Pulmonary Pathology Exam
2. Pulmonary embolism is the blockage of the pulmonary artery by a blood clot, fat globule, bubble of air or other foreign material. Computerized tomography, namely CT pulmonary angiography, is the most used type of examination, in which the clot can be revealed with the help of radiocontrast (iodinated agents). The V/Q scan is used to determine whether there are some areas of the lung that are not perfused with blood, though ventilated. In order to conduct this examination, gaseous radionuclide for inhaling and intravenous injection of technetium macro aggregated albumin are used. End tidal CO2 monitoring indicates the maximal concentration of carbon dioxide at the end of the exhaled breath, i.e. partial pressure of CO2 during expiration. Normally, the values should vary from 5% to 6%, or 35-45mm Hg. In the setting of pulmonary embolism, the values of ETCO2 are
decreased. It is important to assess the oxygenation status of a patient with PE, which includes measurement of arterial partial pressure of oxygen – PaO2. In patients with lung obstructions it is lower than 90 mm Hg. The symptoms, associated with PE, include shortness of breath, chest pain, rapid heartbeat or breathing,
fainting, bluish skin, cough, and hemoptysis.
3. Category “C” is characterized by the comatose state of a drowning victim with abnormalities in respiratory and motor functions (responses to painful stimuli) and infrequent seizures. Hypotension, abdominal swelling, bluish skin can be observed in a drowning victim. After the cardiopulmonary resuscitation, the respiratory,
cardiovascular, and neurologic evaluation must be done. Normally, a patient should undergo such laboratory tests, as arterial blood gas, serum glucose, chest radiograph tests, as well as renal and liver function tests.
4. 5. Burns can be of different etiology, namely of thermal, chemical, radiation or electrical nature. There are four degrees of burns, depending on the severity of damage to the body, ranging from redness and swelling of the epidermis (1st degree) to drastic damage of tendons and bones (4th degree). On the background of burns, a patient experiences a loss of water and mineral substances, of blood and plasma volume, high inflammation susceptibility, organ failures, and poor immune function.
Case: As a result of the explosion at the chemical plant, several people died and one survived. As for the general patient description, the survivor is a 45-year-old man, 6ft tall, suffered severe burns of the third degree over the upper body half. Due to the leakage of some harmful substance, preceding the explosion, the patient was subject to the noxious inhalation, which caused serious damage to the left lung parenchyma and led to pulmonary edema, i.e. the accumulation of fluid in the tissue and air spaces of the lung. The extent of burns covers the left side of the face (with the sign of smoke inhalation, i.e. carbonaceous …
