USMLE Step 1: How to solve V/Q mismatch questions, the A-a gradient

V/Q mismatch USMLE Step 1 up and down arrows.
Hey guys, in this video I'll show you an easy way to think about V/Q mismatch questions that have those up and down arrows. You have to understand that an A-a gradient is a representative metric of a mismatch between ventilation and perfusion; V/Q mismatch. Keep watching to learn more!
Instagram: / sugarnoor101

Пікірлер: 43

  • @thegryffindoctor
    @thegryffindoctor3 жыл бұрын

    Thank you so much- you literally explained most of resp physio in such a short video!

  • @acingmedicine

    @acingmedicine

    3 жыл бұрын

    I'm so glad you found it helpful!

  • @rubaalqudah5534
    @rubaalqudah55342 ай бұрын

    Best explanation! thank you very much for sharing this.

  • @acingmedicine

    @acingmedicine

    2 ай бұрын

    Glad it was helpful!

  • @solomonmpalanyi7226
    @solomonmpalanyi72262 жыл бұрын

    Am speechless whatever u touch turns into gold. Best explanation ever for this crap! Now I get it. Thanks lots Noor, and keep up the good work. You deserve an award in my opinion! Now I see why u had a 265, it’s the extra brain u got that most people lack!

  • @acingmedicine

    @acingmedicine

    2 жыл бұрын

    Your comments always leave me speechless Solomon. Thank you so much, Looking forward to hearing that you got the score of your dreams! 💪🏻

  • @mathis20737
    @mathis207373 жыл бұрын

    Great video. Thanks!

  • @acingmedicine

    @acingmedicine

    3 жыл бұрын

    Anytime!

  • @mustafaal-samhouri3846
    @mustafaal-samhouri38463 жыл бұрын

    Wonderful, Thank you.

  • @acingmedicine

    @acingmedicine

    3 жыл бұрын

    Anytime!💙

  • @jorgemd5544
    @jorgemd55443 жыл бұрын

    High Yield video! Thank you very much for all the great content! I have a question, Dr. Ryan says that in hypoxemia with a High A-a gradient there is no increase in CO2, how is that possible?

  • @MalkAhmad02
    @MalkAhmad023 жыл бұрын

    proud of you 🔥👏

  • @acingmedicine

    @acingmedicine

    3 жыл бұрын

    Thank you so much Malak!! ❤️

  • @samarelraie9066
    @samarelraie90663 жыл бұрын

    Thank you for sharing this 🤩🤩

  • @acingmedicine

    @acingmedicine

    3 жыл бұрын

    Glad you liked it!

  • @ezatullaha.3502
    @ezatullaha.3502 Жыл бұрын

    👍🏼

  • @adamjerusalem366
    @adamjerusalem366Ай бұрын

    الله يرضى عنك

  • @acingmedicine

    @acingmedicine

    Ай бұрын

    🤲 امين و عنك

  • @drzainabtahir3554
    @drzainabtahir3554 Жыл бұрын

    Uff.... Finally understood this topic.... Thanks alottttt.

  • @acingmedicine

    @acingmedicine

    Жыл бұрын

    You’re welcome I’m glad it helped!

  • @virajpanchal988
    @virajpanchal9883 жыл бұрын

    Hey, can you make another video explaining the changes of PaO2 , SaO2 and HbO2 with CO and Meth hb? This video is great !

  • @acingmedicine

    @acingmedicine

    3 жыл бұрын

    Sure Viraj, will add that to requests

  • @mahmoudhadhoud9133
    @mahmoudhadhoud91332 жыл бұрын

    Amazing

  • @acingmedicine

    @acingmedicine

    2 жыл бұрын

    Thank you Mahmoud!

  • @aseelalami
    @aseelalami Жыл бұрын

    Thankkkk uuuuuuuuu❤

  • @acingmedicine

    @acingmedicine

    Жыл бұрын

    you're welcome

  • @octaviablink5706
    @octaviablink57063 жыл бұрын

    Very good video, thank you! May I ask what type of V/Q mismatch we would see in a patient with late stages of COPD? Would we have both increased/decreased and shunt?

  • @acingmedicine

    @acingmedicine

    3 жыл бұрын

    With COPD the main problem is ventilation so V/Q is expected to be low resulting in shunt and hypoxemia.

  • @octaviablink5706

    @octaviablink5706

    3 жыл бұрын

    @@acingmedicine Thank you so much Noor. in case we have damaged areas with damaged pulmonary capillaries preventing perfusion, could we also be presented with a high V/Q ratio?

  • @acingmedicine

    @acingmedicine

    3 жыл бұрын

    @@octaviablink5706 in that case yeah, that would be a deadspace

  • @MsEsyC
    @MsEsyC Жыл бұрын

    Can you do a similar video explaining the pathophysiology of the heart and major concept in cardiac physiology, especially pediatric Congenital conditions like tetralogy of Fallot, tricuspid atresia, VSD/ASD etc.? 😮

  • @acingmedicine

    @acingmedicine

    Жыл бұрын

    Alright sure

  • @Be1smaht
    @Be1smaht Жыл бұрын

    What about atelectasis and can you explain DLCO

  • @acingmedicine

    @acingmedicine

    Жыл бұрын

    Atelectasis is a form of shunt due to decreased ventilation in the collapsed alveolus leading to low V/Q ratio DLCO is the diffusion capacity of Carbon Monoxide. We use this as an index to assess how fast diffusion occurs across the alveolar-capillary barrier. The thicker the barrier, the slower the gas exchange; hence, lower DLCO

  • @wingsnotstrings
    @wingsnotstrings3 жыл бұрын

    What’s your concept for the difference between A-a gradient and VQ ratio ? Because if I listen to only the first 2 mins of this video it looks like they’re both the same

  • @acingmedicine

    @acingmedicine

    3 жыл бұрын

    A-a gradient is an index of V/Q mismatch. Because there's a disconnect between ventilation [how much air goes in the lungs] and Perfusion [how much of this air reaches the blood], the PAO2 becomes much higher than the PaO2, thus creating a gradient [which is called the A-a gradient]. I hope that makes sense.

  • @wingsnotstrings

    @wingsnotstrings

    3 жыл бұрын

    @@acingmedicine yes indeed ! Thanks : )

  • @TanTan-ch3vq

    @TanTan-ch3vq

    19 күн бұрын

    V/Q is focused on the rate for air exchange, please note

  • @mahmoudhadhoud9133
    @mahmoudhadhoud91332 жыл бұрын

    Does pnemonia cause a shunt or a vq mismatch?

  • @acingmedicine

    @acingmedicine

    2 жыл бұрын

    it causes a VQ mismatch where ventilation is lower relative to perfusion. The extreme of the VQ mismatch in pneumonia would be a shunt. for example, If the entire alveolus collapses or is fully filled with pus then this part will be a shunt (as ventilation becomes zero so V/Q is zero)

  • @mahmoudhadhoud9133

    @mahmoudhadhoud9133

    2 жыл бұрын

    This is what I have an issue with unfortunately..I associate V/Q mismatch with anything that obstructs the blood flow and I associate the shunt with alveoli obstruction.. how can pneumonia be a v/q mis mismatch if it does not obstruct the blood flow? Thank you so much for helping

  • @acingmedicine

    @acingmedicine

    2 жыл бұрын

    Hi Mahmoud, a V/Q mismatch means Ventilation (V) doesn't match Perfusion (Q), whether V is more than Q in case of deadspace or Q is more than V in case of shunt. If V is zero then this is a shunt. If Q is zero then this is a deadspace (wasted ventilation because of no perfusion). However, it's not always a zero value. These are two extremes. it could be reduced but not to the extent of zero. In such a case we call it a mismatch. So, shunt and deadspace are the two extremes of V/Q mismatch.

  • @kafge7798
    @kafge77985 ай бұрын

    you mentioned nothing regarding v/q