1: Acute Pulmonary Oedema

Question 1

What is acute pulmonary oedema

Answer 1

Accumulation of fluid in the lungs

Question 2

What can cause acute pulmonary oedema

Answer 2

Left ventricular failure
Fluid overload
Acute respiratory distress syndrome (ARDS)

Question 3

What may cause left-ventricular failure

Answer 3

MI
Valve disease
Arrhythmias

Question 4

What are 3 symptoms of pulmonary oedema

Answer 4

acute-onset dyspnoea, orthopneoa and production of pink frothy sputum

Question 5

What are 5 signs of acute pulmonary oedema

Answer 5

Sympathetic signs - pale, sweaty
Raised JVP
Fine lung crackles
Gallop rhythm

Question 6

What is pulsus alternans

Answer 6

Arterial pulse with altering strong and weak pulse

Question 7

What investigations are performed in acute pulmonary oedema

Answer 7

• CXR
• ECG
• ABG
• NT-pro-BNP
• Troponin
• U+E

Question 8

What will CXR show in pulmonary oedema

Answer 8

Alveolar oedema
Kerley B lines
Cardiomegaly
Dilated upper lobe vessels 
Effusion

Question 9

What will ECG show in pulmonary oedema

Answer 9

Indications of arrhythmias that may have lead to pulmonary oedema

Question 10

What is the management of acute pulmonary oedema

Answer 10

Loop diuretics
Morphine
GTN infusion
Oxygen
Position upright 
Positive pressure ventilation

Question 11

What dose of loop diuretic is given in acute pulmonary oedema

Answer 11

40-80mg furosemide, IV bolus