Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Kydd - Pathophysiology 2 > Pulmonary Vascular Disorders - Edema, Embolism, Hypertension, ARDS > Flashcards

Pulmonary Vascular Disorders - Edema, Embolism, Hypertension, ARDS Flashcards

1
Q

What are the four conditions covered under Pulmonary Vascular Disorders?

A

Pulmonary Edema, Pulmonary Embolism, Pulmonary HTN, Acute Respiratory Distress Syndrom (ARDS).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is Pulmonary Edema?

A

Pulmonary edema is the accumulatin of fluid in the alveoli.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most common cause of Pulmonary Edema?

A

Left-sided Heart Failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some non-cardiogenic causes of Pulmonary Edema?

A

IV fluid overload, Smoke Inhalation, Aspration, IV drug use.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does smoke inhalation cause pulmonary edema?

A

Inhalation of noxious fumes induces inflammation. Inflammation results in exudate and increased fluid into the lungs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why does aspiration cause pulmonary edema?

A

Aspiration of anything that is not air into the lungs leads to massive lung damage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the pathophysiology of pulmonary edema?

A

Fluid from blood moves to the intersticial space and then into the aveoli. The increased fluid leads to decreased respiratory function.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The presence of fluid in the alveoli increases the _____ _____, resulting in a decrease in the diffusion capabiltities.

A

diffusion distance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are lobules?

A

Lobule is the lung unit distal to the respiratory bronchioles. It is comprised for the alveolar ducts, alveolar sacs and alveoli.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the manifestations of pulmonary edema?

A

Productive cough, Dyspnea, Decreased compliance, Crackles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the treatment for pulmonary edema?

A

Respiratory support (O2, Respirator in worst case), Treat cause (CHF, inc heart function).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is Pulmonary Embolism?

A

Pulmonary embolism is a thrombus in a pulmonary vessel. It is potentially lethal and has an approximate recurrence rate of 10%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

That is a thrombus?

A

A clot.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is an Embolis?

A

A moving/travelling clot.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is an Embolism?

A

The process of obstruction which begins with a thrombu, and then progesses to an embolis as it dislodges and moves.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the etiology of pulmonary embolism?

A

Usually caused by a deep vein thrombosis. Can also be caused by other emboli.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are several other examples of emboli which can lead to pulmonary embolism? (Other than DVT)

A

Fat, Air, Amniotic Fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How does fat cause pulmonary embolism?

A

Fat causeing embolism come from bone marrow when an individual fractures a bone which consequentially severes a blood vessel.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How does amniotic fluid cause pulmonary embolism?

A

During labour amniotic fluid become free and the mother can be actively bleeding. Particulate matter can get into the mother blood stream and travel into the pulmonary circuit.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the pathophysiology of pulmonary embolism?

A

A DVT (or other embolism cause) breaks free and the embolus travels and to the arterial bed and becomes a thrombus. The blocked vessel leads to impaired perfusion of the local tissues. Ventillation and perfusion imbalance leads to hypoxemia. Platelets degranulate leading to bronchial and pulmonary airway constriction and hemodynamic instability. The body then undergoes bronchoconstriction, leading to dreacrease cardiac output. There is a loss of surfactant which leads to atelactasis and ultimately right-sided heart failure.

21
Q

In the pathophysiology of pulmonary embolism the patient experiences decreased cardiac output. Why?

A

The obstruction in the pulmonary circuit prevents the blood from circulating as it normally would. The decrease in blood flow in the pulmonary circuit decreases the amount of blood delivered to the left-side of the heart, decreaseing the hearts output.

22
Q

Why does pulmonary embolism lead to right-sided heart failure?

A

The heart has to pump against resistance in the pulmonary circuit. The right-side of the heart is responsible for pumping blood through the resistance and then it is delivered to the left side of the heart.

23
Q

What are the manifestations of pulmonary embolism?

A

Manifestations are based on size and site. Usual manifestations are chest pain, tachypnea, and dyspnea. Tachycardia also manifests.

24
Q

Why are chest pain, tachypnea, dyspnea manifestations of pulmonary embolism? Why is tachycardia a manifestation?

A

Chest pain - d/t physical obstruction, and hypoxia which always presents with pain. Tachypnea - a compensatory mechanism. Dyspnea - d/t hypoxemia. Tachycardia - is a compensatory response to hypoxia.

25
Q

How is diagnosis of pulmonary embolism made?

A

Patient Hx, Physical, ABGs, LDH3, Lung Scan, CT Scan, Pulmonary Angiogram

26
Q

What is LDH3?

A

Lactate Dehydrogenase Isoenzyme 3 Is an enzyme found in the cells of the lung which have become damaged due to the pulmonary embolism. It helps to differentiate the type and location of damaged cells.

27
Q

Explan how a lung scan works, and what is I-HSA?

A

HSA is human serum albumin. A lung scan is a nuclear scanning test. Human serum albumin is biomarked with an radiated iodine marker (131). It is then injected into the vasculature and travels through the bod and into the lungs. Pictures are then taken of the lungs, showing which areas are not receiving enough blood, denoting the location and presence of a pulmonary embolism.

28
Q

In pulmonary embolism diagnosis why should a pulmonary angiogram be avoided, if possible?

A

If a lung scan can be used with effect, it should be avioded because it is an invasive procedure.

29
Q

What is the treatment for Pulmonary Embolism?

A

Stat treatment will mean a better prognosis. Anticoagulants and thrombolytics. Treatment wil aim to maintain cardiopulmonary function to avoid shock. If the patient has a DVT, it will also be treated.

30
Q

What is Pulmonary hypertension?

A

Sustained high pressure in the pulmonary circuit (>25mmHg; Normal = 15mmHg)

31
Q

What is mmHg is considered Pulmonary HTN?

A

> 25mmHg

32
Q

What is the normal pressure in the pulmonary circuit?

A

15mmHg

33
Q

If cardiac output increases, what happens to pulmonary pressure?

A

It rises as well, but only slightly.

34
Q

Pulmonary vasoconstriction leads to ____?

A

Increased pressure in the pulmonary circuit.

35
Q

What is the cause of pulmonary HTN? What are the three categories of causes?

A

It is caused as a secondary problem to cardiac and pulmonary problems. The three categories are: Increased pulmonary volume, Hypoxemia, Increased pulmonary venous pressure.

36
Q

What is an example of increased pulmonary volume causing pulmonary HTN?

A

Cardiac Septal Defects

37
Q

Why would hypoxemia cause pulmonary HTN?

A

Normally hypoxemia causes vasodilation in the vasculature, however, in the pulmonary circuit the arteries constrict In the presence of hypoxia redirecting blood flow to alveoli with higher oxygen content.

38
Q

What may cause increased pulmonary venous pressure?

A

Left-ventricle dysfunction (The blood in the heart doesn’t get fully delivered to the body, thus it stacks into the pulmonary circuit.

39
Q

What are some manifestations of pulmonary HTN?

A

Dyspnea, Syncope and Chest pain on exertion. Manifestations of right-sided heart failure. Fatigue. Some manifestations can also be seen on an x-ray.

40
Q

What manifestations of pulmonary HTN may possibly show on a chest x-ray, and why does the patient show the manifestations of RSHF?

A

Right Ventricle hypertrophy, Distended pulmonary arteries. The patient is experiencing RSHF manifestations because the right ventricle is pushing against increased resistance in the pulmonary circuit due to the pulmonary hypertension.

41
Q

What is treatment for pulmonary HTN?

A

The cause of the HTN must be addressed. If d/t hypoxemia, solving the hypoxemia will solve the problem. Otherwise, it is difficult to treat. Vasodilators can be administered, but have limited success. Prognosis is poor if severe.

42
Q

What does ARDS stand for?

A

Acute Respiratory Distress Syndrome

43
Q

What is ARDS?

A

Acute Respiratory Distress Syndrome is severe damage to alveolar and capillary walls. It is also called “post tramatic lung”.

44
Q

What is the mortality rate of ARDS?

A

40-60% mortality.

45
Q

What are some examples of etiology of ARDS?

A

Aspiration, Massive smoke inhalation, Fat embolus, Septicemia, Near drowning, Cocaine and Heroin misuse.

46
Q

What is the pathophysiology of ARDS? (Beginning at Lung Trauma)

A

Lung trauma triggers an influx of netrophils. Activated neutrophils release a variety of products like free radicals, phospholipids and proteases which directly damage the capillary endothelial layer and alveoli epithelium. The damage results in increased permiability allowing an influx of proteins, cells and fluid into the intersticial space and alveoli, causing edema. Edema results in decreased compliance and impaired gas exchange. The patho of ARDS is also characterized by three main occurances with-in the lung. 1) Surfactant becomes defective and inactivated leading to atelectasis. 2) Thick protein and cell rich exudate lines the alveoli, preventing gas exchange. 3) An impervious hyaline membrane lines the alveoli. Profound hypoemia is the result.

47
Q

What are the manifestations of ARDS?

A

Acute onset respiratory distress, Dyspnea, Tachypnea, Massive hypoxemia, early resp alkalosis, late met acidosis, Diffuse consolidation.

48
Q

Why would someone with ARDS exterience early respiratory alkalosis? Why does it eventually atler and become metabolic acidosis?

A

1) Initially, the patient may experience respiratory alkalosis because the patient will have the capacity to expel C02, but have a low PaO2. The patient will not have enough CO2 to form Carbonic Acid (H2CO3), therefore they will present with Alkalosis.
2) Eventually, due to a worsening PaO2 level, and increased PaCO2, along with metabolic imbalances (Anarobic metabolism = Lactic Acid) will create the metabolic or mixed acidosis. It will be be accompanied by a low vetilation-to-perfusion ratio.

49
Q

What is the treatment for ARDS?

A

Early intervention, Reverse cause, Respiratory support, Complications.

Kydd - Pathophysiology 2 (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions