Pulmonary- Physiology, RDS, PE and Misc.

Question 1

Fat embolism syndrome

Answer 1

24-72 hours following fracture or surgical manipulation of bone with abundant marrow. Physical obstruction in the pulmonary capillaries.
Microvascular occlusion in systemic percolation with inflammatory response

Question 2

fat embolism syndrome triad

Answer 2

Respiratory distress (mimic ARDS)
Neurologic dysfunction
petechial rash (50%)

Question 3

Fat embolism syndrome CT

Answer 3

Bilateral ground-glass opacities

pulmonary capillaries obstructions too small

Question 4

Transfusion- related acute lung injury

Answer 4

Transfusion reaction characterized by respiratory distress caused by noncardiogenic pulmonary edema

Question 5

S&S transfusion related acute lung injury

Answer 5

Respiratory distress

Hypotension

Question 6

Transfusion associated circulatory overload (TACO)

Answer 6

respiratory distress when a large volume of blood product is rapidly transfused leading to fluid overload

Question 7

S&S TACO

Answer 7

Within 6hrs 
Respiratory distress
Hypertension
Tachycardia 
Pulmonary edema 
Sign of volume overload

Question 8

Risk factors TACO

Answer 8

Cardial/ Renal disorders
Age <3 or >60
Chronic anemia

Question 9

Treatment of TACO

Answer 9

respiratory supper
Diuresis (furosemide)
Slow transfusion in high risk pts

Question 10

S&S ARDS

Answer 10

Rapidly progressive dyspnea 
diffuse crackles 
bilateral lung infiltrates
Acute hyperemic respiratory failure 
Edema (not due to CHF or overload)
PaO2/FiO2 ≤ 300

Question 11

Mechanism ARDS

Answer 11

increased alveolar capillary permeability
Exudation of proteinaceous fluid into airspace
Recruitment of leukocytes and cytokines
Impaired Gas exchange and Reduced lung compliance