1. Gilead -Topics in Human Pathophysiology Fall 2009 Drug Safety and Public Health

2. Respiratory system and Disease Respiratory System structures – Airways – Respiratory interface – Gas transport – Lungs and ventilation Selected Respiratory Disorders

3. Unlabeled Figure 10.1

4. Figure 10.1

5. Respiratory Interface Alveolar wall Capillary wall Surfactant Gas Exchange occurs by diffusion

6. Figure 10.8

7. Gas Transport Oxygen Carbon dioxide

9. Figure 10.7

12. Respiratory Disorders H1N1 Asthma Cystic fibrosis Pulmonary aspergillosis Pneumonia

13. H1N1 Cause – Influenza A virus Symptoms – Fever – Sore throat – Cough – Body aches – Headache – Chills – Fatigue – Vomiting and diarrhea

14. H1N1

15. Susceptible populations Antivirals for influenza – Tamiflu (oseltamivir), Relenza (zanamivir), peramivir Complications – Pneumonia and respiratory failure – Bronchitis – Ear infections – Sinus infections

16. Asthma

17. 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.

19. 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

20. Pulmonary Aspergillosis from an AIDS patient during autopsy http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijid/vol 6n1/aspergillosis.xml

21. 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)

22. Pneumonia

23. Tests for Lung Function Chest X-ray (CXR) Pulmonary function tests Sputum cultures Pulse oximetry Arterial Blood Gases (ABGs)

24. Pneumonia X-ray http://www.med-ed.virginia.edu/courses/rad/cxr/pathology3chest.html

25. Figure 22.16a Pulmonary Function Tests

26. Figure 22.16a FEV 1 Should be at least 80% of VC FEV 1 Should be at least 80% of VC (VC)

27. Sputum Culture Patient donates a sputum sample It is cultured with various media to determine causative agent of lung infection

28. Pulse Oximetry Measures arterial hemoglobin oxygen saturation Normal is > 95% Indicator of effectiveness of respiratory interface and gas diffusion

29. Arterial Blood Gases pH PCO 2 PO 2 O 2 Saturation HCO 3 -