Week 6: Alterations of Pulmonary Function Flashcards
***What part of the COVID-19 virus structure causes infection?
Spike Protein (S)
***What makes the (S) Spike Protein so special?
It fuses into our cells, causing MASSIVE replication without recognition from our immune system.
more review What is the patho of COVID-19?
- Hyperinflamm. response causes increased permeability of vascular & epithelial membranes, edema, & tissue necrosis (esp. lung tissue)
- Hypercoagulable state like Disseminated Intravascular Coagulation (DIC)
***What are the non-respiratory symptoms of COVID-19?
- (heart) inflammation/immune changes in myocardium; cardiomyocyte death
- (brain) Neuro. inflammation.; brain damage @ parenchyma & cerebral vasculature
- (kidneys) Acute Kidney Injury (AKI); especially in critically ill patients…
nephrology –> acute tubular necrosis (ATN) –> glomerulosclerosis
What does ARDS stand for?
acute respiratory distress syndrome
What is ARDS? (2)
- acute lung inflammation
- diffuse alveolocapillary injury
…because of direct pulm. injury/severe sys. infection
TRUE or FALSE: ARDS is potentially deadly
TRUE
TRUE or FALSE: Since COVID-19 emerged, there has been a decrease in ARDS cases globally
FALSE
What is seen in ARDS? (2)
- acute onset of BILATERAL INFILTRATES on chest x-ray (ex. pulmonary edema)
- persistent hypoxemia even though O2 is given :(
What does PARDS stand for?
PEDIATRIC acute respiratory distress syndrome
_______ & ________ cause direct lung injury in PARDS (?)
COVID-19 & pneumonia
more review What is the patho of ARDS?
- Inflammatory response
—–infiltration of macrophages…activation of complement/clotting system “cytokine storm”
—— Results in diffuse alveolar & micro. vas. DAMAGE and THROMBOSIS
——- Fluid LEAKS into pulm. interstitium…so V/Q mismatch & hypoxemia
What are the 3 stages of ARDS?
- Exudative (inflammatory)
- Proliferative
- Fibrotic
**In ARDS, during the _________ stage, there is severe _____________.
Fibrotic stage, RIGHT to LEFT shunting
What are the key clinical manifestations of ARDS? (5)
- Dyspnea, hypoxemia
- Initial hyperventilation & resp. Alkalosis
- Metabolic acidosis