Other Pulm Disorders

Question 1

What is acute respiratory distress syndrome (ARDS)?

Answer 1

• inflammation of the lung that has gone out of control d/t acute lung injury
• radiographic syndrome: only dx via CXR

Question 2

What cx ARDS?

Answer 2

• major injuries

- ill (sepsis)

Question 3

Pathophysiology of ARDS?

Answer 3

damage to endothelial cels and alveolar epithelial cells cxing increase in vascular permeability and decrease in production of surfactant cxing interstital alveolar edema (pus) cxing alveolar to collapse

Question 4

Sx/PE of ARDS?

Answer 4

• sudden onset of dyspnea
• not responsive to O2 supplement
• tachynpea, intercostal retractions, crackles
• multiple organ failure b/c this is an inflammatory process, there is low perfusion d/t the microclotting cxing hypoxia cxking vasoconstriction which furthers decreasing perfusion leading to organ failure (ischmea)

Question 5

How to dx ARDS?

Answer 5

CXR:

• diffuse or patchy bilateral infiltration that becomes confluent (becoming “one”)
• NOT found in controphrenic angles (controphrenic angles are only found if there is a cardiac prob that is cxing lung probs)
• air bronchograms: air collected in the bronchi and calcification around the bronchus

Question 6

How to tx ARDS?

Answer 6

• underlying dz

- supportive

Question 7

Prognosis of ARDS?

Answer 7

-mortality 30-40%; 90% if sepsis

Question 8

What is respiratory distress syndrome (RDS) / hyaline membrane dz?

Answer 8

acute lung dz of the newborn d/t surfactant deficiency leading to alveolar collapse and noncompliant lungs

Question 9

RDS affects?

Answer 9

premature infants (gestation)

Question 10

RDS RF?

Answer 10

• premature gestation
• maternal diabetes
• second born twins
• patent ductus arteriosus (when the baby doesn’t try to use it’s lung to breathe after birth b/c they didn’t use lungs when they’re in the mom)

Question 11

Sx/PE of RDS?

Answer 11

• tachypnea
• respiratory grunts & whines
• flaring of nares
• poor color (b/c no O2)

Question 12

Labs of RDS?

Answer 12

• CXR

- fluids (amino when baby is in womb; tracheal when baby is out)

Question 13

Tx of RDS?

Answer 13

• antenatal steroids if suspicions of mom going into premature labor is high
• postnatal surfactant therapy: trying to get surfactant in the baby’s lungs

Question 14

Who is affected by FB aspiration in the trachea & bronchi?

Answer 14

children and elderly (dentures)

Question 15

Labs of FB aspiration in the trachea & bronchi?

Answer 15

• CXR

- inspiratory and expiratory to test air trapping

Question 16

Tx of FB aspiration in trachea & bronchi?

Answer 16

• heimlich maneuver
• cricothyrotomy
• rigid bronchscopy

Question 17

Tx of FB aspiration in esophagus?

Answer 17

• partial: consult
• complete: endoscopic removal; may be able to pass 24hrs IF NOT SHARP (do CXR to confirm) b/c 50% can pass spontaneously