Chronic Obstructive Pulmonary Forums This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

two resp questions
Hi - 1) Why does destruction of "lung parenchyma" in COPD lead to pulmonary hypertension? The way I am envisioning it, is that there is simply less tissue so the blood vessels have less resistance and should therefore NOT lead to hypertension. Perhaps you can paint a better picture for me. 2) Shunting increases the A-a gradient as mentioned in First Aid. I wanted to clarify and confirm with yall that they are talking about BLOOD SHUNTING (aka R to L shunt, specifically as seen in the... two resp questions (Source: Student Doctor Network)
Source: Student Doctor Network - February 17, 2018 Category: Universities & Medical Training Authors: aashkab Source Type: forums

RP recurrence of urothelial carcinoma
67 yo woman COPD very poor lung fx (FEV 1 < 1.0) on 4L O2 at rest s/p nephroureterectomy 1 year ago for localized transitional cell carcinoma of the renal pelvis with recurrence in the left retroperitoneum on 6 month fu scan after surgery. Med onc thought it was a nodal recurrence (i feel more likely local recurrence) gave her chemo for a few months; the recurrence was about 1.5 cm in size, now its about 2.5, no other dz has developed. They referred for consideration of RT. Below is the... RP recurrence of urothelial carcinoma (Source: Student Doctor Network)
Source: Student Doctor Network - February 11, 2018 Category: Universities & Medical Training Authors: Haybrant Source Type: forums

Prescription Pad Writing Software: Safety Measures
Prescription Pad Writing Software developed by CompuRx Infotech Pvt. Ltd. is having the ability to check for drug or brand safety in common conditions like pregnancy, lactation, children, elderly as well as in condition of liver insufficiency, renal insufficiency & pulmonary insufficiency. Safety check at individual disease level like in case of G6PD(40 drugs contraindicated), PORPHYRIA ( 223 drugs contraindicated ), HYPERTENSION, COPD etc. is also possible with this software.... Prescription Pad Writing Software: Safety Measures (Source: Student Doctor Network)
Source: Student Doctor Network - January 12, 2018 Category: Universities & Medical Training Authors: Compurx Source Type: forums

Case: Navigational Bronchoscopy
60yoF BMI 51 COPD with bronchodilator and tiotropium, chronic 5L home O2 and BiPAP at night for sleep, asthma, recent TTE HFpEF Grade 1 diastolic heart failure, mild concentric LVH, HTN, HLD, NIDDM2. Has had a chronic dry cough and 1 episode of scant hemoptysis, now RLL lung mass lights up. Undergoing navigational bronchoscopy posted for 5 hours procedural time. ...GO! (Source: Student Doctor Network)
Source: Student Doctor Network - September 28, 2017 Category: Universities & Medical Training Authors: ethilo Source Type: forums

Opioid Refugee Squatting in SNF; Refuses Discharge
Situation: 56 year old morbidly obese female with bilateral hip AVN status post bilateral THA with multiple medical comorbidities (RA, COPD, DM, HTN, and Crohn;s disease) admitted to SNF for post-acute care rehabilitation. Post-op course complicated by DVT and difficult to control pain. Acute care hospitalist RX's FNT TD 150 mcg/hr and oxycodone 30 mg Q 4 hrs PRN BTP prior to transfer to SNF. POD #21 patient now ready for DC to apartment with home health. Background: You... Opioid Refugee Squatting in SNF; Refuses Discharge (Source: Student Doctor Network)
Source: Student Doctor Network - September 24, 2017 Category: Universities & Medical Training Authors: drusso Source Type: forums

VBG vs ABG in neurosurgery
I had a case of a ruptured aneurysm clipping on a patient with COPD yesterday with a poorly functioning A-line. We hyperventilated to an ETCO2 of 19 that correlated to a pCO2 of 32 by A-line. Shortly thereafter we lost the A-line because it just wouldn't draw back. We thought we'd just go off of the EtCO2 at that point and would be fine. On closing, the surgery team noted the brain was too swollen to close the dura. They demanded a pCO2 which we couldn't get off of the A-line. We tried a... VBG vs ABG in neurosurgery (Source: Student Doctor Network)
Source: Student Doctor Network - July 30, 2017 Category: Universities & Medical Training Authors: ethilo Source Type: forums

T2?N1? NSCLC Case - any suggestions?
I have a 77 year old male, long time smoker with COPD (FEV1 ~35% of predicted, DLCO 20% of predicted, on O2 prn). Not a surgical candidate. He was diagnosed with what was initially thought to be a ~4 cm peripheral left upper lobe squamous cell. CT C/A/P negative for nodal or distant mets (non contrast). For whatever reason he had EBUS before PET. All nodes "looked small" so none sampled. Then came PET and a small L hilar ?node? is hot (PET done without IV contrast, so no node was seen... T2?N1? NSCLC Case - any suggestions? (Source: Student Doctor Network)
Source: Student Doctor Network - July 4, 2017 Category: Universities & Medical Training Authors: BobbyHeenan Source Type: forums

2017 psaps
I am currently working through the new Pulmonary/EM 2017 PSAPS. I have completed the COPD and am now working on the CF module. Please DM me if you are currently also working on these modules. (Source: Student Doctor Network)
Source: Student Doctor Network - June 21, 2017 Category: Universities & Medical Training Authors: ChampagnePharmD Source Type: forums

Sevoflurane or Desflurane for COPD?
Which one would you use for a pt. with COPD? (Source: Student Doctor Network)
Source: Student Doctor Network - June 12, 2017 Category: Universities & Medical Training Authors: Dr-Junior Source Type: forums

Question about proceeding w case.
Just curious if you guys would proceed w the case or cancel. Case is lap radical nephrectomy for cystic neoplasm. 60s years old avg sized, has mild copd , htn , smoker/drinker, had SOB 3 months ago found to have large anterior MI on EKG . tte per cardiologist note said 31% ef and lv aneurysm, etc and cleared him. According to patient he said he had stress test sometime after the MI and he thinks it was normal.. Labs today normal. Does get SOB w some exertion. Got a Aicd placed couple week... Question about proceeding w case. (Source: Student Doctor Network)
Source: Student Doctor Network - May 26, 2017 Category: Universities & Medical Training Authors: waterbottle10 Source Type: forums

Supplemental Oxygen induced Hypercapnia Question
Did some research regarding a oxygen-induced hypercapnia in a patient with COPD exacerbation question in UW, and to quote Med-Bullets, 100% supplemental O2 would lead to: Increased dead space to tidal volume ratio worsens V/Q matching because of loss of hypoxic vasoconstriction most important contributing factor to worsening hypercapnia How is it that the loss of hypoxic vasoconstriction increases physiologic deadspace? Wouldn't the vasodilation... Supplemental Oxygen induced Hypercapnia Question (Source: Student Doctor Network)
Source: Student Doctor Network - May 18, 2017 Category: Universities & Medical Training Authors: 403710 Source Type: forums

Lobectomy Fluid Management
Seeking comments and advice from those of you much wiser and more experienced than than I am. (All of you) Question about intraoperative fluid management in this theoretical case: Morbidly obese 67 yo F 5'2" 137kg with COPD and history of delayed emergence presents for right VATS upper lobectomy. Case goes for 8hrs induction to emergence (no conversion to thoracotomy). Difficult DLT placement takes 20 minutes of tweaking to sit right. Ultimately complicated by ~1200ml blood loss, lowest... Lobectomy Fluid Management (Source: Student Doctor Network)
Source: Student Doctor Network - May 2, 2017 Category: Universities & Medical Training Authors: DocMcCoy Source Type: forums

How expiring through pursed lips assists expiration in COPD patients etc?
Forum: Medicine Posted By: MedStudentt Post Time: 01-05-2017 at 01:04 (Source: The Student Room)
Source: The Student Room - May 1, 2017 Category: Universities & Medical Training Source Type: forums

Why is COPD a progressive disease?
(Source: Student Doctor Network)
Source: Student Doctor Network - March 8, 2017 Category: Universities & Medical Training Authors: arossm Source Type: forums

Stereotactic radiation lung mass without biopsy
I am a pain management physician who is active on another forum. While I know that SDN Is not a place for medical advice I hope you will answer a question in general terms. 91 year old former smoker with multiple medical problems including COPD on chronic oxygen therapy and low dose steroids. However she is cognitively 100% intact. Incidentally found on chest CT is left upper lobe mass approx 3 cm in size. Not present on CT one year prior. In younger healthier patient she would be candidate... Stereotactic radiation lung mass without biopsy (Source: Student Doctor Network)
Source: Student Doctor Network - February 13, 2017 Category: Universities & Medical Training Authors: NJPAIN Source Type: forums