Internal Medicine

Presented case report documents an example of a patient with an accidentally diagnosed chronic obstructive pulmonary disease (COPD) based on clinical signs. Diagnosis was confirmed by a pneumologist using spirometry. A bronchodilation test was carried out to confirm the irreversibility of detected obstructive ventilatory impairment. The patient was given combined bronchodilator treatment with ß2-mimetics and anticholinergics to relieve symptoms, improve functional parameters and prevent subsequent exacerbations.

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Lung abscesses are caused due to microbial infection when an area of infected lung becomes necrotic, which results in the development of a cavity containing pus or necrotic debris within the lung itself (Figure 1). In contrast to pleural infection, the incidence and mortality rate of lung abscesses have steadily declined since antibiotic era. The case report presents a 43-year-old patient with multiple lung abscesses.

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Isolated posterior myocardial infarction is occurring in 3-11% of all infarctions. ST - segment depression in leads V1-V3 suggests myocardial ischaemia, especially when the terminal T - wave is positive (ST - segment elevation equivalent), and confirmation by concomitant ST-segment elevation ≥ 0,5mm recorded in leads V7-V9 should be considered as a mean to identify posterior myocardial infarction. Emergent coronary angiography and percutaneous coronary intervention of the infarct - related artery is indicated.

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Obesity hypoventilation syndrome (OHS) is defined as the combined presence of obesity (BMI > 30kg/m²) with awake arterial hypercapnia (pCO₂ > 6.0 kPa / 45 mmHg) in the absence of other causes of hypoventilation. The exact prevalence of OHS in the general population remains unknown, and most prevalence data describe subjects with obstructive sleep apnoea, wherein its prevalence has been estimated to range from 10% to 38% in different groups. On the other hand, patients with OHS often suffer from sleep-related breathing disorders. Prevalence of obstructive sleep apnoea may reach up to 90-95% in OHS patients.

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Lecture for 5- year subject Internal Medicine 4. Basic knowledge of disorders of the internal environment, their cause, diagnosis and principles of treatment of metabolic and respiratory acidosis and alkalosis. Metabolic processes ► acid/base ACIDS from carbohydrates and fat metabolism (15-20 000 mmol of CO2 daily) CO2 + H2O ►H2CO3 ►(carbonic anhydrase) H + HCO3 H + Hb in RBC ►released with oxygenation in the alveoli ►reversed reaction – H2O + CO2 – exhaled in each breath.