pulmonary

Question 1

Low V/Q (shunt) means

Answer 1

area of unventilated lung/ good blood flow

Question 2

causes of low V/Q (5)

Answer 2

chronic bronchitis
asthma
pneumonia
pulmonary edema
atelectasis

Question 3

high V/Q (dead space) means

Answer 3

area of ventilated lung/ no blood flow

Question 4

cause of high V/Q mismatch

Answer 4

pulmonary embolus

Question 5

matched defect (decreased V and Q) cause

Answer 5

emphysema

Question 6

decreased respiratory drive is seen

Answer 6

paralysis, Gullain-Barre, Opioid overdose

Question 7

a patient comes with shortness of breath, what is the initial test?

Answer 7

CXR w/ AP & lateral views

Question 8

Light’s criteria

Answer 8

-Pleural fluid protein/serum protein > 0.5
• Pleural fluid LDH/serum LDH > 0.6
• Pleural fluid LDH > 2/3 upper limit of normal serum LDH

Question 9

how to differentiate transudative or exudative from light criteria

Answer 9

1 criterion needs to be met; it must not meet any of the criterion

Question 10

transudative etiologies (5)

Answer 10

CHF, nephrotic syndrome, hepatic hydrothorax, low albumin, peritoneal dialysis

Question 11

exudative etiologies (6)

Answer 11

parapneumonic, other infections, cancer,inflammatory disease, connective tissue disease, lymphatic abnormalities (chylothorax)

Question 12

exudative + increase lymphocytes

Answer 12

TB

Question 13

exudative + bloody

Answer 13

malignancy, embolus

Question 14

exudative + decrease glucose

Answer 14

rheumatoid arthritis

Question 15

Progressive dyspnea, hypoxemia and bilateral alveolar infiltrates (not explained by fluid overload/ CHF) w/in 6-72 hrs of an inciting event

Answer 15

ARDS

Question 16

Mild ARDS severity in terms of PaO2/FiO2

Answer 16

200-300mmHg

Question 17

Moderate ARDS in terms of PaO2/FiO2

Answer 17

100- 200 mmHg

Question 18

Severe ARDS in terms of PaO2/FiO2

Answer 18

<100 mmHg

Question 19

Complications of ARDS

Answer 19

Barotrauma, nosocomial infections, delirium, stress ulcer