Ards (restrictive Acute) Flashcards

1
Q

What causes surface tension in ards

A

The build ip of fluid in alveoli oncewases st causing alveolsr collqpse (oedema)

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2
Q

What event leads to this

A

Inflammation mainly neutrophilic in nature

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3
Q

What are some stats

A

Mortaoty is 40%

Prognosis deends on age, race (african/hispanic) and cause of arss

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4
Q

What is the radiology like

A

Hazy patrern and also increased consolidation and gg opacity

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5
Q

What can cause neutrophil attraction

A

Infection picked up by mac, aspiration eg via damage ti epi cells or attraction of neutrophils, transplants

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6
Q

What does neutrophil cause which allows oedema

A

Increased permeability of vascular and alveolar epithelium

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7
Q

What is rhe membrane called which is a build of debris, accumulated fibrosus and dead crlls

A

Hyaline membrane

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8
Q

What sort of events occur before ards

A

Trauma, shock, injuries or drug od

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9
Q

Which article discusses role of neutrophils in ards

A

Grommes et al 2011

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10
Q

After injurt what events allow neurrophils to get into alveoli

A

Margination and extravasation

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11
Q

Which release of cytokines after trauma by macrophages allows recruitment of neutrophils

A

Tnf, il1, il8, il6, il10

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12
Q

What sorts of things are released by neutorphil degranulation

A

Paf, leukotrienes (blth permeability)
Proteinases
Mmps
Ros

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13
Q

Which protease from neutrophils attacks surfsctant opsonins a and d which also reduce inflammation

A

Protease 3

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14
Q

Which mmp is most important by neutrophils causing inflammation and subsequent fubrosis in atds

A

Mmp9

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15
Q

What sort of things can ros do

A

Disrupt toght junctikns in epitheli, induce cell death causing inflammation, induce inflammasome

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16
Q

Which 3 cells seen hugh in arss in alveoli

A

Mac, neutrophils, rbc

17
Q

What is in ordema fluid in high conc

A

Proteins

18
Q

Why isn’t giving oxygen good for ards

A

Cant cross the fluid and distupted slveoli

19
Q

What is given instead

A

Constant posiitive air pressure cpap

20
Q

Wht does this do

A

Forms a positive pressure which inflates the alveoli and redcued collqpse from surfsce tension by fluid

21
Q

Acure phase has been descirebd of ards. What is the subacute ohase (7-14 days)

A

Oedema restored, repair starts ti occur eg fibrosis laying down. Can also go weong

22
Q

Where is fluid removed eventuslly

A

To microbasculsture or via lung lymphatics

23
Q

Which 2 things releaxed by intact endothelium will later prevent neutrophil migration and activation

A

Lipoxins and resolvins

24
Q

Why are alveolar macrophages good for resolution

A

Phagocytose inflammatory cells and the hyaline membrnae

25
Q

Why can agba be used to investigate ards

A

Forms hypoxia