Pulmonary Diseases

Question 1

V/Q ratio (Normal)

Answer 1

Normal: V/Q = (4L/min) / (5L/min) or 0.8
V=ventilation
Q=perfusion

Question 2

V/Q shunt

Answer 2

Low V/Q
Alveoli perfused but not ventilated
ARDS, Pneumonia,

Question 3

V/Q Deadspace

Answer 3

High V/Q
Alveoli ventilated but not perfused
Pulmonary Embolism, Cardiac arrest

Question 4

Asthma

Answer 4

Difficulty breathing out
Hypercarbic
flattened diaphragm on chest x ray (over inflated lungs push diaphragm down)
Shark fin
Tx: I:E ration of 1:4
low PEEP
O2
bronchodilators
Steroids
Epi
Magnesium
Fluids
Ketamine for sedation

Question 5

COPD

Answer 5

Difficulty breathing out
Hypercarbic
Chronic Bronchitis: Blue Bloaters
Emphysema: Pink Puffers
-Pink due to polycythemia
Flattened diaphragm on X ray
Tx: Increase I:E 1:4
Low PEEP
bronchodilators
steroids
IV fluids
Ketamine for sedation

Question 6

Pleural Effusion

Answer 6

Fluid in pleural space
will gravitate to most dependent area
Tx: drain, manage cause

Question 7

Pneumonia

Answer 7

usually viral
X-ray shows pleural effusions, lobar consolidation
R middle lobe most common site of consolidation
Tx: O2,
fluids
bronchodilators
ATB if bacterial