I usually do not comment on any videos. This is the first time you made you me to log in to my youtube account to just Thank you for explaining it such a easy way. You are the Legend. Hats off to you !
some day, you'll be nominated for a Nobel Prize in medicine, for discovering an effective, succinct, and digestible way to teach medicine to aspiring and current doctors, PAs, nurses and technicians, and vicariously saving millions of lives...
every single video I watch really helps me prepare for my lectures as well as review after. They are AWESOME. highly recommend the notes/subscription. I'm in CRNA school and it is a little bit less of a struggle with your help. Thank you!!!
I really hope you live forever. I can't believe you're also working as a PA-C and providing such great content geared towards med students and PA students.
i started watching your videos for physiology in first year in 2021 during lockdown. Now im in final year and you’re helping me with gen med. thank you.
All your videos are posted 7 years ago , Many students passed by your videos till now and I hope it will reach to many more generations 🤞, Many many many and many more thanks team , Sending Lots of love Zach❤❤
this is great!! so much better than my prof teaching it!! I'm an RT student and would love it if you could do any videos about SABA, LAMA, SAMA, LABA, ICS meds
I've always hated Lung Function Test interpretation, because of how complicated they made it look like, but you made it so much easy and understandable. Thank you so much!
Hii Zach thanks for teaching us in a simple and wonderful way to understand. I have told about ur videos to so many f my friends. Be healthy and happy so that v all r happy
I just want to leave a comment for you ! Although you deserve even more , you are making students life ❤. I want to say thank you 😊 ❤ . Real hero who is helping costs infinity 😊
Thanks for the info and great videos! I have had asthma my whole life and feel like my lungs are working better than ever. I'm trying to understand my numbers from a recent PFT (done for another reason). My recent FEV1/FVC on a test was 64%. I feel like my lungs are super reactive and am 100% sure I have been dealing with asthma for the past 40 years, as diagnosed. I am allergen, exercise, and cold-induced and will wheeze loudly when triggered. I reacted so strongly to the methacholine challenge in the past that they shut down the test after the 1st lowest dose. I have been hospitalized in exacerbations where I needed IV steroids to get my lungs to work again. (I am a triathlete, so I exercise quite a bit, which I think has helped my lungs over the years.) But, for whatever reason, my change after a breathing treatment was only 8%. So, not asthma? If I felt like my lungs were working well before the administration of the albuterol. If my asthma was acting up, I would have expected a bigger change after the breathing treatment. But, not when I feel like I am breathing well. (Apparently, 64% is feeling well for me.) Why is the bar set at 12%? It seems to me that the change would depend on how constricted the airways were beforehand.
Comment ✔ I am in mbbs 1st year but in my free time instead of any so called fun hobby, i just goes to ninja nerd and click to a random video because it doesn't really matter , you can make an infant to understand the concept who just learn to speak language, # Keep up what you care for @ Zack💓❤🔥
hey, your lecture are always so wonderful to me. love you so so much. but if my memory server me right, to do bronchodilator test, the patient inhales 400 micrograms ipratropium which is in SAMA medicine group not SABA.
New things I learn't (for my own future reference) : * the volume loops in spirometry start from 0 which is to the right, hence in restrictive diseases, graph shifts to the right, and loop is smaller from reduced TLC. COPD, graph shifts to left and has kink. Also COPD has increased TLC from the hyperinflation. * If patient comes in with a resp. illness, do spirometry and peak flow meter tests. Those tell you if its obstructive or restrictive diseases (correlate with clinical history and exam). -> If COPD, then extra step here is to give them SABA to see if their FEV1 improves by 12%. If yes then thats asthma, if not then thats COPD -> Next common step in both obstructive and restrictive, is to give them CO and then see how much they exhale. Tells u how much CO is passing into alveoli. Thats the DLCO. If DLCO is low, thats narrows down the diagnosis. If suspicion was obstructive, then low DLCO indicates emphysema over chronic bronchitis. If suspicion was restrictive, then low DLCO indicates that its ILD - interstitial lung disease instead of an extra-pulmnoary cause eg. pectus excavatum etc. * One thing that was not discussed here was the AA gradient. Thats a good indicator to tell what the cause of hypoxaemia is (O2 sat less than 94%). AA gradient = dif. if O2 partial pressure b.w. alveolus and arterial blood. In a perfect world, all the O2 from alveolus would go to artery so AA gradient would be 0. But normal AA gradient is positive, and somewhere bw 5 and 15 (increases as you age, I guess because less O2 able to enter artery). Exact ideal AA = 2.5 + 0.21xage. If person is hypoxaemic, then AA gradient is higher, means some sort of V/Q mismatch exist obviously. Eg. asthma, COPD, bronchiectasis, cystic fibrosis, interstitial lung diseases (ILDs), and pulmonary hypertension etc. If hypoxaemia is present but AA gradient is normal, means diffusion seems to be fine, and cause of low O2 in blood is that less O2 is reaching the alveoli = hypoventilation mainly. Or could be that ur at mt. everest and the O2 in air is too low.
Correction * RV + ERV = Functional residual capacity (FRC). This will increase in obstructive lung diseases and decrease in restrictive ones. TLC will remain the same however.
the criteria you used for interpretration is old and not recommended anymore ,now the ATS and URS recommend to used LLN and Zscore and not used fixed precentage
Literally you are the light of my medical life 😭♥️( thanks for being the bestest teacher ever )
I usually do not comment on any videos. This is the first time you made you me to log in to my youtube account to just Thank you for explaining it such a easy way. You are the Legend. Hats off to you !
some day, you'll be nominated for a Nobel Prize in medicine, for discovering an effective, succinct, and digestible way to teach medicine to aspiring and current doctors, PAs, nurses and technicians, and vicariously saving millions of lives...
Don't get death for atleast 500 years zach. Tonnes of Decades requires you ❤
Really ❤
every single video I watch really helps me prepare for my lectures as well as review after. They are AWESOME. highly recommend the notes/subscription. I'm in CRNA school and it is a little bit less of a struggle with your help. Thank you!!!
I've got an exam in 4 hours
Haven't slept
Thanks for this
It really goes a long way❤
Clear, succinct, comprehensive, as always. I always look for your videos when I need a great explanation of a medical topic.
I really hope you live forever. I can't believe you're also working as a PA-C and providing such great content geared towards med students and PA students.
i started watching your videos for physiology in first year in 2021 during lockdown. Now im in final year and you’re helping me with gen med. thank you.
Just in time for my PFT exam! ❤ you guys!
All your videos are posted 7 years ago , Many students passed by your videos till now and I hope it will reach to many more generations 🤞, Many many many and many more thanks team , Sending Lots of love Zach❤❤
This is one of the most easiest and simpler method of understanding pft … thank u so much mam
this is great!! so much better than my prof teaching it!! I'm an RT student and would love it if you could do any videos about SABA, LAMA, SAMA, LABA, ICS meds
I've always hated Lung Function Test interpretation, because of how complicated they made it look like, but you made it so much easy and understandable. Thank you so much!
Hii Zach thanks for teaching us in a simple and wonderful way to understand. I have told about ur videos to so many f my friends. Be healthy and happy so that v all r happy
I just want to leave a comment for you ! Although you deserve even more , you are making students life ❤. I want to say thank you 😊 ❤ . Real hero who is helping costs infinity 😊
Thank you for saving me before my pulm exam!
as far as respiratory system is concerned , it is always hectic and boring but if teachers like you are present then no boringness !!!! thanks
You are amazing!. Thank you so much. I am looking forward to more videos in the clinical section.
Oh my goodness... So amazing, thank you so much for the whole work
Thanks for the info and great videos! I have had asthma my whole life and feel like my lungs are working better than ever. I'm trying to understand my numbers from a recent PFT (done for another reason). My recent FEV1/FVC on a test was 64%. I feel like my lungs are super reactive and am 100% sure I have been dealing with asthma for the past 40 years, as diagnosed. I am allergen, exercise, and cold-induced and will wheeze loudly when triggered. I reacted so strongly to the methacholine challenge in the past that they shut down the test after the 1st lowest dose. I have been hospitalized in exacerbations where I needed IV steroids to get my lungs to work again. (I am a triathlete, so I exercise quite a bit, which I think has helped my lungs over the years.) But, for whatever reason, my change after a breathing treatment was only 8%. So, not asthma? If I felt like my lungs were working well before the administration of the albuterol. If my asthma was acting up, I would have expected a bigger change after the breathing treatment. But, not when I feel like I am breathing well. (Apparently, 64% is feeling well for me.) Why is the bar set at 12%? It seems to me that the change would depend on how constricted the airways were beforehand.
Could you please make videos about more detail on each test?😊
Comment ✔
I am in mbbs 1st year but in my free time instead of any so called fun hobby, i just goes to ninja nerd and click to a random video
because it doesn't really matter , you can make an infant to understand the concept who just learn to speak language,
# Keep up what you care for @ Zack💓❤🔥
very informative and easy to listen to
God sent you as a gift to medical students
You are a blessing!
Omg! Thank you so much. You simplified it really well ❤
Thank you for the great lecture❤❤
So helpful! Thank you!
Good video, the only suggestion I'd give is that current ATS changed their post bronchodilation significant response value to 10% or greater.
You have greatest gratitude for this
hey, your lecture are always so wonderful to me. love you so so much.
but if my memory server me right, to do bronchodilator test, the patient inhales 400 micrograms ipratropium which is in SAMA medicine group not SABA.
I love this mannnnnn❤❤❤❤❤
This was incredibly helpful!!
The great professor zach🙏
Great explanation 👏🏼❤
What a great content! Thanks NN
great explanation
Thanks for the video!
New things I learn't (for my own future reference) :
* the volume loops in spirometry start from 0 which is to the right, hence in restrictive diseases, graph shifts to the right, and loop is smaller from reduced TLC. COPD, graph shifts to left and has kink. Also COPD has increased TLC from the hyperinflation.
* If patient comes in with a resp. illness, do spirometry and peak flow meter tests. Those tell you if its obstructive or restrictive diseases (correlate with clinical history and exam). -> If COPD, then extra step here is to give them SABA to see if their FEV1 improves by 12%. If yes then thats asthma, if not then thats COPD -> Next common step in both obstructive and restrictive, is to give them CO and then see how much they exhale. Tells u how much CO is passing into alveoli. Thats the DLCO. If DLCO is low, thats narrows down the diagnosis. If suspicion was obstructive, then low DLCO indicates emphysema over chronic bronchitis. If suspicion was restrictive, then low DLCO indicates that its ILD - interstitial lung disease instead of an extra-pulmnoary cause eg. pectus excavatum etc.
* One thing that was not discussed here was the AA gradient. Thats a good indicator to tell what the cause of hypoxaemia is (O2 sat less than 94%). AA gradient = dif. if O2 partial pressure b.w. alveolus and arterial blood. In a perfect world, all the O2 from alveolus would go to artery so AA gradient would be 0. But normal AA gradient is positive, and somewhere bw 5 and 15 (increases as you age, I guess because less O2 able to enter artery). Exact ideal AA = 2.5 + 0.21xage. If person is hypoxaemic, then AA gradient is higher, means some sort of V/Q mismatch exist obviously. Eg. asthma, COPD, bronchiectasis, cystic fibrosis, interstitial lung diseases (ILDs), and pulmonary hypertension etc. If hypoxaemia is present but AA gradient is normal, means diffusion seems to be fine, and cause of low O2 in blood is that less O2 is reaching the alveoli = hypoventilation mainly. Or could be that ur at mt. everest and the O2 in air is too low.
i always recommend you to my friends
Thank you as alwaysss
Can't say thank you enough
Thank you so much for the great video
Thanks .very clear very easy
SEN MÜKEMMEL Bİ ADAMSIN THANK U MAN
thank you ninja nerd
Vera level thalaiva nee
Thank you soooo much ❤
Ilysm zach❤
I will appreciate you forever
Really great 😊
Great job!
The greatest alive♥️♥️
Thank you
Thanks you 😊
Perfect.. thnx alot 🙏🏻
Thank you so much!!
Thank you so much sir
You are the best😍😍
Correction * RV + ERV = Functional residual capacity (FRC). This will increase in obstructive lung diseases and decrease in restrictive ones. TLC will remain the same however.
Great bro,Thank you❤
Great job
its just so so so good
ERV is increased in obstructive diseases? Or is the FRC increased just because RV is increased?
You are a legend 💙💙
these are too good to be available at free of cost.
Can you please come to my college and teach RT. Please we need you! Badly!
zach the great 😍
Thank you so muchhh
God bless you
McLaughlin Inlet
Thanku
Perfect
YES
the criteria you used for interpretration is old and not recommended anymore ,now the ATS and URS recommend to used LLN and Zscore and not used fixed precentage
The best in the world❤
THANK U
i love you dawg
❤❤❤❤ you are amazing 👏
DA GOAT
thank youuuuuu!
🙌🙌🙌 you rock!
Nice
174 O'Keefe Keys
Favt teacher
Awesome
Thank youu
nice
thanks :)
love u bro
Goat ❤️🔥
bro , thank you for uncomplicating this !
Teresa Curve
My broo❤❤❤
Rath Ferry
I just feel like all of us listening to this ar
Martinez William Williams Nancy Lewis Cynthia
❤❤❤
Cooool baby