RV failure in chronic bronchitis but not in emphysema - why?

[Phloston]

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Why the RV failure in chronic bronchitis but not in emphysema?

What's the mechanism?

Probably very simple and I had just missed the boat a long time ago.

 

[Kaputt]

I thought both emphysema and chronic bronchitis caused cor pulmonale. In both cases you get pulmonary HTN from hypoxemia which leads to right heart failure.

 

[illegallysmooth]

Why the RV failure in chronic bronchitis but not in emphysema?

What's the mechanism?

Probably very simple and I had just missed the boat a long time ago.

I don't think this is 100% true. But hypoxia is usually worse in CB than emphysema, no?

 

[alternatego]

Emphysema CAN cause RV failure, because with the gradual destruction of the alveolar walls, the pulmonary capillary bed is also being destroyed. This leads to a decreased total surface area of the pulmonary capillary vasculature, increased pulmonary pressure -> RVH and eventual failure.

Hey Phloston, why haven't you been using Pathoma? You have the time and I'm pretty sure Dr. Sattar can add a little bit depth to your knowledge base (I'm not implying that your knowledge isn't deep enough as it is, just that Pathoma is a wonderful resource you might have overlooked).

 

[Kaputt]

Hey Phloston, why haven't you been using Pathoma? You have the time and I'm pretty sure Dr. Sattar can add a little bit depth to your knowledge base (I'm not implying that your knowledge isn't deep enough as it is, just that Pathoma is a wonderful resource you might have overlooked).

Probably because Pollux didn't use it (because it wasn't out back then)

 

[RedSoxSuck]

Probably because Pollux didn't use it (because it wasn't out back then)

I love Dr. Sattar in a bro way!!😍

 

[Kaputt]

I love Dr. Sattar in a bro way!!😍

Maybe I should have done Pathoma. People seem to rave about it. But then again, path was never my weakspot. If there was a Pathoma equivalent for pharm or phys that would have been excellent for me.

 

[Aclamity]

Chronic bronchitis leads to an insane amount of hypoxic vasoconstriction, so cor pulmonale happens pretty early (relative to emphysema). The fact that they're classically known as "blue bloaters" is testament to how hypoxic they really are.

In emphysema it's true you're getting gradual destruction of alveolar-capillary walls and decreased surface area for gas exchange, but in order to get enough destruction to cause cor pulmonale it takes a VERY long time (you'd likely die of other causes first)

 

[Aclamity]

Maybe I should have done Pathoma. People seem to rave about it. But then again, path was never my weakspot. If there was a Pathoma equivalent for pharm or phys that would have been excellent for me.

I only saw a couple pathoma videos (free ones on website) and I kinda wished I had used it throughout MS2. He explains everything so darn well it would've saved me a lot of wiki'ing time throughout the year. In the end I ended up learning everything just as well as I would've with pathoma--it just took me longer. If path wasn't your weak point I'm sure it was the same for you.

 

[Phloston]

Emphysema CAN cause RV failure, because with the gradual destruction of the alveolar walls, the pulmonary capillary bed is also being destroyed. This leads to a decreased total surface area of the pulmonary capillary vasculature, increased pulmonary pressure -> RVH and eventual failure.

Hey Phloston, why haven't you been using Pathoma? You have the time and I'm pretty sure Dr. Sattar can add a little bit depth to your knowledge base (I'm not implying that your knowledge isn't deep enough as it is, just that Pathoma is a wonderful resource you might have overlooked).

Probably because Pollux didn't use it (because it wasn't out back then)

Although Kaputt might be throwing a little dry humor in here, he's right. I'm using a slightly modified version of Pollux's prep.

We've all realized at this point that there are a million different effective resources out there. We just can't use them all.

I view my route as "plan A." If I had to choose a hypothetical plan B though, it would be the hardcore Gunner Training route. There are a few posts I've read over the past several months where 270+ had been achieved with Gunner training having been sworn by. Although some people love it, I've tried it out, and unfortunately it doesn't just give me ADD, it gives me ADHD.

Chronic bronchitis leads to an insane amount of hypoxic vasoconstriction, so cor pulmonale happens pretty early (relative to emphysema). The fact that they're classically known as "blue bloaters" is testament to how hypoxic they really are.

In emphysema it's true you're getting gradual destruction of alveolar-capillary walls and decreased surface area for gas exchange, but in order to get enough destruction to cause cor pulmonale it takes a VERY long time (you'd likely die of other causes first)

Brilliant. That's exactly what I needed. In fact, I'm a little bit too happy right now.

 

[tk0102]

Chronic bronchitis leads to an insane amount of hypoxic vasoconstriction, so cor pulmonale happens pretty early (relative to emphysema). The fact that they're classically known as "blue bloaters" is testament to how hypoxic they really are.

In emphysema it's true you're getting gradual destruction of alveolar-capillary walls and decreased surface area for gas exchange, but in order to get enough destruction to cause cor pulmonale it takes a VERY long time (you'd likely die of other causes first)

The "blue bloater"/"pink puffer" distinction has more to do with differing ventilatory responses to hypercapnia than with differing pathophysiology. Those with the "pink puffer" phenotype are more likely to have compensatory hyperventilation and thus be normocapnic with less hypoxaemia than those with the "blue bloater" phenotype.

I know it's what's in Pathoma. But the explanation doesn't make any sense. "Mucus plugs trap carbon dioxide." Like you couldn't just ventilate that off...

 

[Dallas]

Maybe I should have done Pathoma. People seem to rave about it. But then again, path was never my weakspot. If there was a Pathoma equivalent for pharm or phys that would have been excellent for me.

There is one for pharm.
Kaplan videos with Raymond.

That guy is a god damn genius, the only good thing that has come out of kaplan IMHO.