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Patho 1 (PATH 254) > Pulmonary Edema > Flashcards

Pulmonary Edema Flashcards

1
Q

Generally; Define Pulmonary Edema

A

Accumulation of extra vascular fluid in the lungs.

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2
Q

What affects can pulmonary edema have systemically?

  • To be specific; what are the 2 categories?
A
  • cardiogenic pulmonary edema: Increase in pulmonary hydrostatic pressure secondary to left sided heart disease
  • Noncardiogenic pulmonary edema - Increased membrane permeability
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3
Q

How/What does Cardiogenic Pulmonary Edema measure?

A

Measure rate of filtration of fluid

insert screen shot of slide 4

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4
Q

In Cardiogenic pulmonary edema: what happens when hydrostatic pressure increase?

A

Excess filtrate seeks and fills the peri-bronchovascular interstitial spaces
- normal is 300-400 ml of fluid

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5
Q

Normal bronchovascular interstitial spaces can accommodate 300-400 mls of fluid:

  • What happens when interstitial space are brimming?
A

Fluid begins to flood the alveolar spaces.

  • its a all or none phenomenon
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6
Q

What are some common causes of cardiogenic pulmonary edema?

A

Dysrrhythmias (PVC, Bradycardia, tachycardias)
- systemic hypertension
- Renal failure
- viral and bacterial infections
- any condition that clots or affects the heart (left in particular )

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7
Q

EDEMA

Left off @slide 2 + the flashcards from the RT quizlet

A

https://quizlet.com/ca/691530978/pulmonary-edema-flash-cards/?funnelUUID=de4c401f-1706-45ea-93b7-28b9f8ca52f9

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8
Q

Common causes for cardiogenic pulmonary edema

A
  1. Dysrrhythimias (PVC, Brady, Tachycardia)
  2. Systemic hypertension
  3. congenial heart defects
  4. Excessive fluid admin
  5. MI, left ventricular failure, mitral, aortic disease
  6. Cardiac tamponade
  7. PE
  8. Renal failure
  9. Viral and bacterial infections
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9
Q

How does noncardiogenic pulmonary edema happen/occur?

A

It results from injury to the lungs sufficient to increase endothelial permeability and cause extravasation (leaking fluid out of the capillary) of protein-rich fluid into the interstitial alveolar spaces

(Severe ARDS)

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10
Q

what happens because of noncardiogenic pulmonary edema in the lungs and why does it happen?

A
  1. Alveolar filling occurs frequently and early.
  2. It is due to increased permeability of alveolar epithelium.
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11
Q

What is the difference between interstitial (cardiogenic) edema and (noncardiogenic) alveolar edema?

edit

A

Cardiogenic pulmonary edema the interstitial filled followed by the alveoli?

insert images from slide 8

Specifics:
- cardiogenic = increased pressure in pulmonary capillaries due to heart failure and increased pulmonary pressure (can’t effectively pump blood causes back flow)

  • Increased permeability of capillaries by damage to epithelium
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12
Q

What are 4 common causes of non-cardiogenic edema?

A
  1. Increased capillary permeability
  2. Lymphatic insufficiency’
  3. Decreased intrapleural pressure
  4. Decreased oncotic pressure
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13
Q

What factors would increase capillary permeability?

A
  • Infection/inflammation
  • hypoxemia
  • ARDS
  • Radiation therapy
  • Acute head injury (neurogenic pulmonary edema)
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14
Q

Clinical manifestations of Pulmonary edema?

A
  • Decreased sodium levels
  • Tachypnea/tachycardia
  • hypertension
  • cheyne-stokes resp.
  • pink frothy sputum
  • wheezing, crackles
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15
Q

What are expected CxR markings for a pulmonary edema?

insert image from slide 12

A
  1. bilateral fluffy opacities
  2. Dilated pulmonary arteries
  3. Left ventricular hypertrophic (cardiomegaly)
  4. Kerley A & B lines
  5. Batwings/butterfly pattern
  6. Pleural effusion
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16
Q

Kerley A and B lines?

slide 14

A
17
Q

Why would a CxR for pulmonary edema have cardiomegaly?

A

Severe left heart failure

18
Q

Tx for a Pulmonary edema?

A
  1. Preload reduction
  2. Afterload reduction
  3. Oxygen therapy (low and high flow)
  4. CPAP and NIV (NIV for vent. failure)
  5. Intubate and ventilate
19
Q

How would you reduce preload for pulmonary edema?

A
  1. Diuretics
  2. Vasodilation (nitroglycerin)
20
Q

Which 3 diuretics are used to reduce preload?

A
  1. Loop diuretics (Furosemide)
  2. Thiazides (hydrochlorothiazide)
  3. Spironolactone
  4. Antidysrhythmic agents
21
Q

Increased excretion of sodium, potassium, and water describes the mechanism of action for which drug group?

A

Loop diuretics (furosemide)

22
Q

the inhibition of sodium and chloride reabsorption describes the mechanism of action for which drug group?

A

Thiazides; theyr’e less effective than loop diuretics

23
Q

Potassium sparing diuretic that acts as a competitive antagonists at the aldosterone receptor describes the mechanism of action for which drug group?

A

Spironolactone

24
Q

Venous dilation describes the mechanism of action for which drug group?

A

Nitroglycerin

25
Q

How would you reduce afterload for the Tx of pulmonary edema?

A
  1. ACE inhibitors
  2. B-blockers
  3. vasodilators
  4. positive inotropic agents
  5. Albumin and Mannitol (diuretics)
26
Q

What drug group has a mechanism of action that:

reverses vasoconstriction (decreases AT II( and volume retention (Decreased aldosterone)

A

ACE inhibitors

27
Q

What drug group has a mechanism of action that:

Inhibition of renin release, reduction of signalling effects of circulating catecholamine, reduction in myocardial O2 demand.

A

Beta blockers

28
Q

What drug class class does hydrazaline fall under?

A

Vasodilators

29
Q

What action do positive inotropic agents have and why would they be used for pulmonary edema?

A

Improved cardiac output via contractility and for some, vasodilation.

  • Digitalis, dobutamine
30
Q

What would Tx would be appropriate via oxygen therapy for Pulmonary Edema?

A
  1. O2 therapy (low and high flow)
  2. CPAP and NIV (NIV for vent. failure)
  3. Intubate and ventilate

Patho 1 (PATH 254) (17 decks)

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