Book Review Of ‘Pulmonary Pathophysiology’ by John B.West

I recently won a competition organised by Lippincott Williams and Wilkins (hereafter LWW). The winning prize was the book Pulmonary Pathophysiology : The Essentials by John B. West. I was quite excited to receive this book as I had already heard some excellent reviews about the previous seventh edition published in 2008. The book is relatively small running at 183 pages long and is meant to act as a companion to the much bigger Respiratory Physiology:The essentials 9th edition. The small size of this book lends itself to quick and efficient review without a lengthy and cumbersome text. Furthermore, the book also comes with online access to a fully searchable ebook which is great for studying on the go, or with any portable devices.

Being very familiar with LWW and having invested in some of their other respected titles such as the illustrated review of pharmacology and Biochemistry, I was very keen to find out whether this text would be a worthy investment to medical students preparing for the USMLE. It is organized into three main chapters entitled: Lung function tests and what they mean, Function of the diseased lung and Function of the failing lung. I found the first chapter on lung function tests to be of particular value to a student preparing for the USMLE step 1 as it extrapolates a huge portion of their basic physiological knowledge to the clinical context.

All of the questions are in a USMLE format and important concepts are highlighted to stand out from the rest of the text which facilitates quick review of the subject content. There is an emphasis on the relations between structure and function in the diseased lung. The presence of anatomic pathology in this text provides a very integrated view of each condition and reinforces the appearance of pathological specimens.

I would recommend that this book should be used once having a strong grounding in basic physiology. This would enrich the learning experience and enable students to make the most out of this book. At least a basic understanding of Histopathology would also be beneficial but not essential as this book does a lot to provide an integrated link between histology and pathophysiology- a feature which I think many students would find useful. Important features are summarised in a greyed box which helps with effective reviewing and overall retention. The author has also made an effort to include clear graphs, diagrams and illustrations where possible. This makes the book more appealing to read and clarifies concepts that are difficult to grasp by textual sources.

Personally, I found the section on COPD to be very informative, especially the inclusion of different views amongst physicians towards Type A and Type B classification. Furthermore, the section on pulmonary edema has a very good explanation which, quite surprisingly, explains with more detail than some, much lengthier and more costly, textbooks available on the market. I quite like the section on advanced Neoplastic diseases and the negative effects on lung function; A topic which I feel is only really touched in some much larger texts on internal medicine. Overall, this book seems like a very good investment as many areas which I feel would be beyond the scope of this book are still covered.

Yet another advantage of this book is the incorporation of contemporary epidemiological information to support the pathogenesis of each condition.
The text features an extensive essential-to-know repository of MCQ questions after each chapter. Whats more, it also features an in-depth rationale for all questions and multiple choice review questions. This rationale is crucial for any student as it is more important to understand why the answer is wrong or right in any circumstance.

Last year, I was asked to teach an intensive Medical Physiology course which will commence this April 2013. Students in China tend to favour books without convoluted text , preferring simple rapid reviews of topics such that this book provides. The writing is clear, concise and succinct.
I will definitely be recommending this book to my students as I feel it successfully bridges the gap between preclinical and clinical disciplines. Furthermore, its section on environmental pollutants is particularly germane to the health crises in the polluted cities of China, where a vast number of patients present with deposition of aerosols in the lungs.

In the preface, the author invites any suggestions for selection of material. Whilst I could always mention some area to be expanded I fear that this book would lose its character. There is a great balance between information and readability. As it is, this book is very accessible, with information ready at your fingertips, without it being intimidating or too clunky; it is small enough to peruse on a crowded bus, or whilst  moving down a corridor on your hospital rounds, for example. The purpose of this book is to provide medical students with an insight into pulmonary pathophysiology that might be required for board examinations, and perhaps even for those who are already in practice and require a review of some sort. I would definitely recommend this book to medical students and those in related programmes. This is yet another excellent resource from Lippincott Williams and Wilkins and I will be placing it on the reading list for my Medical physiology course next month.

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