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Respiratory Failure: Hypoxemia, Hypercapnia and Hypoxia

The inspiration of oxygen and expiration of carbon dioxide are vital functions of the human body. A decrease in PO2 and increase in PCO2 can alter many normal physiologic processes, and may eventually be fatal. The human body has various reflex mechanisms to manage such changes. Understanding of these reflexes and identification and management of any impairment in them is essential in the management of many respiratory and renal diseases.

Arterial Blood Gas (ABG) Analysis

ABG analysis is an indispensable test for critically ill patients or patients treated in an ICU. Interpretation of ABG analysis seems complicated; however, an understanding of the basic physiology can ease the interpretation. In this article, the basic physiology behind ABG analysis and a stepwise approach to interpreting ABG analysis will be discussed in detail.

Chronic Bronchitis — Symptoms and Treatment

Chronic bronchitis is characterized by expectoration for a period of more than three months, in more than two consecutive years. Chronic irritation caused by smoking promotes hyperplasia of mucus glands and increases the production of mucus. Central and peripheral airways are involved in the pathophysiology of the disease and it includes inflammation, oxidative stress, inhibited repair processes, and an imbalance of proteinases/anti- proteinases. This article will prepare you perfectly well for your next exam!

Pulmonary Function Tests (PFT)

Pulmonary function tests (PFT) are a battery of tests that measure lung function and aid in the management of patients with respiratory disease. They are performed using standardized equipment and can be used for diagnosis, prognostication, management and follow-up of patients with pulmonary pathology. Although PFT may not identify the exact pathology, it broadly classifies respiratory disorders as either obstructive or restrictive. In this article, the role of PFT in the measurement of lung mechanics and diagnosis of various diseases will be discussed in detail.

Dyspnea (Shortness of Breath) — Causes and Symptoms

Dyspnea or shortness of breath is a normal manifestation of heavy exertion, but it can also be caused by different underlying diseases, therefore understanding the etiology, pathophysiology and differential diagnosis of dyspnea is important in the diagnosis of serious underlying clinical conditions. In this article, the etiology, pathophysiology and differential diagnosis of dyspnea will be discussed in detail.

Emphysema — Causes and Treatment

Emphysema is a condition characterized by the dilation of air spaces, with decreased elasticity and increased compliance, due to alveolar wall destruction; capillaries are also destroyed along with the alveoli. The most common cause for developing emphysema is smoking. Alpha-1-antitrypsin deficiency may also result in the development of emphysema.

Cough and Wheezing — Definition and Treatments

A cough is one of the common presenting symptoms in the clinic and is associated with a number of respiratory and non-respiratory diseases. It can have a number of distinguishing characteristics such as quality, sputum production, timing, onset, duration and associated symptoms. The physiological mechanisms underlying cough involve a reflex arc with a command center in the medulla. Common non-respiratory causes include gastroesophageal reflux disease and postnasal drip, whereas, the most common respiratory etiologies are infectious diseases, chronic obstructive pulmonary disease, asthma and interstitial lung disease. Wheezes are high-pitched, loud sounds that usually accompany asthma, while stridor is most prominent with upper respiratory obstruction. In this article, physiology, different causes of cough and wheezing will be discussed in detail.

Bronchiectasis — Diagnosis and Treatment

Bronchiectasis can develop from chronic lung diseases or pulmonary infectious diseases. Since it is irreversible, it is most important to diagnose it timely. Only then, it is possible to prevent it from progressing by implementing appropriate measures. This article will introduce you to the pathophysiological and etiological basics of bronchiectasis, and will prepare you for the treatment of affected patients.

Cystic Fibrosis (CF, Mucoviscidosis) — Symptoms and Diagnosis

Mucoviscidosis or Cystic Fibrosis is the most common congenital and early lethal metabolic disease in Europe. Only if diagnosed early do those affected stand a chance of living beyond young age. The following article summarizes all the facts on formation, diagnosis, therapy and prognosis of mucoviscidosis. This will prepare you comprehensively for clinical exams, practical trainings and your final exam.

Chronic Obstructive Pulmonary Disease (COPD) — Classification, Symptoms and Diagnosis

Chronic obstructive pulmonary disease (COPD) is the most common chronic disease of the airways that is caused in 90 % of cases by smoking. COPD is a preventable and treatable disease. However, many patients do not know that they suffer from the disease, so the number of unreported cases of patients is very high. In this article, you will find important information on the epidemiology, etiology, pathophysiology and diagnosis, as well as the differential diagnosis and treatment of COPD.

Asthma (Bronchial Asthma) — Classification, Diagnosis and Treatment

It is the chameleon of pulmonology: With as many different clinical phenotypes, making a diagnosis isn’t always easy, and pathogenesis is complex. In the following article, you will find all the important information about one of the most common chronic diseases in human beings: bronchial asthma.

Diagnostic Imaging: X-Ray and CT Scan in the Integrated Pulmonary Pathology

Radiological investigations like x-ray and CT scan are required for the confirmation of clinical findings. The field of radiology in the 21st century has become very advanced and through various radiological investigations, even the smallest calcifications and vascular pathologies can be diagnosed. The chest radiograph (CXR) is the most common radiological investigation.

A-A Gradient & Alveolar Gas Equation – Laboratory Diagnostics

A-A Gradient & Alveolar Gas equation are very evident to determine various causes of hypoxemia. Alveolar gas equation is useful for calculation of the partial pressure of oxygen in lung alveoli and A-A Gradient is the value that shows the difference between alveolar oxygen pressure and arterial oxygen pressure. The etiology of hypoxemia can be hypoventilation, diffusion impairment, and presence of shunt, V/Q mismatch and high altitude. The variation in the values of alveolar gas equation and A-A Gradient establish the laboratory diagnosis of the lung pathologies.

Modes of Ventilation

Sometimes ventilation is the only way to save a patient's life. Here you'll read about the different forms of mechanical ventilation, how it is different from spontaneous breathing and what modes of ventilation exist.

Anatomy of the Respiratory System and the Respiratory Muscles

Without oxygen, the human organism is not capable of living. It gains a major part of its energy from oxidative degradation of nutrients. The processes involved in this are called pulmonary respiration or external respiration. The carbon dioxide that is formed in the process of combustion has to be released. The gas exchange between air and blood takes place in the lung. When nutrients are degraded in order to gain energy, oxygen is consumed – a process that takes place in every individual cell of the body and is therefore called cell respiration or internal respiration. The detailed processes of cell respiration are the subject of biochemistry and will not be discussed here.

Hemoptysis — Etiology and Diagnostic Approach

Hemoptysis can be defined as the expectoration of blood during coughing that originates from the lower respiratory tract. Per this definition, coughing of blood from an upper respiratory tract illness can be excluded. While coughing blood can be alarming to the patient, it is usually a self-limiting symptom. In clinical practice, only 5% of the patients who present with hemoptysis are found to have a serious medical condition that needs further treatment.

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Introduction to Pulmonary Pathology 00:48 h / 11 videos 11 free

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Respiratory Failures 01:00 h / 11 videos

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Obstructive Lung Disease 02:00 h / 22 videos

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Day 92: Respiratory – Watch Videos

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Carlo Raj, MD

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