + normal A-a:
- depress respiratory center,
- upper airway obstruction,
- chest bellows disease
-
Volumes nol diiectly
measured by spirometry:
TLC, FRC, RV
-
-
TLC and RV:
TLC end of maximal inspiration; RV end of maximal expiration
-
Obstructive pattern:
- nonuniform emptying;
- expiratory curve shift lo
- left of normal curve
-
Restrictive parenchymal:
- expiratory curve shifted to
- right of normal curve
-
Choanal atresia:
newborn cannot breathe through the nose; cyanosis when breast-feeding
-
obstructive sleep apnea
respiratory acidosis and hypoxemia
-
OSA(risk and Ds)
- risk for developing cor pulmonale
- polysomnography for Ds
-
Sinus infections
- maxillary in adults
- ethmoid is children
-
nasopharyngeal carcinoma
association with EBV
-
laryngeal carcinoma
- most on true vocal cords
- squamous cancer
-
resorption atelectasis
- airway obstruction by thick secretions;
- MCC of fever 24-36 hours after surgery
-
compression atelectasis
air under pressure or fluid in pleural cavity
-
surfactant 1.(inhibition and increase of synthesis)
2. function
- 1cortisol increases synthesis
- insulin inhibits synthesis
- 2. decrease surface tension
-
Hypoglycemia in newborn:
due to excess insulin in response to fetal hyperglycemia
-
ARDS:
- severe hypoxemia,
- PA wedge pressure < 18mm Hg,
- increased A-a gradient
-
TB:
- acid-fastness due to mycolic acid
- cord factor is virulence faclor
-
Source of pulmonary thromboemboli:
femoral veins
-
Bronchial arteries
protect lungs from infarction
-
Bronchial arteries arise
from aorta and intercostalarteries
-
Pulmonary infarction:
- dyspnea and tachypnea most common symptom and sign;
- respiratory alkalosis;
- hypoxemia
-
Main cause of secondary PH;
respiratory acidosis and hypoxemia
-
-
goodpasture syndrome:
hemoptysis followed by renal failure
-
Restrictive lung disease
- decreased compliance
- increased elasticity
-
restrictive lung disease
- decreased volumes/capacities
- normal to increased FEV1/FVC ratio
-
Particles size 1-5 mm:
bifurcation respiratory bronchioles and alveolar ducts
-
-
Caplan syndrome:
pneumoconiosis and cavitating rheumatoid nodules
-
Silicosis:
- opacities contain collagen and quartz;
- inc. risk lung cancer and TB
- "egg-shell" calcification in hilar nodes
-
Ferruginous bodies:
iron coated asbestos fibers
-
Bronchogenic carcinoma:
most common asbestos related cancer
-
Malignant mesothelioma:
arises from serosa of pleura; encases the lung
-
Sarcoidosis:
- CD4 Th cells interact wilh unknown antigen
- noncaseating granulomas
-
Sarcoidosis:
- inc.ACE
- hypercalcemia due to hypervitaminosis D
- diagnosis of exclusion; rule out other granulomatous diseases
-
Idiopalhic pulmonary fibrosis:
- alveolitis leading to interstitial fibrosis;
- honeycomb lung
-
Collagen vascular diseases with interstitial
fibrosis:
- systemic sclerosis,
- SLE,
- RA
-
Pleural effusion in young woman:
consider SLE
-
Farmer's lung:
- antigen is thermophilic actinomyces moldy hay
- type III and IV hypersensitivity
-
Silo filler's disease:
Inhalation of gases(oxides of Nitrogen]
-
Byssinosis:
- contact with cotton, linen, hemp products;
- "Monday morning blues"
-
Drugs interstitial fibrosis
- amiodarone,
- bleomycin,
- cyclophosphamide,
- melholrexate
-
Centriacinar emphysema:
- destruction of the distal terminal bronchioles and RBs;
- upper lobe
-
Panacinar emphysema:
- targets distal terminal bronchioles and the entire respiratory unit;
- lower lobe
-
Panacinar emphysema;
loss of alpha1-globulin peak on SPE
-
-
Emphysema:
normal to low arterial Pco2, (respiratory alkalosis)
-
IL-4:
IL-5:
- isolype switching to IgE production;
- production and activalion of eosinophils
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