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Gilead -Topics in
Human Pathophysiology
Fall 2009
Drug Safety and Public Health
Respiratory system and Disease
• Respiratory System structures
– Airways
– Respiratory interface
– Gas transport
– Lungs and ventilation
• Selected Respiratory Disorders
Unlabeled Figure 10.1
Figure 10.1
Respiratory Interface
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Alveolar wall
Capillary wall
Surfactant
Gas Exchange occurs by diffusion
Figure 10.8
Gas Transport
• Oxygen
• Carbon dioxide
Figure 10.7
Respiratory Disorders
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H1N1
Asthma
Cystic fibrosis
Pulmonary aspergillosis
Pneumonia
H1N1
• Cause
– Influenza A virus
• Symptoms
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Fever
Sore throat
Cough
Body aches
Headache
Chills
Fatigue
Vomiting and diarrhea
H1N1
H1N1
• Susceptible populations
• Antivirals for influenza – Tamiflu (oseltamivir),
Relenza (zanamivir), peramivir
• Complications
– Pneumonia and respiratory failure
– Bronchitis
– Ear infections
– Sinus infections
Asthma
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.
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
Pulmonary Aspergillosis
from an AIDS patient during autopsy
http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijid/vol
6n1/aspergillosis.xml
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)
Pneumonia
Tests for Lung Function
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Chest X-ray (CXR)
Pulmonary function tests
Sputum cultures
Pulse oximetry
Arterial Blood Gases (ABGs)
Pneumonia X-ray
http://www.med-ed.virginia.edu/courses/rad/cxr/pathology3chest.html
Pulmonary Function Tests
Figure 22.16a
(VC)
FEV1
Should be at
least 80% of
VC
Figure 22.16a
Sputum Culture
•Patient donates a
sputum sample
•It is cultured with
various media to
determine causative
agent of lung infection
Pulse Oximetry
•Measures arterial
hemoglobin oxygen
saturation
•Normal is > 95%
•Indicator of effectiveness
of respiratory interface and
gas diffusion
Arterial Blood Gases
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pH
PCO2
PO2
O2 Saturation
HCO3-