V/Q mismatch and pulmonary shunt are two major physiologic mechanisms of hypoxemia, but they affect oxygenation in different ways. In this episode, we compare ventilation-perfusion mismatch with pulmonary shunt physiology, focusing on how each develops, how they differ clinically, and why their response to supplemental oxygen is different. Topics covered include: • What V/Q mismatch means • What pulmonary shunt means • Ventilation and perfusion basics • Low V/Q physiology • High V/Q physiology • True shunt physiology • How V/Q mismatch causes hypoxemia • How pulmonary shunt causes hypoxemia • Response to supplemental oxygen • A-a gradient and oxygenation assessment • Common causes of V/Q mismatch • Common causes of pulmonary shunt • Pneumonia, pulmonary edema, ARDS, atelectasis, COPD, asthma, and pulmonary embolism • Practical comparison for respiratory failure and critical care Watch the full video on YouTube:https://www.youtube.com/watch?v=zfly57Y8COA 📚 Join the WhiteBoard Medicine Patreon Community https://www.patreon.com/WhiteBoardMedicine Join a growing emergency medicine, critical care, and resuscitation education community built around high-yield clinical learning. Patreon members get access to: • Comprehensive Study Guides • Bedside One-Pagers • Clinical Reviews • Mini-Courses • Practice Questions • Ad-Free Videos • Structured Topic Collections 🌐 WhiteBoard Medicine Website Explore our growing library of critical care and emergency medicine content: https://www.whiteboardmedicine.com ⚠️ Educational Disclaimer: This content is intended for educational purposes only and should not be used as a substitute for clinical judgment, institutional protocols, specialist consultation, or individualized patient care. Full disclaimer: https://whiteboardmedicine.com/disclaimer

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“What did the council decide on item 42?” — answered with the speaker and the moment.

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