ARDS

Question 1

What is the presentation/common clinical scenario leading to acute respiratory distress syndrome (ARDS)?

Answer 1

Bilateral exudative chest infiltrates and decreased O2 saturation following:
* Pancreatitis
* Aspiration of vomitus
* Near-drowning episodes
* Improper insertion of NG tube into lungs with feeding initated
* Toxic shock syndrome
* General trauma/sepsis

These scenarios are commonly tested in relation to ARDS on the USMLE.

Question 2

What is a significant cause of death in patients with toxic shock syndrome according to 2CK NBME Q?

Answer 2

ARDS

This highlights the severe complications associated with toxic shock syndrome.

Question 3

What condition is associated with pulmonary decompensation in pancreatitis?

Answer 3

ARDS

This association is frequently noted in medical examinations.

Question 4

What should be monitored in patients brought to the hospital following near-drowning episodes?

Answer 4

ARDS

Monitoring for ARDS is crucial due to the risk of lung injury from aspiration.

Question 5

What is the technical definition of ARDS?

Answer 5

PaO2/FiO2 <300

However, this ratio is often disregarded in USMLE questions.

Question 6

Why is the bilateral nature of ARDS emphasized in medical questions?

Answer 6

Many questions provide ARDS as a differential diagnosis for unilateral conditions, which is incorrect.

Understanding this distinction is vital for accurate diagnosis.

Question 7

What are the ventilation strategies for patients with ARDS?

Answer 7

Prone positioning, low-tidal volume setting, permissive hypercapnia

These strategies aim to improve oxygenation and reduce lung injury.

Question 8

What marker is associated with recovery from ARDS?

Answer 8

Increased surfactant protein D

Footnote:

Apparently surfactant protein D is a marker of lung injury and is ­ in patients with ARDS (or who are recovering from it).