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V/Q Mismatch Physiology

by Dr. Lizzy Hastie @LizzyHastie

#VQMismatch #pathophysiology #diagnosis #pulmonary
V/Q Mismatch Physiology ... LizzyHastie #VQMismatch
Lynch Syndrome:
 • "CRC + Endometrial/Ovarian + Stomach + Urinary → Lynch Syndrome"
 • Autosomal Dominant,
EPCAM genes → Mismatch
Hypoxemia Differential Diagnosis Algorithm by A-a Gradient

Normal A-a Gradient:
 • ↓ Atmospheric pressure
 • Hypoventilation: CNS
Alveolar • V/Q Mismatch
Causes of Hypoxemia- Differential Diagnosis Algorithm
Ventilation/perfusion Mismatch
 • Airway Disease (Asthma, COPD)
 • Vascular (PE*)
 •
Ventilation/perfusion Mismatch
Hypoxemic Respiratory Failure - Differential Diagnosis Framework
DECREASED INSPIRED OXYGEN
 • Low PATM Can decrease first part
common than VIQ mismatch ... PERFUSION (V/Q) MISMATCH
Evolution of stroke on CT and MRI. 

Day 1: NCHCT demonstrates obscure left insular cortex. No
The PWI/DWI mismatch
Approach to the A-a Gradient
A-a gradient = PAO2 - PaO2
A-a gradient = [FiO2 x (Patm -
and more • V/Q Mismatch
Post-Transplantation Lymphoproliferative Disorders (PTLD)
Definition: Lymphoid and/or plasmacytic proliferations that occur as a result of immunosuppression in
liver>kidney), EBV mismatch
TISSUE APPEARANCES ON 
MUSCULOSKELETAL ULTRASOUND 

Bone:
 
Bone is represented as a very bright structure and appears
acoustic impedence mismatch
Blood Transfusion Reactions

Immune Mediated:
 • Febrile Non-Hemolytic Transfusion Reaction (FNHTR): Most common immune reaction to transfusion.
Occurs due to mismatch ... transfusion due to mismatch