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Pulmonology 2 > Resp Failure > Flashcards

Resp Failure Flashcards

1
Q

WHat is Respiratory Failure?

A

Lungs fail to adequately oxygenate arterial blood and/or Prevent retension of CO2

Consequence of underlying conditions

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2
Q

WHat is Acute Respiratory Failure?

A

Abrupt onset with rapid progression

Sometimes reversible

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3
Q

WHat is Chronic Respiratory Failure?

A

Slow onset and progression

irreversible

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4
Q

What is Acute on ChronicRespiratory Failure?

A

increased baseline O2 requirements

Increase CO2 above baseline enough to drop pH

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5
Q

What are ventilation causes of Acute Resp Failure?

A

Drug overdose

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6
Q

What are oxygenation causes of Acute Resp Failure?

A

Pneumonia

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7
Q

What are ventilation causes of Chronic Resp Failure?

A

Neuromuscular Disease

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8
Q

What are oxygenation causes of Chronic Resp Failure?

A

Pulmonary Fibrosis

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9
Q

WHat are the types of Respiratory Failure?

A

Hypoxemic Resp Failure

Hypercapnic Resp failure###

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10
Q

What are the causes of Hypoxemia?

A 
Host
-Hypoventilation 
-Diffusion impairment
-Shunt
-V/Q mismatch
Environment
-Low FiO2
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11
Q

What are the clinical Manifestations of Tissue Hypoxia?

A 
Resp
-Cyanosis
-Tachypnea
CV
-Tachycardia
-Hypertension
CNS
-Confusion
Lactic Acidosis
Low SpO2 
Other Organ Failure
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12
Q

What are common conditions that Can lead to Resp Failure?

A 
Cardiac Dysfunction
Pulm infection or Aspiration
Venous Thromboembolus
Obstructive Lung disease
Pleural Disease
-Pneumothorax
-Effusion 
Chest Trauma
-contusion
-hemothorax
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13
Q

What is the P/F Ratio

A

Ratio of Oxygen delivery to Arterial Oxygen

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14
Q

What is done to give initial support to a Pt in Resp Failure?

A 
Supplemental O2
IV Acess
Vital Sign monitoring
-SpO2
-HR
-BP
-EKG
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15
Q

What drugs are given to Support someone in resp failure?

A

Chronotropes
Ionotropes
Arrhythmia Control

Vasodilators in CHF

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16
Q

What are the goals in Advanced support in Resp Failure?

A 
Hb Conc > 7
COutput
-IVF 30ml/kg
-Vasopressors
Goal Lactic Acid
17
Q

WHat are the affects of CO2 on pH?

A

Acute rise of 10 = dec pH by 0.08
Acute drop of 10 = raise pH by 0.08
Chronic rise of 10 = dec pH by 0.03
Chronic drop of 10 = Raise pH by 0.03

18
Q

What are the effects of CO2 changes on Bicarb concetrations?

A

Acute Resp Acidosis: CO2 +10 = Bicarb +1
Chronic Resp Acidosis: CO2 +10 = Bicarb +3
Acute Resp Alkalosis: CO2 -10 = Bicarb -2
Chronic Resp Alkalosis: CO2 -10 = Bicarb -5

19
Q

What is the treatment of Chronic Respiratory Failure?

A 
Smoking cessation
Vaccination
Oxygen therapy
Mech Ventilation
Supportive Care and ED
Nutrition (wt loss/gain)
Pulm Rehab
Transplantation
Palliation
20
Q

What are the vaccines that COPD patients need to recieve?

A

Pertussis
Influenza
Pneumococcal

21
Q

What are the effects of oxygen therapy in COPD?

A

Improves survival, dyspnia, and Exercise Tolerance

No improvement in Lung function, or survival in Pts with Moderate or nocturnal Hypoxemia

22
Q

What qualifies someone for Oxygen therapy?

A

PaO2

23
Q

What are the Absolute Contraindications for Lung Transplant?

A 
Absolute:
Major organ dysfunction
HIV
Hep C/B
Active Malignancy
Substance abuse
Non-osteoporotic musculoskeltal disease
24
Q

What are the Relative Contraindications for Lung Transplant?

A 
Systemic or Multisystem dz
Active infection
Resistant microorganisms
Osteoporosis
Mech Ventilation
BMI >30
Steroids
25
Q

WHat are signs of Chronic Respiratory failure?

A 
Polycythemia
Elevated CO2
Nomral pH w/ elevated PaCO2
Elevated Bicarb
Clubbing
26
Q

What are adverse effects of O2 administration in someone with Respiratory failure?

A

Hypercapnia 2/2
increased physiologic dead space from V/Q mismatch
Attenuated hypoxic ventilatory drive
Haldane effect

27
Q

What is the Haldane effect?

A

Deoxygenation of the blood increases its ability to carry carbon dioxide.
Conversely, oxygenated blood has a reduced capacity for carbon dioxide.

28
Q

What are the causes of Hypercapnia?

A 
(Increased CO2)
Hypoventilation(drive)
Neuromuscular
Body Habitus
Drugs
Increased Production
-Sepsis, fever, burns, trauma, seizures
Airway obstruction
Resp muscles
V/Q mismatch

Pulmonology 2 (18 decks)

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