Step 1 Basics (USMLE)

Pulm| Pickwickian Syndrome (Obesity Hypoventilation Syndrome)


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2.17 Pickwickian Syndrome

Pulmonary system review for the USMLE Step 1 Exam

  • Pickwickian Syndrome is also called obesity hypoventilation syndrome
  • Characterized by daytime hypoventilation leading to hypercapnia
  • Often occurs in individuals with a BMI over 30
  • Excess fat puts pressure on lungs and reduces ability to fully inflate
  • Reduction in ventilatory drive may also cause hypercapnia
  • Typical patient presents with obesity, daytime sleepiness, and symptoms consistent with obstructive sleep apnea
  • Diagnosis confirmed by arterial blood gas
  • Short term treatment with positive airway pressure therapy
  • Long term treatment involves lifestyle changes to lose weight
  • CPAP machine supplies positive pressure to reduce CO2 build up
  • Weight loss relieves symptoms by reducing excess weight on lungs.
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Step 1 Basics (USMLE)By Sam Smith

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