Dude your videos are amazing. I'm doing residency and going for my IM final board exam in 3 months. Brushing up on some of the topics I haven't read in a while can be a pain. Seeing your lectures for a topic I need to review provides me with so much relief. Wish I knew about your channel in medschool. Keep it up.
Thank you for simple and knowledgeable explanation. I have one question, why PT. with ARDS sometimes has problem with ventilation (CO2 removal) despite oxygenation is fine?
Please solve my doubt We say that in case of vq defect the aa gradient increase But how does that occur in case of ventilation block I mean when ventilation is zero, there is no air reaching the alveoli for getting exchanged with the blood so the arterial blood po2 (i.e “a” of the Aa gradient drop) But if the ventilation is zero, then there is no air reaching the alveoli and then shouldn’t also the alveoli po2 (i.e “A” of Aa gradient also decrease as there is no incoming oxygen)? And if both A and a are decreasing, then how come (A-a) is increasing
Yess that is only true when you have high VQ mismatch or even shunting.. Due to diffusion problem.. That’s why it’s more important to give high PEEP than fio2.. when their a shunting, increasing FIO2 will only increase PAO2 but little or no effect on PaO2 causing your A-a griedient to be in the 30’s
Medicosis Perfectionalis when I used 0.3 x age and when I use age/4+4 it’s different results. Eg. Assuming pt is 22, using 0.3 x 22=7.3, but when I do 22/4+4 it turns out to be 9.5.
is an increased dead space also a kind of V/Q mismatch? Also ARDS? But they don’t response to 100% oxygen // what does it mean by V/Q mismatch response to 100% oxygen? Thank you in advance
Usually VQ mismatch responses to O2.. when VQ mismatch is extremely low is call Dead space which doesn’t respond to oxygen unless you resolve the perfusion (obstruction) problem.. when VQ mismatch is severely high, it call Shunting and shunting doesn’t respond to oxygen either. So that’s why we use high PEEP to help with that.. I hope this help.. I wish I could explain it better but I’m only an ICU nurse
💊 Endocrine Pharmacology Lectures: www.medicosisperfectionalis.com/
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I love your humor while also explaining things in a way that I can grasp. Bravo!
Thank you so much 😊
Dude your videos are amazing. I'm doing residency and going for my IM final board exam in 3 months. Brushing up on some of the topics I haven't read in a while can be a pain. Seeing your lectures for a topic I need to review provides me with so much relief.
Wish I knew about your channel in medschool.
Keep it up.
am R one
Im
@@ramlaessa9756 it'll get much easier with time, believe me.
Thank you so much!
Thank you so much! I like your profile name :)
thank you sir. not only have you taught this topic well, you've also taught me the art of sass.
Haha 🤣
Thank you for simple and knowledgeable explanation. I have one question, why PT. with ARDS sometimes has problem with ventilation (CO2 removal) despite oxygenation is fine?
Hi, thanks a lot for your videos! Where can we find the answers to the questions to put at the end?
Thank you! Currently watching during the COVID 19 outbreak because my in person classes have been moved online and these videos are helpful!
Thank you so much 😊 for watching!
15:20 when he says answers are in the next video, what video? I looked in "Ventillation/Perfusion Ration" and didn't see anything
Your way of making things easier is great.
Thank you so much 😊
thank you for the video but I can't find the answers to the questions in final section, they were not in your next video.
Awesome video! I'm here cuz of my license exam part 1. Thanks a lot for the concept and humor! Much love❤️❤️
My pleasure!
I'm genuinely studying and laughing at the same time. Thank you ^_^
My pleasure 😇
Please solve my doubt
We say that in case of vq defect the aa gradient increase
But how does that occur in case of ventilation block
I mean when ventilation is zero, there is no air reaching the alveoli for getting exchanged with the blood so the arterial blood po2 (i.e “a” of the Aa gradient drop)
But if the ventilation is zero, then there is no air reaching the alveoli and then shouldn’t also the alveoli po2 (i.e “A” of Aa gradient also decrease as there is no incoming oxygen)?
And if both A and a are decreasing, then how come (A-a) is increasing
The sass in this is real ... and hilarious
Haha 😂
Thanks a lot! you always create good stuff. Keep up the good work!
Thank you so much 😊
This guy....So nice......🎉🎉🎉🎇🎇
Thank you 🙏
Thank you for making it easier.
My pleasure 😇
Still cant really understand T.T .....guess I’m screwed
Excellent!
Thank you!
Thank you
I appreciate you!
This guy is so sassy, so much sass. I'm here for it though, not gonna lie.
:)
Thank you for an extraordinary presentation......
Can you pin answer for the question that you asked at last
Love this but I wish I could slow play you 😊
Kindly give referneces of this charts ? Books?
yea man good stuff it makes sense and its funny
Thank you!
Thank you for the video! In class, we were told that raising oxygen fraction increases the A-a gradient. Would you be able to explain that please?
Can you give me an example?
@@MedicosisPerfectionalis This might be due to diffusion limitation along the alveolar capillaries.
Yess that is only true when you have high VQ mismatch or even shunting.. Due to diffusion problem.. That’s why it’s more important to give high PEEP than fio2.. when their a shunting, increasing FIO2 will only increase PAO2 but little or no effect on PaO2 causing your A-a griedient to be in the 30’s
Hi! Thanks for the video where can i find the answer?
In the next video in the Pulmonology playlist
Nice video.
Thanks 😊
Can someone please post the next video link ty
@medicosis perfectionalis
They are presented in order in the pulmonology playlist.
i thought P Aco2=P aco2..? How can P Aco2 equal Paco2/0.8 in this equation???
What will happen to the gradient in emphysema
Widened A-a gradient.
Love lot
👍👍
on Monday💔 i have exam about this subject online can you do this examInstead of me?😔😔
Thanks👍
Sure!
But, how? 🤪
@@MedicosisPerfectionalis I gave my email and password on classroom and do it😔😭
You can do it, my friend!
Don't be afraid!
@@MedicosisPerfectionalis i study on my lectures and watched your beautiful videos for you ,so i feel l can do it..thank you very much doctor🥀💡
You’re welcome 😇
Good luck 🍀
are you the god of medicine😅😅😅😅😅😅😅
Thank you ☺️
The next video doesn't have the answers in it
The 2 formular for A-a gradient don't match up.
What do you mean?
Medicosis Perfectionalis when I used 0.3 x age and when I use age/4+4 it’s different results. Eg. Assuming pt is 22, using 0.3 x 22=7.3, but when I do 22/4+4 it turns out to be 9.5.
They are not supposed to match exactly.
Go with the agex0.3 that’s what everyone uses
"Here's another stupid formula" LOL Love this video!
Thank you so much ☺️
i didnt understand anything you said
is an increased dead space also a kind of V/Q mismatch? Also ARDS? But they don’t response to 100% oxygen // what does it mean by V/Q mismatch response to 100% oxygen? Thank you in advance
Watch my video on hypoxia.
Usually VQ mismatch responses to O2.. when VQ mismatch is extremely low is call Dead space which doesn’t respond to oxygen unless you resolve the perfusion (obstruction) problem.. when VQ mismatch is severely high, it call Shunting and shunting doesn’t respond to oxygen either. So that’s why we use high PEEP to help with that.. I hope this help.. I wish I could explain it better but I’m only an ICU nurse
@@tijanitunkara2553 Zero VQ is shunting
Lmao I love this video
Thank you 😊
Dude you should be a comedian.:)
Haha 😂
Thank you so much 😊
lol this guy is kind of a jerk but I love it
Hehe 😜
You talk too fast .. sry its bad
You can make it slow):
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Pathetic this is