Pulmonary Oedema - PHTN, ARDS

Question 1

Pulm HTN 2* to ? pulm oedema -> ? structural changes to ? arteries (hypertrophy)
This puts more pressure on the ?? of heart -> ?? hypertrophy and ??F - known as ? ?

any resp pathology causing ? can also cause ? ? via similar mech

Answer 1

prolonged
irrev
pulmonary
RV
RV
RHF
cor pulmonale
hypoxia
cor pulmonale

Question 2

ARDS 1

• leads to non-? pulm oedema
• pulm response to either direct (?) or indirect (?-?) insults
• characterized by ? infiltration of pulm capillaries -> incr ? and ?-rich pulm oedema
• also damage to type ? pneumocytes -> ? depletion and ? collapse due to lack of lung compliance

Answer 2

cardiogenic
inhaled
blood-borne
neutrophil
perm
protein
2
surfactant
alveolar

Question 3

ARDS 2

• direct causes - ? of gastric contents, ?/toxin inhalation, pneumonia or near-?
• indirect causes - ?, multiple ?, ?-itis, ? reactions, ? or drug reactions

Answer 3

aspiration
smoke
drowning
sepsis
trauma
pancreatitis
transfusion
anaphylaxis

Question 4

ARDS Features

• ?aemia
• absence of signs of raised ? ? pressure
• diffuse ? ? on CXR
• impaired ? compliance

Answer 4

hypoxaemia
right atrial
bilateral infiltrates
lung

Question 5

ARDS Mx

• often admitted to ? for resp/circ support
• sit ? with ?% O2
• non-invasive ? ? ventilation (eg CPAP) used initially - most need ? ventilation
• then kept on ? ? with cont monitoring, and Ix / trt underlying cause

Answer 5

`ICU
upright
100%
pos press
mechanical
bed rest

Question 6

ARDS Medications

• IV ? titrated ? until improv seen (or drop in ?)
• IV ? (40-80mg)
• m..? (10-20mg IV) and m..? (10mg IV)
• aminophylline if ? also present

Answer 6

nitrates
up 
SBP
furosemide
morphine
metoclopramide
bronchospasm