![]() ![]() Shunt = foreign body aspiration obstructive conditions, e.g., asthma, atelectasis, bronchitis certain restrictive lung conditions, e.g., pulmonary edema, fibrosis. USMLE wants you to know that pulmonary embolism = dead space because this presents a scenario of ventilation without perfusion.Ī shunt refers to pretty much any other cause of lung pathology, where ventilation is reduced for whatever reason. Physiologic (total) dead space = anatomic dead space + alveolar dead space.Īnatomic dead space = ventilation within the conducting zone of the airways that is unable to participate in gas exchange because there is simoply an anatomical lack of respiratory epithelium this includes the trachea, bronchus, bronchioles, and terminal bronchioles in contrast, the respiratory bronchioles and alveoli participate in gas exchange.Īlveolar dead space is ventilation within underperfused alveoli (usually negligible in healthy patients). But this is actually in UWorld for 2CK, and everyone gets it wrong for obvious reasons.ĭead space = ventilation without perfusion We definitely do V/Q scan instead. But if the question asks you what the next best step in diagnosis is after a V/Q scan has already been performed, the answer is still spiral CT. This is where you say, “Wtf? You just said we don’t do spiral CT in pregnant women cuz of the radiation.” Correct, we don’t. Now this is where it gets weird: if they tell you a pregnant woman has a V/Q scan that shows segmental defects (positive for PE), and then they ask you for the next best step in diagnosis, the answer is spiral CT. In pregnant women, do V/Q scan (ventilation/perfusion scan), not spiral CT, because of the radiation. ![]() spinner-icon.ks-button-primary:not(.ks-button-green).ks-button-spinner: embolism –> most common thing you see on an ECG = sinus tachycardia (really HY) –> they might say patient has HR of 92 and that ECG shows no abnormality (same thing that’s sinus tachy) –> first Tx is heparin, then do spiral CT scan of chest. Watch Naruto (2002) Online for Free | The Roku Channel | Roku spinner-rotate.ks-button-primary:not(.ks-button-green).ks-button-spinner:-button-small. ![]()
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