histopathologic findings of idiopathic pulmonary fibrosis(IPF)• Patchy areas of chronic interstitial inflammation(lymphocyte infiltration) and ☆interstitial fibrosis intermixed with normal lung
• Early lesions consist of fibroblastic foci that become increasingly collagenous with time
• Honeycomb pattern with fibrotic walls and cystic spaces lined by bronchiolar epithelium
• Fibrosis most prominent in the ☆subpleural and perilobular regions respiratoryUWorld HirotoShishido
pathologic findings in chronic bronchitis
how to evaluate themmucus-secreting gland hypertrophy and hyperplasia
Bronchial gland hyperplasia in the submucosa is the major contributor to
bronchial wall thickening. The severity of this change can be measured by the Reid index.
three forms of carbon dioxide in the body①HCO3-(70%)
HCO3- converted from CO2 in RBCs is transferred out of it via band 3 protein ☆in exchange for chloride ions to maintain electrical neutrality
methemoglobinemia
cause, symptoms, treatmentnitrates(nitroglycerin), nitrites(亜硝酸塩, high altitude water sources), ☆benzocaine(local anesthesia for apthous stomatitis),dapsone
☆chocolate colored blood, cyanosis(☆Fe3+ has ↑ affinity for cyanide→ left shift), pulse oximetry inaccuracy
work of breathingIn patients with restrictive lung disease, the WOB is minimized when the tidal volume is low. Therefore, to compensate for low lung volumes, ☆rapid, shallow breathing is favored (as in this patient).
In contrast, in patients who have obstructive lung disease, the WOB is minimized with lower respiratory rates and higher tidal volumes (ie, relatively slow, deep breathing) (due to faster airflow with increased turbulence) respiratoryUWorld HirotoShishido
the most common presenting symptoms of Pancoast tumor・☆shoulder pain radiating toward the axilla and scapula (involvement of the lower brachial plexus)
Klebsiella pneumoniaCommunity-acquired pneumonia caused by Klebsiella pneumoniae, often affects patients who are malnourished and debilitated, including individuals with a history of ☆chronic alcoholism
