Disorders of O2/ perfusion

Question 1

Acute respiratory failure- Eti

Answer 1

• Secondary to underlying disease

Question 2

Acute respiratory failure- Sx

Answer 2

• Hypoxemia- dyspnea, cyanosis, confusion, delirium, anxiety, tachypnea, brady or tachycardia
• Hypercapnia- dyspnea & HA (+) peripheral/ conjunctival hyperemia, HTN, tachy, imparied consciousness, asterixis

Question 3

Acute respiratory failure- Dx

Answer 3

Arterial blood gas: PO2 < 60 mmHg, PCO2 > 50 mmHg

Question 4

Acute respiratory failure- Tx

Answer 4

• Supportive care: nutrition, opioids, paralysis, skin care, O2

Question 5

Acute respiratory distress syndrome- Eti

Answer 5

• Acute hypoxemic respiratory failure following systemic pulmonary insult w/o evidence of L. side HF
• Damage to capillary endothelial & alveolar epithelial cells

Question 6

Acute respiratory distress syndrome- Sx

Answer 6

• Rapid onset of dyspnea 12-48 hrs after initiating event
• Labored breathing and tachypnea with crackles
• Marked hypoxemia refractory to supplemental o2
• Multiple organ failure

Question 7

Acute respiratory distress syndrome- Dx

Answer 7

• ID systemic cause

- CXR- diffuse bilateral opacitis rapidly confluent, NO HF

Question 8

Acute respiratory distress syndrome- Tx

Answer 8

• Underlying cause

- improve O2 though intubation/ ventilation

Question 9

Acute respiratory distress syndrome- Prog/ prev

Answer 9

• 30-40% mortality
• Median survival 2 wks
• Survivors with pulm sx

Question 10

Obesity- Hypoventilation Syndrome- Eti

Answer 10

• Blunted ventilatory drive and increased mechanical load imposed on chest

Question 11

Obesity- Hypoventilation Syndrome-Sx

Answer 11

• Obseity, lethargy, HA, hypersomnolence, snoring, cyanosis or cor pulmonale, erthytocytosis
• Dyspnea absent

Question 12

Obesity- Hypoventilation Syndrome- Dx

Answer 12

• Arterial blood gas- daytime hypoxemia & hypercapnia- improve with voluntary hyperventilation
• Sleep study

Question 13

Obesity- Hypoventilation Syndrome-Tx

Answer 13

• Wt loss
• Positive pressure ventilation
• Resp. stimulants