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Coexisting > Resp 2 > Flashcards

Resp 2 Flashcards

1
Q

Pulmonary edema from tube will be what color

A

pink man

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2
Q

Pulmonary edema ( acute intrinsic restrictive lung diseases) causes

A

aspiration, ACDS neurogenic, problems, opioid overdose, high alt, re expansion of collapsed lung, upper airway obstruction (neg pressure), CHF

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3
Q

Pulmonary edema pattern on CT

A

batwing or butterfly

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4
Q

Two types of pulmonary edema

A

cardiogenic PE & increased capillary permeability PE

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5
Q

cardiogenic pulmonary edema characteristics

A

will be assumed first before in cap perm. Xtreme dyspnea, tachy hyper, diaphoresis

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6
Q

increased capillary permeability pulmonary edema

A

same as cardio but higher protein

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7
Q

Aspiration signs

A

tachy, broncho, acute pul hyper. chest Xray ray may be 6-12 h after

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8
Q

Which lobe most often aspiration in supine?

A

Right lower lobe

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9
Q

Treatment for aspiration

A

02, PEEP, bronchodilation, corticosteroid treatment is +- with controversy

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10
Q

Neuro problems

A

sympathetic overload from injured ICP –> vasocon, blood vol shift, increases pulmonary capillary pressure

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11
Q

Opioid induced pulmonary edema

A

high perm pulm edema may result following administration of opioids. Evidence says do not give naloxone

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12
Q

Opioid induced pulmonary edema trtment

A

Support, tracheal intubation, mech vent. Evidence says do not give naloxone

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13
Q

High altitude Pul edema cause

A

Hypoxic pulmonary vasoconstriction= Increased pulmonary vascular pressures. Nitric oxide when oxygen? (nitric not okay for adult just kids)

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14
Q

re expansion of collapsed lung trick

A

usually 24h (not a lung or heart case for a couple hours). when you get chest tube in do not expand in all one breath. slowly increase tidal volumes.

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15
Q

Upper airway obstruction ( neg pressure pul edema)

A

OSA patients, any airway stuff

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16
Q

Buried kid story

A

increased in transcapillary pressure gradient

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17
Q

Negative pressure pul edema (onset, symptoms, trtment)

A

2-3 hours post obstruction relief, pink froth, tachy, cough failure sat 95, trtmt= mt of airway supp oxygen, mech vent.

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18
Q

Management of PE anestetically

A

Delay elective, optimize cardiac & respiratory, mech vent & PEEP if hypoxemia is present (02 is less than 90)

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19
Q

Intraop management

A

double RR half tv, & MORE

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20
Q

Interstitial lung disease

A

chronic inflam of interstitial tissue, progressive pul fibrosis ( VC & FRC down) less than 70 ml/kg VC, less 15 means severe

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21
Q

Pul HTN

A

mean PAP >25mmHg, with PAWP

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22
Q

Fibrotic lung disease CXR

A

honeycomb

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23
Q

Worsen Pul HTN by:

A

hypoxia, hypercapnia, acidosis, hypothermia, Extreme catecholamines surges should be avoided

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24
Q

Sarcoidosis

A

systemic granulomatous disorder (granuloma = local collection of macrophages)
Symptoms: dyspnea cough, hypercalcemia
mediastinoscopy

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25
Q

Hypersensitivity pneumonitis

A

Diffuse interstitial granulomatous rxns ( fungi, black mold etc)
4-6 hours cough after

26
Q

Alveolar proteinosis

A

Hella protein in lungs. Common causes: chemo patients, AIDS, mineral dusts. dan says he would do DLT with lung lavage in one lung at time

27
Q

Lymphangioleiomyomatosis (LAM)

A

excessive smooth muscles in airway , lympthatics, blood vessels. reproductive age females.rest&obst DECREASE IN FEV1 FEV ratio.

28
Q

Lymphangioleiomyomatosis (LAM) fatal within _ years

A

10

29
Q

Autoimmune diseases causing PE

A

rheumatoid arthritis & esinophilic granuloma

30
Q

Bleomycin & nitrofurantoin S/e

A

PE, o2 toxcitiy. MUST DECREASE OXYGEN AS LOW AS POSSIBLE! (for spo2 of 88-92%)

31
Q

What patients may have bleomycin

A

hodgkins lymphoma.

32
Q

Chronic extrinsic restrictive lung disease

A

disorders on the thoracic cage which interfere with lung expansion

33
Q

Chronic extrinsic restrictive lung disease causes

A 
Obesity
Deformities of the costovertebral skeletal structures
Sternum deformities
Flail chest
Neuromus disorders
34
Q

Why is Obesity is a Chronic extrinsic restrictive lung disease?

A

Inc. restricive load on cage
FRC decreased
v/q mismatch
daytime hypoxia with morbity

35
Q

Costo vertebral skeletal structure 3 main disorders

A

kyphosis( rounded upper back), scoliosis (S back), Lordosis ( 50 degrees of curvature at the lower back

36
Q

Kyphoscoliosis

A

common in childhood/ early adol.

when VC < 45% & >110 degree scoliotic angle = compressed lung A-a gradient

37
Q

Mild to moderate Kyphoscoliosis angle

A

<60 degrees

38
Q

Severe Kyphoscoliosis angle

A

> 100 degrees

39
Q

Pectus excavatum

A

inward concave of lower sternum

40
Q

Pigeon chest (pectus carinatum)

A

inward convex of lower sternum

41
Q

Pectus excavatum (severe) puts pressure on.. resulting in decreased…

A

right side of heart. preload

42
Q

Haller Index

A

ratio of transverse inside of ribcage and anteroposterior

43
Q

Normal Haller index & severe

A

2.5, 3.25

44
Q

Nuss procedure

A

sx for pectus excavatum( idea to get pop back up in small children) use of curved bars to be flipped and push out chest.

45
Q

Pectus Carinatum causes

A

down syndrome, edwards syndrome, marfans, homocystinuria, morquio syndrome, dwarfism

46
Q

Pectus Carinatum trtmt

A

chest brace (dental braces idea )

47
Q

Flail Chest

A

inward movement of unstable portion of the thoracic cage. dehiscence of a median sternotomy, Tv diminished. pneuomothorax risk.

Need PPV until stable.

48
Q

diaphragmatic paralysis when? (better upright or supine)?

A

phrenic nerve neoplastic invasion, after abdominal sx can see. upright

49
Q

diaphragmatic paralysis

A

open or thoracoscopically, sew slack out in diaphragm into a more normal position

50
Q

Guillain-Barre Syndrome

A

sudden onset of skeletal muscle weakness or paralysis beginning in legs, resp. insufficiency requiring mech vent in 20-25%, vent support for 2 months

51
Q

Myasthenia gravis & NMB dose

A

chronnic autoimmune disorder from decrease in functional Ach receptors at NMJ (SMALL NMB dose)

52
Q

Eaton-Lambert Syndrome (myasthenic syndrome)

A

NDMR = prolonged paralysis & weakness

53
Q

do we use sugammadex or roc for MS pt?

A

sugammadex

54
Q

Sensory levels above _ __ can associate with impairment of resp muscle activity needed to maintain an adequate vent. (regional never above T10)

A

T10

55
Q

Intraplural pressure is __mmHg

A

-4mmHg

56
Q

Cocaine esophageal tear

A

pneumomediastinum

57
Q

Mediastinal anesthetic

A

spntaneous, sitting induction, position prone or lateral to reduce severe airway obstruction, conservative fluids

58
Q

Pulmonary embolism pts likely

A

trauma, prostate or orthopedic, malignancy, immobility, obesity, smokers, oral contraceptives, hormone replacement therapy, antipsychotic meds

59
Q

Pulm Embolism asleep symptoms

A

hypoten, tachy, hypoxemia, decreased end tidal co2, shock and right vent failure

60
Q

Case study: bone fracture 12-72 hrs. post injury, hypoxia, mental confusion, petechiae

A

fat embolism

Coexisting (5 decks)

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