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MS2 Unit4 CardioResp > Week2 Lectures > Flashcards

Week2 Lectures Flashcards

Path and Micro

1
Q

Name this tx for mechanical ventilation:

  • P applied during all phases of respiratory cycle
A

CPAP (continuous pos pressure)

hint: tight mask; spont breathing

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2
Q

max P measured by ventilator during inspiration

A

PIP (Peak Inspatory Pressure)

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3
Q

P in the airways at end of expiration

A

PEEP (Peak End Expiratory Pressure)

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4
Q

Name the dvice/tx:

  • pt breathes spont in bwn ventilator breaths
  • support some/all breaths
A

SIMV (synchronized intermittent mechanical vent)

hint: pt-ventilator synchrony for comfort + help weaning

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5
Q

the following are conditions for ______ (controlled/normal) ventilation

  • RR 8-10
  • Tv 3-5cc/kg
  • PIP < 35
A

controlled

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6
Q

Barotrauma can occur as a result of (3 dx)

A
  1. Pneumodmediastinum
  2. Pneumothorax
  3. Alveolar overdistension
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7
Q

the following are conditions for ______ (controlled/normal) ventilation

  • RR = 12
  • TV = 7cc/kg
A

normal

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8
Q

Explain how pH, PaCO2, and HCO3 change with the following dx’s (see pic)

A

answer below

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9
Q

What are pulmonary (4) and cardiac (2) complications for ventilation

A

see pic below

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10
Q

what should be added to the ventilation regimen when sedated pts can possibly still sense pain (2)?

A
  1. sedation: benzos/propafol
  2. pain: opiates/ketamine
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11
Q

Contraindications for ______ ventilation (NIV) -

  1. Coma
  2. ø airway protection (lethary, emesis, angioedma, mass, bleeding)
  3. Resp arrest
  4. Precipitous/Acute Instability
  5. pH < 7.20 rel to failure
A

non-invasive

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12
Q

explain the pathophysio behind failed CPAP tx

A
  • = extrinsic PEEP + EPAP –> ↑alv recruitment + intrathoracic P
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13
Q

explain the pathophysio behind failed NIV/bilevel tx?

A
  • P support from IPAP
  • resting during inspiration (breaths should be triggered by pt?)
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14
Q

what are the 2 forms of Aorta Coarctation

A
  1. infantile: with PDA + tubal hypoplasia –> narrowing prox to arch
  2. adult: narrowing/infoldings distal to arch + branches
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15
Q

Name the dz

  1. males:females = 2:1
  2. 2 forms
  3. 50% involves bicuspid aortic valve
  4. assc w Turner’s Syndrome
  5. ± assc ASD+ VSD, aortic stenosis, mitral regurg, berry aneurysms
A

Coarctation of the Aorta

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16
Q

Name the congenital malf

  • parallel pulmonary and systemic circ
  • 50% VSD*
  • ∆truncal/aortal septa formn
  • pulm trunk + artery arises from LV, post and to the left of aorta, which arises from RV

*explain why?

A

Transporition of the great arteries

*bonus: required intra/extra-cardial communication, otw NCWL

17
Q

15% of TOF cases occur with what 3 dx?

A
  1. Down syndrome
  2. Alagille syndrome
  3. Digeorge syndrome
18
Q

what’s the syndrome?

  1. RV hypertrophy
  2. polycythemia*
  3. cyanosis
A

Eisenmenger Syndrome

* bonus: hypoxemia –> inc EPO from kidney –> inc RBCs

19
Q

Which congenital defect?

  • most common
  • assc with fetal alcohol syndrome
  • small defects → asympto; large defects → Eisenmenger
  • surgical or spont closure
A

VSD

20
Q

Which congenital defect?

  • 90% involve ostium secondum
  • Ostium Primum type assc w Down Syndrome
  • split S2*
  • complication –> paradoxical emboli**

explain * and **

A

ASD

*bonus: inc blood in R heart –> delayed pulm valveclosure

**bonus: R-> L shunt, thf emboli can lodge in L circuit (brain/periphery)

21
Q

Which Cong Defect:

  • assc with cong rubella
  • cont. machine~ murmur
  • L –> R shunt →bypasses Lungs –> LE cyanosis + Eis Synd
  • tw indomethacin → ↓PGe → closure
A

PDA (patent ductus arteriosus)

22
Q

Which cong defect

  • R →L shunt –> early cyanosis
  • boot shaped heart
  • squating → cyanotic spell relief*

* explain why?

A

Tetralogy of Fallot (TOF)

*bonus: squatting ↑TPR → back pressure ↓shunting → more blood to lungs

23
Q

The 4 chr’s of TOF

A
  1. Pulmonic Stenosis (RV outflow tract)
  2. RV hypertrophy
  3. Overriding aorta (over VSD)
  4. VSD

hint: PROV

24
Q

Obstruction from the narrowing of pulmonic outflow tract in TOF is a results of narrowing of the ______

A

infidibulum (where?)

25
Q

how do you treat TOF?

A
  • PGE keeps PDA open until surgery
  • surgical repair
  • 10% live to adulthood w/o surgery
26
Q

Which cong defect?

  • PFO/ASD allows pulm blood to enter LA failed connxn of pulm vein + LA
  • ± cyanosis
  • LA hypoplasia w/ normal LV
  • Dilation of R heart + pulm trunk
A

Total Anomalous Pulmonary Venous Connection

27
Q

Which COng Defect

  • failed tri valve formn →hypoplastic RV
  • ↑mitral valve size
  • ASD/PFO allows for R→L shunt; but also systemic cyanosis
  • high mortality in first few wks/months
A

Triscupid Atresia

28
Q

Which cong defect:

  • failed separation of truncus → single large vessel from both ventricles
  • early systemic cyanosis
  • deoxy blood mixture before pulm and aortic branching
A

truncus arteriosus

29
Q

Which defect:

  • htn in UEs; ↓pulses in LEs
  • collateral circ to intercostal arteries → engroged arteries + ↑rib knotching
  • bicuspid aortic valve
A

adult coarctation of the aorta

30
Q

describe a partial AV septal defect? -2

A
  1. Primum ASD
  2. cleaft mitral leaflet → mitral insuffc
31
Q

Describe a complete AV septal defect? - 3

A
  1. combined AV septal defect + large common AV valve
  2. all 4 chambers freely communicate
  3. down syndrom in 1/3 pts

MS2 Unit4 CardioResp (4 decks)

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