YEAR 2 SYSTEMS REVIEW - RESPIRATORY
YEAR 2 | PAGE 47B - MECHANICS -> V/Q / DIFFUSION -> PFT / ABG -> DISEASE PATTERN -> THERAPY
RESPIRATORY SPINE: PRESSURE / COMPLIANCE / RESISTANCE -> VENTILATION -> PERFUSION -> DIFFUSION -> O2 / CO2 TRANSPORT -> SPIROMETRY -> OBSTRUCTIVE / RESTRICTIVE / INFECTIOUS / VASCULAR FAILURE -> SUPPORT + DRUG TARGET. D. RESPIRATORY CLOSED-BOOK REVIEW MAP
| LANE | MUST RETRIEVE WITHOUT NOTES | HIGH-DISCRIMINATION TRANSFER |
|---|---|---|
| Mechanics | Pressure gradients; compliance/recoil; airway resistance; surfactant; lung volumes/capacities. | Predict work of breathing, volume changes and flow-loop shape from the underlying mechanical defect. |
| Gas exchange | V/Q; shunt; dead space; diffusion; hypoventilation; A-a logic; oxygen content and O2-Hb curve. | Name the hypoxemia mechanism first, then predict oxygen response, CO2 tendency, A-a pattern and imaging context. |
| PFT + ABG | FEV1/FVC, FVC/TLC, DLCO, flow-volume loops; primary acid-base process and expected compensation. | Move from numbers/curve to mechanism rather than starting with the diagnosis name. |
| Disease + therapy | Asthma/COPD; fibrosis/restriction; pneumonia; PE; ARDS; pleural disease; pulmonary drugs/support. | Connect physiologic failure -> test pattern -> treatment target; avoid treating an image label in isolation. |
E. TOP 10 MOST-MISSED SYSTEM CONCEPTS - #5 TO #7
| # / CONCEPT | DEEP EXPLANATION | WHY STUDENTS MISS IT | EASIEST CLUE |
|---|---|---|---|
| 5. V/Q mismatch vs shunt vs dead space | Low V/Q means perfusion exceeds ventilation; true shunt sends blood past nonventilated alveoli; dead space ventilates poorly perfused alveoli. Diffusion limitation and hypoventilation are separate mechanisms. | All can cause dyspnea/hypoxemia, so learners memorize disease lists instead of asking what happened to ventilation and perfusion. | Ask where did the air go and where did the blood go? |
| 6. Obstructive vs restrictive PFT logic | Obstruction primarily impairs expiratory flow, reducing FEV1/FVC; restriction reduces lung volumes with a preserved or high ratio. DLCO and loop shape help localize the mechanism. | Students memorize COPD/asthma vs fibrosis labels but fail on neuromuscular, chest-wall or mixed patterns. | Start with ratio, then volume, then DLCO. |
| 7. Oxygenation and ventilation are different problems | Oxygenation reflects alveolar/vascular gas exchange; ventilation reflects removal of CO2. A patient can have severe hypoxemia with near-normal CO2, or hypercapnia from inadequate alveolar ventilation. | PaO2 and PaCO2 are read as one severity scale rather than separate physiologic outputs. | Remember O2 = exchange; CO2 = ventilation. |
F. HIGH-VALUE REVIEW RESOURCES - DIRECT + PLAYABLE
| RESOURCE | ROLE IN THIS REVIEW |
|---|---|
| Ninja Nerd - Mechanics of Breathing | Pressure gradients and why air moves. |
| Ninja Nerd - Ventilation-Perfusion Coupling | Apex/base V/Q, mismatch, shunt and dead-space reasoning. |
| Ninja Nerd - Spirometry / Volumes | Volumes, capacities and obstructive/restrictive transfer. |
| Ninja Nerd - Asthma | Reversible obstruction, diagnostics and mechanism-based treatment. |
| Ninja Nerd - COPD | Obstruction, hyperinflation, PFT/imaging and therapy. |
| Dirty Medicine - Acid/Base | Fast board consolidation after deep compensation logic is secure. |
F. HIGH-VALUE REVIEW RESOURCES - DIRECT + PLAYABLE
| SCHOOL-EXAM GATE | ERROR-LOG TAGS |
|---|---|
| • Derive mechanics and gas-exchange changes from first principles. • Interpret unfamiliar PFT/ABG/loop/image data. | • MECHANICS - compliance/resistance/volume. • GAS EXCHANGE - V/Q/shunt/dead space/diffusion. |
| • Distinguish hypoxemia mechanism before selecting treatment. 2026/27 systems-review expanded edition - align with school objectives and verify official exam updates before testing | • PFT/ABG - ratio/volume/DLCO/compensation. • THERAPY - wrong physiologic target or support sequence. |