VM 536 2024 Day 1 Introduction

Respiratory II Course Overview

Course Mission

  • Integrates basic and pathological sciences with clinical scenarios

  • Focus on clinical disorders of the respiratory system

Course Structure

  • Prep-work: Combination of reading, recorded lectures, VOPP

  • Pre-class quizzes: Two chances to achieve the highest score based on prep-work

  • In-class activities: Team-based lessons around themes with multiple content experts

  • Clinical scenarios: Case-based learning correlates with basic sciences

  • Assignments: Small group assignments (summative) and quizzes (formative)

  • Evaluations: Mid-term and final exams based on lessons

Assignments

  • Written Assignment: SOAP notes based on clinical case

    • Integrates concepts from respiratory diseases

    • Incorporates communication skills

  • Exams:

    • Mid-term on October 24 covering lessons 1-7

    • Final on November 1 covering lessons 8-14, not cumulative

Learning Objectives

  • Understand the path of O2 from air to blood

  • Recall and identify the causes of hypoxemia

  • Master the bicarbonate buffer equation

  • Perform an arterial blood gas analysis

Hypoxemia Causes

  • Identify the big 5 causes of hypoxemia:

    • 1. Hypoventilation: Decreased O2 intake

    • 2. Diffusion impairment: Issues at alveolar-capillary membrane

    • 3. V/Q mismatch: Uneven distribution of ventilation and perfusion

    • 4. Shunt: Blood bypasses the lungs

    • 5. Altitude: Decreased atmospheric pressure

Path of O2 from Air to Arterial Blood

  1. Air Intake: O2 pressure in the atmosphere

  2. Alveolar Gas Exchange: O2 partial pressure in alveoli

  3. Blood Transfer: O2 moving from alveoli to lung capillaries

  4. Arterial Blood Gases: O2 in arterial blood, influencing its partial pressures

Bicarbonate Buffer Equation

  • H2O + CO2 ⇌ H2CO3 ⇌ HCO3- + H+

    • Critical for maintaining pH balance in the body

Arterial Blood Gas Analysis Steps

  1. Sample Collection: Blood sample from arterial source

  2. Analysis:

    • Measure pH

    • Measure PaO2 and PaCO2 (partial pressures)

    • Measure HCO3- levels

  3. Interpret Results: Determine acid-base status

  4. Assess Adequacy of Ventilation: Evaluate CO2 removal efficiency

  5. Make Clinical Decisions: Apply findings to patient management

Important Dates in Course Schedule

  • Mid-term Exam: October 24

  • Final Exam: November 1

Faculty Team

  • Dr. Susan Ewart, Dr. Ioana Sonea, Dr. Steve Carey, Dr. Mayra Tsoi, Dr. Rob Abramovitch, Dr. Linda Mansfield, Dr. Kent Ames, Dr. Roger Maes, Dr. Gisela Hussey, Dr. Ashley VanDerBroek, Dr. Matt Beal, Dr. Deborah Wilson, Dr. Christopher Thibault, and Bharadhwaj Ranganathan.