*Pleural disease 2 (pulmonary vascular and pleural pathology)

Question 1

Is the pulmonary circulation a low or high pressure system?

Answer 1

Low pressure system (therefore thin walled vessels and a low incidence of atherosclerosis at normal pressures)

Question 2

What is pulmonary oedema?

what type of pattern of lung disease does this cause?

Answer 2

Accumulation of fluid in the lung interstitium and alveolar spaces
Restrictive pattern

Question 3

Causes of pulmonary oedema?

Answer 3

Haemodynamic (increased hydrostatic pressure)
Cellular injury (alveolar lining cells, alveolar endothelium) e.g. pneumonia, Adult respiratory distress syndrome

Question 4

What are 2 other names for adult respiratory distress syndrome?

Answer 4

Diffuse alveolar damage syndrome

Shock lung

Question 5

What are causes of ARDS?

Answer 5

Sepsis
Diffuse infection (virus, mycoplasma)
Severe trauma
Oxygen

Question 6

Pathogenesis of ARDS?

Answer 6

Injury e.g. bacterial endotoxin causing:
Infiltration of inflammatory cells
Cytokines
Oxygen free radicals
Injury to cell membranes

Question 7

Pathology of ARDS?

Answer 7

Fibrinous exudate lining alveolar walls
Cellular regeneration
Inflammation

Question 8

Outcome of ARDS?

Answer 8

Death
Resolution
Fibrosis (chronic restrictive lung disease)

Question 9

What type of babies get neonatal RDS?
Why?
What causes the physical damage to cells?

Answer 9

Premature infants
Deficient in surfactant
Increased effort in expanding the lungs = physical damage to cells

Question 10

What type of emboli are 95%?

Answer 10

Thromboemoli - can however be gas, fat, foreign bodies and tumour clumps

Question 11

What can recurrent small pulmonary emboli lead to?

Answer 11

Pulmonary hypertension