Obstructive Disease TBL

Question 1

Hypercarbinc vs. hypoxemic failure

Answer 1

PaCO2>50 mmHg and pH<7.36…example is severe emphysema

Hypxoemic -

Room air PaO2 <50-60 mmHg

Abnormal A-a graident

ARDS or pneumonia

Question 2

Compensations

Answer 2

Resp acidosis - HCO3 will increase

Met acidosis - pCO2 will decrease

Question 3

Emphysema V/Q and why

Answer 3

Higher because of increase physiologic dead space

Question 4

Patients with hyperexpansion

Answer 4

Are in an unfavorbale starting position and therefore have a reduced force generation

Question 5

Why is there hyperexpansion in emphysema

Answer 5

Increased airflow resistance

Question 6

PE presentation

Atelectasis presentation

Answer 6

Dyspnea and hypoxemia

HYpoxemia due to low V/Q

Question 7

NM weakness meachanism

Answer 7

Need to increase the RR to makeup for decreased tidal volume

THis will increase minute ventilation but will NOT increase alveolar ventilation enough to over compensate (because of the dead space)

Therefore hypercarbia still develops

Question 8

O2 induced hypercarbia mechanism

Answer 8

decreased resp drive, transient worsening of V/Q mismatching and the haldane effect

Inhaled bronchodilators should be given

Question 9

Intubating patients with respiratory failure

Answer 9

Can compress the heart and lead to hypotension

INterferes with systemic venous return to the RA