chapter 141

Establecer medidas que ayuden a contrarrestar los efectos del calentamiento global solo ser posible cuando las personas conozcan qu factores lo ocasionan. En primer lugar se encuentra la contaminacin ambiental, consecuencia de las fbricas que no regulan la liberacin de gases txicos y el exceso de vehculos antiguos o en mal estado que usan combustibles fsiles. Por otro lado se halla la liberacin masiva de CO2, que altera la composicin qumica de la atmsfera. Entre otras causas, esto ltimo es producto de los incendios forestales.

Question 1

As a third-year medical student in Russia I am researching 'the role of

proteolytic enzymes and their inhibitors in lung pathology'. Can you

explain how proteolytic enzymes function in the normal lung?

Question 2

Bronchiectasis is given as one of the causes of bronchial breath sounds.

This is difficult to comprehend. Could you explain the mechanism of

bronchial breath sounds more clearly?

Question 3

I have been taught to examine vocal resonance by asking the patient to

say 'ninety-nine' while auscultating. I listen for a louder 'ninety-nine'

over an area of consolidation and more quiet sounds with effusion.

Is this right?

Question 4

What role does bupropion play in giving up smoking?

Question 5

The clinical signs and symptoms of rhinitis are very similar to those of

the common cold (influenza). How do I differentiate between the two?

Question 6

What is the advantage of the drugs des-loratidine and levo-cetirizine

over their parent compounds? Are they safe in pregnancy and lactation?

Question 7

What are the differences between acute bronchitis and pneumonia? Are

both diseases caused by infection?

Question 8

1. If a patient with chronic bronchitis develops obstructive jaundice

and Escherichia coli biliary sepsis, should the routine administration

of oral steroids (e.g. prednisolone) be suspended until liver function

improves?

2. Are there any adverse reactions that preclude the concurrent use of

steroids while the patient is treated with IV ciprofloxacin, gentamicin,

metronidazole and cefuroxime?

Question 9

Robbins Basic Pathology mentions that in patients with chronic obstructive

pulmonary disease (COPD), the forced ventilation capacity (FVC) is

either normal or slightly increased! I just can't justify that. I mean it

should decrease. And this is exactly what is mentioned in your book. I

couldn't contact the authors of that book so I decided to ask you whether

there is actually a situation in which the FVC in COPD patients might

increase?

Question 10

Is there any obstructive pulmonary condition in which there might be an

increase in FVC? If so by what mechanism?