Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

2. Pulmonology > 10. Pulmonary emergencies > Flashcards

10. Pulmonary emergencies Flashcards

1
Q

What is Adult respiratory distress syndrome (ARDS)?

A

It is a severe inflammatory reaction of the lungs that leads to pulmonary damage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the characteristics of ARDS?

A

It is a syndrome of acute respiratory failure characterized by hypoxemia (type 1) and bilateral pulmonary infiltrates on chest imaging.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the systemic causes of ARDS?

A

Systemic causes of ARDS include sepsis (most common), trauma, shock, and acute pancreatitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the primary causes of lung damage that can lead to ARDS?

A

Primary causes of lung damage that can lead to ARDS include pneumonia, aspiration, inhaled toxins, and drowning incidents.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the pathophysiology of ARDS?

A

Tissue damage (pulmonary or extrapulmonary) leads to the release of inflammatory mediators, which causes an inflammatory reaction and migration of neutrophils into alveoli, leading to injury to alveolar capillaries and endothelial cells (diffuse alveolar damage).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the phases of ARDS?

A

The phases of ARDS include the exudative phase, hyaline membrane formation, and organizing phase.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the management of ARDS?

A

The management of ARDS includes
- supportive care such as mechanical ventilation,
- oxygen therapy, and fluid management,
- treatment of underlying cause,
- prevention through early recognition and treatment of sepsis, trauma, and other systemic causes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the mechanism behind impaired gas exchange in ARDS?

A

Exudation of neutrophils and protein rich fluid into alveoli : formation of hyaline membranes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the clinical features of ARDS?

A

Acute dyspnea, tachypnea, tachycardia, cyanosis, and diffuse crackles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the Berlin criteria for ARDS diagnosis?

A
  • Acute onset,
  • bilateral opacities on CXR or CT,
  • hypoxemia with PaO2/FiO2 < 300mmHg,
  • respiratory failure that cannot be fully accounted for by HF or fluid overload.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the treatment for ARDS?

A
  • Oxygenation
  • Lung protective ventilation (low tidal volume, low plateau pressure…)
  • supportive care (fluid management, furosemide)
  • Treat underlying cause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is respiratory alkalosis?

A

It is a condition characterized by a decrease in carbon dioxide levels in the blood, leading to an increase in blood pH.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is PaO2/FiO2?

A

It is a ratio used to assess the severity of hypoxemia in patients with respiratory failure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the complete blood count used for in sepsis/pneumonia?

A

It is used to detect leukocytosis, which is an increase in the number of white blood cells, in patients with sepsis/pneumonia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is lung-protective ventilation?

A

It is a ventilation strategy that uses low tidal volume, low plateau pressure and PEEP > 5cmH2O to prevent alveolar distention and barotrauma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is PEEP?

A

PEEP stands for positive end-expiratory pressure and is a pressure applied at the end of expiration to keep the alveoli open.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is pneumonia?

A

It is an inflammation of the distal small airways, alveoli, and the interstitium, which is associated with exudate accumulation in the alveolar space.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the difference between typical and atypical pneumonia?

A

Typical pneumonia has a sudden onset of fever and productive cough, while atypical pneumonia has a gradual onset of unproductive cough and dyspnea.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is ventilator-associated pneumonia (VAP)?

A

Pneumonia occurring in patients on mechanical ventilation breathing machines in hospitals (typically in the ICU).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the gram-negative pathogens commonly associated with VAP?

A

Pseudomonas aeruginosa, Enterobacteriaceae (E.coli), Acinetobacter spp.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the symptoms and signs of pneumonia? (8)

A
  • Fever,
  • cough,
  • sputum,
  • dyspnea,
  • chest pain,
  • shortened sound with percussion,
  • auscultation: fine crepitation (temporary), rales,
  • X-ray shadow.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What laboratory tests are used to diagnose pneumonia?

A
  • ↑ CRP,
  • neutrophil granulocytes,
  • ESR,
  • LDH,
  • GOT,
    -↑ procalcitonin in severe sepsis (may increase in lung cancer),
  • ↓ renal function.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What imaging techniques are used to diagnose pneumonia?

A

Chest X-ray (PA and lateral), Chest CT.

24
Q

What is the PORT score used for?

A

To calculate the probability of morbidity and mortality among patients with community-acquired pneumonia.

25
Q

What are the findings of lobar pneumonia on chest X-ray?

A

Opacity of one or more lobes, air bronchograms.

26
Q

What are the findings of bronchopneumonia on chest X-ray?

A

Poorly defined patchy infiltrates.

27
Q

What are the findings of atypical/interstitial pneumonia on chest X-ray?

A

Diffuse reticular opacity.

28
Q

When is a chest CT indicated for pneumonia diagnosis?

A

If CXR is unclear or in case of recurrent pneumonia.

29
Q

What are the findings of pneumonia on chest CT?

A

Localized areas of consolidation (hyperdense), air bronchograms, ground-glass opacities.

30
Q

What is the PORT score used for?

A

It is used to predict the need for hospitalization in people with pneumonia.

31
Q

What factors increase the PORT score?

A

Age, comorbidity, and severity of pneumonia symptoms increase the PORT score.

32
Q

What is the treatment for PORT I pneumonia?

A

Amoxicillin-clavulanic acid or macrolides are used to treat PORT I pneumonia.

33
Q

What is the treatment for PORT II-III pneumonia?

A

Levofloxacin is added to the treatment for PORT II-III pneumonia.

34
Q

What is the treatment for PORT III-IV pneumonia?

A

Amoxicillin-clavulanic acid/ceftriaxone + macrolides/levofloxacin are used to treat PORT III-IV pneumonia.

35
Q

What is the treatment for PORT IV-V pneumonia?

A

Ceftriaxone/meropenem/piperacillin + macrolides/levofloxacin/aminoglycosides are used to treat PORT IV-V pneumonia.

36
Q

What is pneumothorax?

A

Pneumothorax is the collection of air within the pleural space between the lung and the chest wall, which can lead to partial or complete pulmonary collapse.

37
Q

What is primary spontaneous pneumothorax?

A

Primary spontaneous pneumothorax occurs in patients with no underlying lung disease.

38
Q

What is secondary spontaneous pneumothorax?

A

Secondary spontaneous pneumothorax occurs as a complication of underlying lung disease.

39
Q

What is traumatic pneumothorax?

A

Traumatic pneumothorax is a type of pneumothorax caused by a trauma, such as a penetrating injury or iatrogenic trauma.

40
Q

What is tension pneumothorax?

A

Tension pneumothorax is a life-threatening variant of pneumothorax characterized by increasing pressure in the chest

41
Q

What are the risk factors for primary spontaneous pneumothorax?

A

The risk factors for primary spontaneous pneumothorax include family history, male, young age, slim + tall, and smoking.

42
Q

What are the causes of secondary spontaneous pneumothorax?

A

The causes of secondary spontaneous pneumothorax include COPD (smoking), pulmonary tuberculosis, CF, Marfan syndrome, and malignancy.

43
Q

What are the clinical features of pneumothorax?

A

The clinical features of pneumothorax include
- sudden, severe or stabbing, ipsilateral pleuritic chest pain
- dyspnea,
- reduced or absent breath sounds,
- hyper-resonant percussion,
- decreased fremitus,
- subcutaneous emphysema.

44
Q

What are the additional findings in tension pneumothorax?

A

The additional findings in tension pneumothorax include
- distended neck veins
- hemodynamic instability (tachycardia, hypotension, pulsus paradoxus),
- severe acute respiratory distress (cyanosis, restlessness, sweating).

45
Q

What is the diagnostic test of choice for pneumothorax?

A

Chest X-ray: Diagnosis of PTX is confirmed by CXR (upright PA).

46
Q

What are the findings of pneumothorax on chest X-ray?

A

Pleural line with reduced/absent lung markings and deep sulcus sign.

47
Q

What are the findings of tension pneumothorax on chest X-ray?

A

Diaphragmatic flattening on ipsilateral side and tracheal deviation + mediastinal shift toward contralateral side.

48
Q

What is the recommended respiratory support for pneumothorax?

A

Upright positioning and provide supplemental high-flow oxygen (target SpO2 > 96-100%).

49
Q

What is the management for unstable (high risk) spontaneous pneumothorax?

A

Suspected tension = emergency needle thoracostomy / bilateral PTX = emergency chest tube placement.

50
Q

What is the management for stable (low risk) primary spontaneous pneumothorax?

A

Observation or aspiration.

51
Q

What is the recommended treatment for stable primary spontaneous PTX with an apex-to-cupola distance less than 3cm?

A

Usually resolves spontaneously.

52
Q

What is the recommended treatment for stable secondary spontaneous PTX with an apex-to-cupola distance greater than 3cm?

A

Same or thoracic surgery consultation.

53
Q

What is the procedure for needle thoracostomy?

A

Immediate insertion of a large-bore needle, use the 2nd intercostal space at midclavicular line or the 4th-5th intercostal space between the anterior and midaxillary line (safe triangle), followed by the insertion of a chest tube.

54
Q

What is the procedure for finger thoracostomy?

A

Initial steps identical to chest tube placement (area should be cleaned, infiltrated with local anesthetic, incised and bluntly dissected down to parietal pleura), a gloved finger is inserted into the pleural space to create an open PTX, no chest tube is inserted or secured.

55
Q

What is chest tube placement?

A

It is the insertion of a flexible tube into the thoracic cavity to drain air or fluid in order to facilitate lung re-expansion.

56
Q

Where is the chest tube most commonly placed?

A

Most commonly in the 4-5th intercostal space (nipple line), between the anterior and midaxillary line (safe triangle).

57
Q

What should be done after the chest tube placement procedure is complete?

A

Always check CXR after the procedure is complete.

2. Pulmonology (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions