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Alveolar Proteinosis



Alveolar proteinosis is caused by the accumulation of protein-lipoid substance in the alveoli. The histological picture is characterized by the presence in the lumen of the alveoli of granular exudate with a Schick-positive reaction. Transmitted by autosomal recessive type.

Pathogenesis. A genetic defect leading to the synthesis of a defective surfactant that does not have surface-active properties; this lipoprotein is characterized by a strong SHIC-positive reaction; filling of alveoli with lipoprotein causes changes in lung function and corresponding clinical symptoms: progressive dyspnea, cough, pain in the chest, hemoptysis; further pulmonary heart with corresponding or meeting symptomatology is formed.

Diagnostics.
At a radiography two-sided fine-focal (small-dot) obscurations are defined, having a tendency to merge, fibrotic changes are subsequently revealed.

At a biopsy: presence SHIK-positive substance (acknowledgment or confirmation of the diagnosis).

In electron microscopy, the detection in the alveoli and alveolar macrophages of the surfactant in the form of lamellar bodies.

Treatment. Therapeutic bronchoalveolar lavage; the appointment of trypsin, chymotrypsin.

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Alveolar Proteinosis

  1. Pulmonary alveolar proteinosis
    This is a rare disease, the cause and pathogenesis of which is unknown. Some patients have professional contact with various types of irritating (in particular, siliceous) dust. On the radiographs there is a diffuse darkening of the lung tissue. Macroscopically, in disintegrating lungs, massive dense patches are found, whitish-gray on the incision, emitting a turbid liquid. Under
  2. Disturbance of alveolar ventilation
    Alveolar hypoventilation is a typical form of SVD disorders, in which minute alveolar ventilation (MAP) is less than the body's gas exchange demand. At the heart of the development of ventilation deficiency are the two main mechanisms? a) violation of the biomechanics of respiration (determined by pressure in the pleural cavity, alveoli, airways, gradients of these pressures, tracheobronchial
  3. Alveolar stress of carbon dioxide
    The alveolar voltage of carbon dioxide (РлСО2) reflects the balance between the total production (production) of carbon dioxide (VCO2) and alveolar ventilation (CO2 elimination): РдСО2 = VCO2 / VA, where VA is the alveolar ventilation (Figures 22-21). PcCO2 is much more dependent on the elimination of carbon dioxide than on its production. Although in a stable state the production and elimination of CO2 are equal, with acute
  4. Alveolar microlithiasis
    It is characterized by the formation of minute concrements in the lung alveoli, which consist of calcium carbonate and thiophosphates with a small admixture of iron salts and traces of magnesium. As a result of the deposit of concrements, an alveolar capillary block arises, and ventilation-perfusion relations are violated. It is inherited by autosomal recessive type. Pathogenesis. Formation of concrements in the alveoli
  5. Alveolar oxygen tension
    With each inhalation, the inhaled gas mixture is humidified in the upper respiratory tract at a temperature of 37 0C. Consequently, the oxygen partial pressure in the inspired mixture (PiO2) is reduced due to the addition of water vapor. The saturated vapor pressure depends only on the temperature and at 37 ° C is 47 mm Hg. Art. In humidified air at sea level, PiO2 is 149.3 mm Hg. (760-47) х 0.21 = 149, Змм
  6. Alveolar гіповентиляція внаслідок порушення активності дихальних м'язів
    The pathology is humbled by the incompetence of the mnual aparatus of the thoracic clusci in the diencechanical dihannya. Гіповентиляція - the main reason for malnutrition in the colonies of the colonies, mastastia, poliomyelitis, botulism, pravitsev, otruennyh fosfororganichnymi rechovinami. In hvorih z hirurgichnoyu pathology soi pravoshennya mozhut buti zoumovleni zalishkovoy dіyu m'yazovih relaxants in the early
  7. Acute left ventricular failure is interstitial and alveolar pulmonary edema. Noncardiogenic pulmonary edema.
    Pulmonary edema is cardiogenic and noncardiogenic considered as the immediate cause of death in every fourth deceased person. Pathogenesis. In a healthy person, the hydrostatic pressure in the pulmonary capillaries is 7-9 mm Hg. it somewhat exceeds that of interstitium. The liquid is retained in the capillaries due to its viscous properties, high enough numbers of oncotic
  8. Mounier-Kuhn syndrome
    Clinical picture. From an early age cough with sputum, repeated exacerbations of bronchopulmonary disease, the increase in respiratory failure during exacerbation and with age. Deformation of nail phalanges in the form of "drumsticks." X-ray signs: deformation of the pulmonary pattern with foci of compaction. Expansion of the lumen of the trachea and large bronchi. Bronchiectasis in the lower-lobar
  9. Typical violations of gas exchange function of the lungs.
    Do the following typical violations of gas exchange function of the lungs? 1. Violation of alveolar ventilation? a) alveolar hypoventilation b) alveolar hyperventilation c) uneven ventilation 2. Violation of lung perfusion. 3. Violation of ventilation-perfusion relations. 4. Diffusion of the lungs. Mixed
  10. Idiopathic fibrosing alveolitis.
    Idiopathic fibrosing alveolitis (EIA) is not a single nosology. Currently, ELISA is believed to represent a group of diseases, including the following units: classical interstitial pneumonia, "nonspecific" interstitial pneumonia, desquamative pneumonia, obliterating bronchiolitis with organizing pneumonia and giant cell interstitial pneumonia. Early
  11. The voltage of carbon dioxide in the blood of the terminal pulmonary capillaries
    Fig. 22-21. Effect of alveolar ventilation on alveolar PCO2 at two rates of formation of CO2. (Permission From Nunn JF Applied Respiratory Physiology, 3rd ed. Butterworths, 1987.) The CO2 voltage in the blood of the terminal pulmonary capillaries (Pc'CO2) is almost identical to PdCO2, which is due to the same reasons as for {foto48} oxygen. In addition, we point out that the diffusion rate of CO2
  12. The voltage of carbon dioxide in the final portion of exhaled gas
    The final portion of the exhaled gas is practically an alveolar gas, and PcCO2 is virtually identical to PaCO2, so the CO2 stress in the final portion of exhaled gas, PktCO2, is used clinically to evaluate PaCO2 (Chapter 6). The difference between РлСО2 and РктСО2 in norm does not exceed 5 mm Hg. Art. and is due to the dilution of the alveolar gas with gas from nonperfused alveoli that does not contain CO2 (i.e.
  13. Restrictive pulmonary disease
    Causes of restrictive lung pathology Causes of acute restrictive pathology: • edema of the lungs; • ???? ARDS; •????aspiration; • ???? neurogenic edema; • Overdose of opioids; • ???? congestive myocardial insufficiency; • ???? pleural effusion; •????pneumothorax; • Increase of the mediastinum; • ???? pneumomediastinum. Chronic lung diseases, leading to restrictive
  14. Bronchoalveolar lavage
    This intervention is performed in pulmonary alveolar proteinosis, which is characterized by excessive synthesis of the surfactant and the impossibility of its effective clearance. The disease is manifested by shortness of breath, chest radiograph shows double-sided dimming. Bronchoalveolar lavage is indicated for severe hypoxemia or in the case of progression of dyspnea. Simultaneously spend lavage only
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