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Gilead -Topics in Human Pathophysiology
Fall 2009 Drug Safety and Public Health
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Respiratory system and Disease
• Respiratory System structures– Airways– Respiratory interface– Gas transport– Lungs and ventilation
• Selected Respiratory Disorders
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Unlabeled Figure 10.1
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Figure 10.1
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Respiratory Interface
• Alveolar wall• Capillary wall• Surfactant• Gas Exchange occurs by diffusion
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Figure 10.8
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Gas Transport
• Oxygen
• Carbon dioxide
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Figure 10.7
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Respiratory Disorders
• H1N1• Asthma• Cystic fibrosis• Pulmonary aspergillosis• Pneumonia
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H1N1• Cause
– Influenza A virus• Symptoms
– Fever– Sore throat– Cough– Body aches– Headache– Chills– Fatigue– Vomiting and diarrhea
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H1N1
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H1N1
• Susceptible populations• Antivirals for influenza – Tamiflu (oseltamivir),
Relenza (zanamivir), peramivir• Complications
– Pneumonia and respiratory failure– Bronchitis– Ear infections– Sinus infections
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Asthma
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Cystic fibrosis
• Inherited disorder causing a defect in a cell membrane Cl- channel
• Causes thick sticky mucus buildup in airways and ducts of pancreas, etc.
• Shortens lifespan because of pneumonia, malnutrition, etc.
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Pulmonary aspergillosis
• Fungal lung infection• Common with AIDs patients and cystic fibrosis
patients• Treated with Ambisome (amphoterocin B),
one of several antifungals, alters fungal cell permeability
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Pulmonary Aspergillosisfrom an AIDS patient during autopsy
http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijid/vol6n1/aspergillosis.xml
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Pneumonia
• Fluid buildup in lung alveoli• Thickens respiratory interface, interrupting
diffusion of gases• Caused by a wide variety of microorganisms
including aspergillus and pneumocystis fungi, influenza virus (Tamiflu), cytomegalovirus (Vistide)
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Pneumonia
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Tests for Lung Function
• Chest X-ray (CXR)• Pulmonary function tests• Sputum cultures• Pulse oximetry• Arterial Blood Gases (ABGs)
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Pneumonia X-ray
http://www.med-ed.virginia.edu/courses/rad/cxr/pathology3chest.html
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Figure 22.16a
Pulmonary Function Tests
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Figure 22.16a
FEV1
Should be at least 80% of
VC
FEV1
Should be at least 80% of
VC
(VC)
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Sputum Culture
•Patient donates a sputum sample•It is cultured with various media to determine causative agent of lung infection
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Pulse Oximetry
•Measures arterial hemoglobin oxygen saturation•Normal is > 95%•Indicator of effectiveness of respiratory interface and gas diffusion
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Arterial Blood Gases
• pH• PCO2
• PO2
• O2 Saturation
• HCO3-
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