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Pulmonology > RADS > Flashcards

RADS Flashcards

1
Q

RADS type I

A

hypoxemic; PaO2<60

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2
Q

RADS type II

A

hypercapnic and hypoxemic; PaCO2 > 45

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3
Q

Acute decrease in PaO2

A

increase in a catecholamine surge leading to increase heart rate - carotid body senses it and it leads to increase in resp. rate and ventilation

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4
Q

Acute increase in PaCO2

A
  • decrease in pH and increase in intracranial pressure leading to CO2 narcosis, headache
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5
Q

most common mechanism for hypoxemic RADS

A
  • shunt - V/Q
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6
Q

causes of chronic hypoxemic RADS

A
  • V/Q mismatch: COPD, ILD, Pulm htn - shunt: pulm arteriovenous malformation, hepatopulm. syndrome
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7
Q

hypercapnic RADS

A
  • increase in dead space - increase work of breathing - decrease in resp. drive and pump
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8
Q

causes of acute hypercapnic- hypoxemic RADS

A
  • hypoventilation: drug overdose, acute spinal cord injury, acute neuromuscular dx. - v/q. increase in dead space, load and muscle fatigue: COPD, status asthmaticus
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9
Q

causes of chronic hypercapnic RADS

A

chronic Neuromuscular dx., thoracic cage, OHS

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10
Q

what is an issue with the nasal cannula?

A

variable FiO2

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11
Q

tell me about the standard face mask?

A

high flow O2 but FiO2 is still variable

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12
Q

HFNC

A

there is improved oxygenation, clearing of anatomic dead space and improved secretion clearance

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13
Q

complications of O2 therapy how should we try to prevent them?

A
  • reactive O2 species are cytotoxic - peds: blindness and bronchopulmonary dysplasia - absorptive atelectasis use lowest FiO2 to maintain desired PaO2, SaO2
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14
Q

what is mechanical ventilation?

A

supportive therapy where there can be a reverse but recovery depends upon reversal of underlying disease process - can be either full or partial support

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15
Q

PEEP

A

positive end-expiratory pressure - increase lung volume, decrease in atelectasis

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16
Q

complication of mechanical ventilation

A
  • can lead to over-distension of lung - intubation may be required - ventilator associated pneumonia
17
Q

advantage of non-invasive ventilation? disadvantage?

A

advantages: less sedation, decreases chances of pneumonia disadvantages: hard to tolerate mask

18
Q

inflammatory injury to alveoli leading to increase permeability of alveolar-capillary barrier

A

ARDS

19
Q

all what must be present in ARDS

A
  • acute onset - abnormal CT - respiratory failure - hypoxemia
20
Q

what are some commone causes of ARDS

A
  • direct: pneumonia, inhalation, pulm. contusion - extrapulmonary: sepsis, pancreatitis, drugs
21
Q

acute lung injury leads to

A

increased permeability

22
Q

abnormal surfactant

A

decreased compliance with alveolar collapse anda flodding

23
Q

main cause of neonataal resp. distress syndrome

A

surfactant deficiency

24
Q

ARDS network trial showed

A

lower tidal volumes protect the lung

25
Q

ventilator-induced lung injury

A
  • volutrauma - barotrauma - biotrauma - atelectrauma
26
Q

repetitive opening and closing of alveoli can injury alveoli

A

atelectrauma

27
Q

injury to lung releases harmful cytokines –> further lung injury and injury to other organs

A

biotrauma

28
Q

injury to lung indistinguishable from ARDS

A

volutrauma

29
Q

rupture of alveoli with gas escaping into pleural space (pneumothorax)

A

barotrauma

30
Q
A

ARDS showing dense lower lobe atelectasis- alveoli in these areas are gasless

31
Q

minute ventilation is

A

respiratory rate X volume

32
Q

concentration of O2 equation

A

HbxSaO2 + .003xPaO2

33
Q

is nasal cannula associated with CO2 rebreathing

A

nope

34
Q

whne do you need to humidify air whne delivered through a device

A

at high flows

35
Q

absorption atelectasis

A

happens when an obstructed alveoli is given Pure O2 washing out nitrogen and the partial pressure decreases. Alveoli collapses

36
Q

non-ivasive mechanical ventilation works very well for

A

COPD exarcebation

37
Q

ARDS cut off of symptoms

A

a week

38
Q

alveolar ventilation mechanism

A

increase perfusion and thus imrpving oxygention but not mortality

39
Q

lack of effectiveness of surfactant in adult ARDS

A

there are inhibtors that blcok surfactant

Pulmonology (13 decks)

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