Other Pulmonology

Question 1

What is the underlying abnormality in ARDS?

Answer 1

Increased permeability of the alveolar capillary membranes which leads to noncardiogenic pulmonary edema

Question 2

What are common clinical settings/causes for 75% of ARDS cases?

Answer 2

Sepsis syndrome (most common)

Severe multiple trauma

Aspiration of gastric contents (alcoholics), toxic inhalation, near drowning

Question 3

What is the time period ARDS usually appears with an inciting event?

Answer 3

6-72 hours

Question 4

What are the clinical hallmarks of ARDS?

Answer 4

Hypoxemia and bilateral radiographic opacities

Question 5

28 year old alcoholic who was involved in a motor vehicle collision 2 days ago presents to you with acute onset of dyspnea and tachypnea. He is hypoxic with crackls auscultated bilaterally and frothy pink sputum. Chest radiography reveals diffuse bilateral infiltrates which spare the costophrenic angle and air bronchograms. No cardiomegaly or pleural effusion noted. What would you diagnose?

Answer 5

ARDS (Acute respiratory distress syndrome)

Question 6

What is hyaline membrane disease also known as? What is it caused by?

Answer 6

Neonatal Respiratory Distress Syndrome

Caused by abnormal respiratory function during the transition from fetal to neonatal life

Question 7

What are the treatment options for hyaline membrane disease?

Answer 7

Mechanical ventilation with positive pressure

Artificial surfactant

CPAP

Antenatal corticosteroids to mother

Betamethasone IM x2

Maintaining healthy pregnancy to prevent premature birth (best)

Question 8

Physical examination of the neck on a child which reveals swelling, erythema, or crepitus suggests what?

Answer 8

That an esophageal perforation has occurred and surgical consultation is mandatory