Case 6

The patient has a history of respiratory infections, and has a chronic cough that is worse in the morning. Patient is a smoker since he was a teenager (about one pack a day).VS: T 37C, P 72/min, BP 120/80 mm HG, BMI 28Laboratory tests:FEV1 measurement: 70% of expected.Chest radiograph: normalArterial blood gases: PO2 75, PCO2 42, pH 7.32Questions1) Describe spirometry.2) What is physiologic dead space?3) Describe where gas exchange takes place, and which cells make up the respiratory membrane?4) What is FVC and what is FEV1? What types of pulmonary diseases could change FEV1, and how?5) What is the diagnosis, and describe in detail the cellular cause of this pulmonary disease?6) What is partial pressure? Describe how gain in elevation (-12 ft to 13000 ft; Amsterdam to Breckenridge, CO) will change the ability of this patient to breath correctly in terms of partial pressures of O2 and CO2.7) How are arterial PO2, PCO2 and blood pH related, and explain the chemistry of CO2 gas exchange between the cells, blood, and the pulmonary system and the associated changes in blood pH levels.