Pulmonary: Take-home Points

Today was our last day of Pulmonary block. We ended with a presentation from a master clinician.

"It's nice to be called a master clinician at least once a day," said our presenter.

Today's presentation was from a pulmonologist, who has extensive expertise in Tuberculosis. Interestingly, one-third of the world's population is infected with TB (1.7 billion people). As expected, TB also represents the leading cause of death due to an infectious disease.

As the studies continue for tommorrow's Pulmonary Exam, I figured I would summarize with the take-home points. See, medical students sometimes have a tendency to scrutinize over the details, akin to paying close attention to the leaves and needles rather than looking at the forest. I am definitely a forest-lover and seeing the big picture remains most important.

In summary, here is pulmonary in a few take-home points:
1. The lungs are two flappy sacs that get bigger and smaller to let air in (inspiration) and air out (expiration). Just do not tell this too a pulmonologist; it may be offensive.
2. Air contains 02, which travels into the blood and tissues. C02 needs to leave the body, otherwise bad things happen (your blood gets acidic and we don't want that to happen, do we?) 3. SMOKING IS BAD--> Smoking introduces toxins that destroy the intricate architecture of your lungs (causing collapse and destruction), making it harder to exhale. So, if you smoke- please quit (you can prevent this!)
4. Asthma is caused by an immune system that goes crazy and sensitive. If you have asthma, try to avoid the things that set off your immune system, even if that means putting up Garfield up for adoption. My apologies.
5. The mechanics of breathing are complicated. Just think pressure (moving from high pressure to low pressure).
6. There are just too many restrictive lung diseases...
7. The chief complaint for most any pulmonary (and usually cardiac) disease is shortness of breath. So, if you present with shortness of breath, the differential is long and so is the work-up.

Ok, I'm procrastinating. Time to return to pulmonary world. Here is the most important take-home: Next time, you plan to use the line: "You take my breath away," to woo anyone, please be sure not to drop this pick-up on a medical student. We will just be concerned that you may have a pulmonary dysfunction.
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Here are some photographs that I took at the UCSF Library. Images illustrate the powerful influence of advertising on promoting smoking. What strikes me most is the young boy (below), with a cigarette. We've come a long way, thankfully...