08.14 - ARDS (Muthiah) - Questions Flashcards Preview

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Flashcards in 08.14 - ARDS (Muthiah) - Questions Deck (33):
1

Berlin Criteria

(1) Acute Onset of Respiratory Failure; (2) Bilateral Infiltrates; (3) No evidence of Volume overload; (4) PaO2/FiO2 < 300

2

Cells damaged in ARDS

Capilary Endothelial, Alveolar Epithelial

3

Character of edema in ARDS

Protein-rich

4

Surfactant in ARDS

Dysfunctional

5

Most common direct cause of ARDS

Pneumonia

6

Most common indirect cause of ARDS

Sepsis

7

What is TRALI

Transfused blood has antibodies to white blood cells

8

Stages of ARDS (no time)

(1) Exudative; (2) Proliferative; (3) Fibrotic; (4) Recovery

9

4 predictors of worse outcome

(1) Chronic Liver Disease; (2) Non-pulmonary organ dysfunction; (3) Sepsis; (4) Advanced age

10

Which is more susceptible to injury: Type 1 or 2 Pneumocyte

Type 1

11

Which can proliferate: Type 1 or 2 Pneumocyte?

Type 2

12

4 components of lung injury score

CXR; PaO2:FIO2; PEEP; Respiratory Compliance

13

How do you improve oxygenation in a patient with ARDS?

Increase the PEEP

14

T/F: Using a pulmonary vasoconstricting agent will improve oxygenation in a patient with ARDS?

FALSE

15

T/F: Decreasing the peak inspiratory flow rate will improve oxygenation in a patient with ARDS?

FALSE

16

What is FRC

Amount of air left in lungs after normal expiration

17

Possible mechanism of improvement in oxygenation with application of PEEP in ARDS

Recruiting atelectatic alveoli and increasing FRC

18

Bigger FRC = ___ oxygenation

better

19

3 situations of Low FRC

Pregnancy, Large Ascites, Really Obese

20

T/F: PEEP reduces lung water in ARDS

FALSE

21

T/F: PEEP increases pulmonary vascular resistance and therefore improves oxygenation

FALSE

22

Compliance in ARDS

Acute decrease in compliance due to edema

23

Recommended tidal volume in ARDS

6 cc / kg

24

T/F: Nitric Oxide administration in patients with refractory hypoxemia reduces mortality

False, but it does improve oxygenation

25

The incidence of pneumothorax as a complication of ARDS is usually seen

After 2 weeks of ARDS onset

26

Death in a patient with ARDS is usually due to

Multi-organ failure from raging inflammation

27

T/F: Refractory Hypoxemia often causes death in ARDS

FALSE

28

Acute onset dyspnea, left sided pleuritic chest pain, purulent sputum since last night

Pneumonia

29

Most likely etiological agent of pneumonia

Strep Pneumoniae

30

Doesn't respond to supplemental O2

Shunt

31

In ARDS, there is severe hypoxemia due to ___

Shunting

32

Require mechanical ventilation with ___

PEEP

33

Ventilatory defects in ARDS survivors

Mild to moderate restrictive defects, with mild reduction in DLCO; Improve over following year and may normalize