met abn - puo

[ArchivalUser]

pls explain...I think i have a big confusion.....

[ArchivalUser]

HI,,,USMLGUY,,,WHAT IS THE METABOLIC CHANCHEGES BEFORE AND AFTER COMPENSATION,,,,,,,,Q SHOULD BE LIKE THIS TO BE DISCUSE AWHOLE?PULM EMBOLISIM

[ArchivalUser]

yes absolutely.....

[ArchivalUser]

PUO,,MENTION,,HYPOXIA=HYPERVENT=LEAD TO RESP. ALKALOSI
I SAID IT SHOULD BE HYPERCAPNIA(ACIDOSIS)=THEN HYPERVENT,LATER ON ALKALOIS SO THE PRIMARY CHANGE IS ACIDOSIS

[ArchivalUser]

hmm....

I am not good at explainig but i will still give it a shot !!

Diff.. disorders on the basis of V/Q

1. If there is airway obstruction

V=0, Q=N. So, V/Q=0
No ventilation will lead to inc. PCO2. Pt has airway obstruction, so will get hypercapnia, even if he hyperventilated ...because he cannot ventilate

2. In case of P.E, V=N & Q= 0, so V/Q = infinity

Blood going to the lungs will not be oxygenated------>formation of shunt------>hypoxemia, stimulation of peripheral receptors------> hyperventilation leading to rep. Alkalosis

[ArchivalUser]

SHUNT=FORIGEN BODY IN BRONCHUS,,,, DUE TO HYPOXIC VSOCONSTRICTION
,,,,,,,,,,,,,,,,,,,,, THROMBUS=DEAD SPACE NOT SHUNT

[ArchivalUser]

@usmle_guy, sorry buddy the same problem here, doesn't sound right, but they say that co2 is equual to metabolic rate/alveolar ventilation, so hyperventilation, low co2.
think this way, if one branch of artery is blocked and patient starts hyperventilate, maybe co2 is blown off from the remainder of lung. not sure, but possible

[ArchivalUser]

yes shunting is a problem in ventilation defects and dead space in perfusion defects.like PE..another example of ventilation defect is respiratory distress syndrome where distal airways are collapsed due to absence of surfactant and alveoli wont be ventilated...if there is not much oxygen in alveloi..why would blood go that way?? It just bypasses those crap poor alveoli which have no oxygen( shunting)..

In PE...there is a whole lot oxygen in alveoli coz there is no problem in ventilation...but unfortunetly it is not goin in to the blood coz of that PE....So this oxygen is useless junk oxygen...like a dead person..never involved in gas oxygen...so dead space increased....

[ArchivalUser]

so atlast , wats the answer ?
acidosis or alkalosis ........
in uw is given alkalosis //

[ArchivalUser]

Guys answer is respiratory alkalosis...I confirmed it...Even if there is PE, only some part of lung is affected, rest of the lung is normal so immediate response is hyperventilation and respiratory alkalosis...To have respiratory acidosis there should a big saddle embolus or a major brach of pulmonary artery needs to be blocked...yes...answer is respiratory alkalosis...