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Pulmonology
med emergenceis
| Question | Answer |
|---|---|
| what are the 3 important processes to allow exchange of gas to occur? | ventilation, diffusion, and perfusion |
| what does the amount of airflow with ventilation depend on? | the difference in pressure, airway resistance, and lung compliance |
| which part of the conduit system has the greatest resistance to airflow? | medium-sized bronchioles |
| what is the normal concentration of O2 in the alveoli versus the pulmonary arterial? why is this important? | alveoli = 104mmHG pulmonary arterial = 40mmHG allows for diffusion down gradient |
| what is the pulmonary capillaries CO2 pressure versus alveoli? | capillaries = 45mmHG alveoli = 40mmHG |
| lung perfusion depends on what 3 things? | adequate blood volume, intact pulmonary capillaries, and efficient pumping of blood by the heart |
| what's the primary goal when treating respiratory diseases? | relieve hypoxia and reverse bronchoconstriction |
| What happens with emphysema and why is it hard to breathe? | the alveoli walls are destroyed distal to the terminal bronchioles due to smoking which decreases surface area available for gas exchange. Because of the collapse air gets trapped and exhalation is hindered causing air trapping |
| Treatment for majority of pulmonary issues? | O2 if needed along with advanced airways, EtCO2, beta agonists/anticholinergic, terbutaline, epi, IV, fluids for dehydration with clear lungs |
| What happens in the lungs with bronchitis? | increased goblet cells in respiratory tree causing large quantity of sputum |
| signs of emphysema vs bronchitis | emphysema: pink puffers, weight loss, hypertrophy accessory muscles, dyspnea, pulsus paradoxus, core pulmonal leading to p pulmonal, finger clubbing Bronchitis: productive cough 3+mo/year for 2+ consecutive years, blue bloaters, overweight, rhonchi |
| What happens in the airway with asthma? | chronic inflammation of the airways/bronchioles induce by triggers/inducers |
| how many phases of asthma are there and what are they? | 2 phases; phase 1 is within first minutes due to histamine reversed with bronchodilators; phase 2 within 6-8 hours inflammatory immune response not resolved with beta agonists |
| what additional medications should you consider with severe bronchoconstriction with asthma? | mag sulfate and corticosteroids |
| what happens in the airways with pneumonia? | inflammation of lungs alveoli and bronchioles caused by bacteria/virus/fungi or aspiration |
| what are the 2 categories of ARDS? | direct and indirect |
| what are the direct causes of ARDS | pneumonia, aspiration of gastric contents, near drowning, smoke inhalation |
| what are the indirect causes of ARDS | sepsis, pancreatitis, trauma/burns, medication reactions, high altitude, blood transfusions |
| where in the airway is ARDS usually localized? | caused by severe inflammation in the alveoli |
| what are the percentage ranges for CO poisoning? | <15-20% mild, 21-40% moderate, 41-59% severe, >60 fatal |
| what's the difference between bronchopneumonia, lobar, and interstitial pneumonia? | bronchopneumonia is patchy involving more than one lobe, lobar is part or all of one lobe, interstitial is diffuse bilaterally |
| what happens to the airway with toxic inhalation? | upper airway edema, laryngospasm, bronchospasm, disruption alveolar capillary membrane causing pulmonary edema |
| types of spontaneous pneumothorax: primary vs secondary | primary is genetic and secondary is lung disease |
| when do you give antipyretic for fever | when greater than 101F |
| acute respiratory distress syndrome is also known as what | noncardiogenic pulmonary edema |
| condition described as inappropriate increase in minute ventilation beyond metabolic needs leading to respiratory alkalosis causing trousseaus sign from relative hypocalcemia | hyperventilation syndrome |
Created by:
Lindsey.George