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Kendigs > Lung Injury from hydrocarbon > Flashcards

Lung Injury from hydrocarbon Flashcards

1
Q

Most common and serious complication

A

pneumonitis

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2
Q

aspiration high likely if

surface tension
low viscosity
volatility

A

low surface tension (adherance to surface)

low viscosity (spread easily, seep deeper in TISSUES)

HIGH VOLATILITY (rapid blood stream absorption; spread easily in ALVEOLI interfering gas exchange)

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3
Q

Chemical pneumonitis due to hydrocarbon may have radiologic signs within _____

A

2 hours (88%)
6-12 hrs (98%)

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4
Q

severe injury due to hydrocarbon

A

hemoptysis
pulmonary edema
respi failure within 24 hrs

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5
Q

radio signs

A

Punctate
mottled densities
pneumonitis
atelectasis

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6
Q

blood gas in hydrocarbon hypoxemia without hypercapnia suggesting

A

vq mismatch or diffusion block
*destruction of epithelium, bronchospasm

*displacement of alveolar gas

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7
Q

management

A

Intratracheal surfuctant
peep
ecmo / hfov
antibiotics

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8
Q

PULMO function in hydrocarbon

A

Increase RV/TLC
high volume of ISOFLOW
increased slope of phase III

low FEV1

suggest small airway obstruction

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9
Q

long term ff up showed residual injury to

A

peripheral airways

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10
Q

prognosis depends

A

ph
volume
type

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11
Q

hydrocarbon sniffing

A

results to acute hypoxemia
(displacement of alveolar gas)

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12
Q

3rd MC cause of poisoning deaths <5 yo
highest Morbidity and mortality <5 yo

A

Hydrocarbon aspiration and inhalational injury

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13
Q

common among
poor
african American
native american
<4 yo
and >85 yo

A

smoke inhalation

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14
Q

Blood gas of Carbon monoxide poisoning

A

O2 sat is low
Normal PaO2

*ABG obtained along COHb

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15
Q

Initial pathologic changes in smoke inhalation

A

Tracheobronchitis

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16
Q

Acute pulmonary edema caused by increased vascular permeability can occur within ____

A

30 minutes

17
Q

Upper airway obstruction occurs within ___ and can lead to alveolar hypoventilation

A

24 hours

18
Q

VQ mismatch of carbon monoxide is due to

A

Inflammatory changes in the airways

19
Q

Bronchial and bronchiolar edema leads to _______ airway resistance

A

HIGH

20
Q

Inhaled cyanide binds to _______ system
Inhibits cell metabolism and production of ATP

A

Cytochrome

21
Q

Clinical findings focus on

A

Hypoxemia, cyanosis

22
Q

How many % of COHb would lead to confusion, hallucination, ataxia, coma

A

40%

*increases cerebral blood flow
Permeability of cerebral capillaries
Cerebropspinal fluid pressure

23
Q

Sensitive indicator of cyanide poisoning

A

Plasma lactate concentration >10mM

24
Q

Manifestation of respi distress on cyanide develop within

A

12 hours-24 hours

25
Q

Used in early assessment of the extent of supraglottic or tracheobronchial injury

A

Flexible fiberoptic nasopharyngoscopy or bronchoscopy

26
Q

Chest Xray is not helpful in early diagnosis because in cyanide poisoning

A

Findings lag several hours

27
Q

Should be done before head and neck swelling, which make this examination difficult

A

Direct laryngoscopy

28
Q

Evaluate the extent of mucosal damage

A

Fiberoptic bronchoscopy

29
Q

Administering 100% O2 may reverse CO poisoning reducing by _____ in about an hour

A

HALF

*O2 for bronchiolitis and alveoliis with premature closure of small airways

30
Q

Can cause increased airway resistance from edema and some reflex bronchoconstriction from airway receptors

A

Inhaled bronchodilators

*smokers, CF

31
Q

SIGNIFICANT decrease reintubation incidence and incidence of atelectasis
Reduced mortality

A

Nebulized Heparin and N-acetylcysteine

32
Q

Pulmonary damage from smoke inhalation shows within _____ hours

A

24

33
Q

IV fluid can cause pulmonary edema by

A

Pulmonary vascular engorgement
Increases vascular permeability with fluid leak

34
Q

Increases risk for hypoventilation and atelectasis

A

Chest wall edema or eschar formation

35
Q

Severity of pulmonary parenchymal injury depends on

A

Duration of exposure
Type of inhalant

36
Q

IMPACT of smoke inhalation on long term lung function depends on

A

Stage of lung developmenet AT THE TIME OF INJURY
Confounding lung injury from (ARDS, pneumonia, acute lung injury)

37
Q

PFT after 8 yrs following thermal injury

A

Obstructive
Mixed obstructive and Restrictive

Kendigs (24 decks)

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