Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
2 Pulm: ARDS
Step Up to Medicine, Chap 2: Pulmonary, ARDS
| Question | Answer |
|---|---|
| 3 pieces of info needed to determine underlying mechanism of hypoxemia? | 1. PaCO2 level 2. A-a gradient 3. Response to supplemental oxygen |
| Definition of hypoxia. | PaO2 <60 or PaCO2 >50 (hypercapnia). |
| Hypoxia or hypercapnea?: V/Q mismatch | Hypoxia withOUT hypercapnea (CO2 levels low or normal) |
| Hypoxia due to a shunt is/is not responsive to supplemental oxygen. | Is NOT |
| How does the A-a gradient help distinguish between different causes of hypoxemia? | If hyperventilation is the cause, A-a gradient will be normal. In most other causes, A-a gradient will be increased. |
| Which pts have the highest risk of developing ARDS? | Sepsis or septic shock |
| What is the key pathophysiologic event in ARDS? | Massive intrapulmonary shunting of blood--> severe hypoxemia with no significant improvement on 100% O2. Shunting is 2/2 widespread atelectasis, collapse of alveoli, and surfactant dysfunction |
| Classical criteria for diagnosing ARDS? | *Hypoxemia refractory to oxygen therapy (ratio of PaO2/FiO2 </= 100) *Bilateral diffuse pulmonary infiltrates on CXR *No evidence of CHF: PCWP </= 18mmHg |
| Where should the tip of the ET tube be in relation to the carina? | 3-5cm above the carina |
| Minute ventilation formula? | Minute ventilation= RR x Tidal volume |
| Normal I:E ratio used in ventilators? | 1:2 (twice as much time spent in expiration as in inspiration) |
| Definition of pulmonary HTN? | Mean arterial pulmonary pressure >25mmHg at rest or >30mmHg during exercise |
| CXR findings in primary pulmonary HTN? | Enlarge central pulmonary aa, enlarged RV, and clear lung fields. PFTs show restrictive pattern. EKG shows R axis deviation and RV hypertrophy. |
| Tx for primary pulmonary HTN? | Pulmonary vasodilators (IV prostacyclins/epoprostenol and CCBs), anticoagulation with warfarin, and lung transplantation (optional) |
| Definition of cor pulmonale? | RV hypertrophy with eventual RV failure resulting from pulmonary HTN 2/2 pulmonary disease |
| MCC cor pulmonale? | COPD |
| Nature of the A-a gradient in PE? | Elevated |
| Situations in which pts with PE should be considered as candidates for treated with thrombolytics (streptokinase, TPA)? | 1. Massive PE + hemodynamic instability 2. Evidence of R heart failure (thrombolysis can reverse this) |
| MCC of hemoptysis? | Bronchitis (50% of cases) |
Created by:
sarah3148
Popular USMLE sets