Brainscape's Knowledge GenomeTM

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


See full index

Cardiorespiratory > Respiratory Failure > Flashcards

Respiratory Failure Flashcards

1
Q

Define respiratory failure.

A

syndrome of inadequate gas exchange due to dysfunction of one or more components of the respiratory system

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

List the components of the nervous system involved in respiratory function.

A

CNS/brainstem
PNS
NMJ

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

List respiratory muscles.

A

diaphragm
thoracic muscles
extra-thoracic muscles

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

What is the biggest risk factor for males developing chronic respiratory disease?

A

smoking

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

What is the biggest risk factor for females developing chronic respiratory disease?

A

household air pollution from solid fuels

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

What does ARDS stand for?

A

acute respiratory distress syndrome

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

What two factors increase mortality from acute respiratory disease?

A

severity

advanced age

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

Give examples of acute pulmonary respiratory disorders.

A

infection
aspiration
primary graft dysfunction

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

Give examples of acute extra-pulmonary respiratory disorders.

A

trauma
pancreatitis
sepsis

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

Give examples of acute neuro-muscular respiratory disorders.

A

myasthenia gravis

guillan barre syndrome

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

Give examples of chronic pulmonary respiratory disorders.

A

COPD
lung fibrosis
cystic fibrosis

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

Give examples of chronic musculoskeletal respiratory disorders.

A

muscular dystrophy

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

What is type I respiratory failure?

A

hypoxemic, failure of O2 exchange

[Increased shunt fraction due to alveolar flooding, hypoxemia refractory to supplemental oxygen]

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

What is type II respiratory failure?

A

hypercapnic, failure to exchange/remove CO2

[decreased alveolar minute ventilation, dead space ventilation]

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

What conditions fall under type I respiratory failure?

A 
collapse
aspiration
pulmonary oedema
fibrosis
pulmonary embolism
pulmonary hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What conditions fall under type II respiratory failure?

A

muscle failure
airway obstruction
chest wall deformity

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

What is type III respiratory failure?

A

perioperative respiratory failure, hypoxaemia or hypercapnoea
[increased atelectasis due to low FRC w/ abnormal abdominal wall mechanics]

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

Prevention of type III respiratory failure?

A

anaesthetic or operative technique, posture, incentive spirometry, analgesia, attempts to lower intra abdominal pressure

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

What is type IV respiratory failure?

A

describes patients who are intubated and ventilated during shock (septic/ cardiogenic/ neurologic)

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

List risk factors for chronic respiratory failure.

A 
COPD
pollution
recurrent pneumonia
CF
pulmonary fibrosis
neuromuscular diseases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

List risk factors for acute respiratory failure.

A 
infection
aspiration
trauma
pancreatitis
transfusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

List which criteria are used to classify ARDS.

A

acute onset, ratio PaO2/FiO2 of >200, regardless of positive end-expiratory pressure, bilateral infiltrates seen on frontal chest radiograph, pulmonary artery wedge pressure >18 mm Hg when measured, or no clinical evidence of LA hypertension.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

List pulmonary causes of ARDS.

A 
aspiration
trauma
burns: inhalation
surgery
drug toxicity
infection
24
Q

List extra-pulmonary causes of ARDS.

A 
trauma
pancreatitis
burns
transfusion
surgery
bone marrow transplant
drug toxicity
infection
25
Q

Response to acute lung injury

A

damage to interstitium > macrophages release cytokines > IL-6 +TNF alpha > activates TNFR-1 pathway > protein rich oedema > less efficient expanding

migration of neutrophils increases diffusion distance, increases oedema

26
Q

In vivo evidence of acute lung injury blocking mechanism

A

reduced injury in TNFR1 animal KO, blocking macrophage activation/ neutrophil migration, DAMP release e.g. HMGB1, cytokines IL6 IL8 IL1B

27
Q

Therapies tried as pharmacological intervention for ARDS

A 
steroids
salbutamol
surfactant
N-Acetylcysteine
neutrophil esterase inhibitor
GM-CSF
statins
28
Q

Therapies being trialled for ARDS

A 
mesenchymal stem cells
keratinocyte growth factor
microvesicles
high dose vit C, thiamine, steroids
ECCO2R
29
Q

Underlying distinct biological processes in ARDS

A

pulmonary vascular endothelialitis
thrombosis
angiogenesis
poor perfusion

30
Q

List therapeutic interventions to treat underlying disease of respiratory failure.

A

inhaled e.g bronchodilators, pulm. vasodilators, steriods, antibiotics, antivirals, drugs e.g. pyridostigmine, plasma exchange, IViG, rituximab

31
Q

List respiratory support therapeutic interventions of respiratory failure.

A

physiotherapy, oxygen, nebulisers, high flow, oxygen, non-invasive ventilation, mechanical ventilation, extra corporeal support

32
Q

List cardiovascular support therapeutic interventions of respiratory failure.

A

fluids
vasopressors
inotropes
pulmonary vasodilators

33
Q

List renal support therapeutic interventions of respiratory failure.

A

haemofiltration

haemodialysis

34
Q

List interventional immune therapies for multiple organ support of respiratory failure.

A

plasma exchange

convalescent plasma

35
Q

ARDS and its sequelae include?

A

poor gas exchange: inadequate oxygenation, poor perfusion, hypercapnoea
infection: sepsis
inflammation, systemic effects

36
Q

Types of ventilation?

A

Volume controlled
Pressure controlled
Assisted breathing modes
Advanced ventilatory modes

37
Q

How is compliance affected in respiratory failure?

A

reduced

38
Q

How do you see change in compliance on a pressure-volume loop?

A

gradient of inspiratory curve is less steep in ARDS lung

39
Q

What is upper inflection point?

A

above this pressure, additional alveolar recruitment requires disproportionate increases in applied airway pressure

40
Q

What is lower inflection point?

A

can be thought of as minimum baseline pressure needed for optimal alveolar recruitment

41
Q

pitfalls of ventilation

A 
minute ventilation (PaCO2 control)
alveolar recruitment (PEEP)
V/Q mismatch (ventilation without gas exchange)
42
Q

what is breath stacking?

A

when patients take a breath in, but are unable to get that air out, so it builds up and up in their lungs

43
Q

breath stacking often occurs in what populations?

A

severe bronchospasm

COPD

44
Q

what is driving pressure?

A

difference between peak and plateau (static) pressure

45
Q

how to minimise ventilator induced lung injury?

A

keep driving pressure appropriate

46
Q

what imaging modalities used to guide diagnosis and treatment in the management of the ARDS?

A

lung CT

lung ultrasound

47
Q

how is escalation of therapy guided?

A

Murray Lung Injury score

48
Q

what parameters make up the Murray score?

A

PaO2/FlO2 (on 100% oxygen)
CXR
PEEP
Compliance (ml/cmH20)

49
Q

a 0 Murray score indicates?

A

normal

50
Q

a 1-2.5 Murray score indicates?

A

mild

51
Q

a >2.5 Murray score indicates?

A

severe

52
Q

a >3 Murray score indicates?

A

ECMO

53
Q

inclusion criteria for ECMO?

A

severe resp. failure (non cardiac cause)
Murray score > or = 3
positive pressure ventilation is not appropriate

54
Q

when might positive pressure ventilation not be appropriate?

A

significant tracheal injury

55
Q

exclusion criteria for ECMO?

A

contraindication to continuation of active treatment
significant co-morbidity > dependency to ECMO support
significant life limiting co-morbidity

56
Q

what does ECMO stand for?

A

extracorporeal membrane oxygenation

57
Q

what is ECMO?

A

technique of providing respiratory support; blood is circulated through an artificial lung consisting of two compartments separated by a gas-permeable membrane, blood on one side and ventilating gas on other

Cardiorespiratory (20 decks)

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