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Acute Pulmonary Flashcards

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1
Q

Atelectasis (not super concerning)

A

Small airway collapse (prolonged dependency of lower lobes)

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2
Q

When is atelectasis common?

A

Post surgery (obesity is greater risk)

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3
Q

What are symptoms of atelectasis?

A

Fever

Tachypnea

Tachycardia

Scattered rales (Velcro noise)

Decreased breath sounds

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4
Q

What can happen if atelectasis persists for > 72 hours?

A

Likely to develop pneumonia

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5
Q

How is atelectasis easily preventable?

A

Taking full deep breaths (10 an hour)

Early mobilization

Frequent changes in position

Encouragement to cough

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6
Q

Acute bronchitis

A

Acute inflammation of the large airways of lungs (95% due to virus)

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7
Q

When does acute bronchitis become more likely?

A

During flu season (fairly common, can lead to secondary pneumonia)

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8
Q

What are symptoms of acute bronchitis?

A

Productive cough

Malaise

Difficulty breathing

Wheezing

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9
Q

Pneumonia

A

Acute inflammation of the lungs due to infection or inability to keep lower respiratory tract clean

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10
Q

When does pneumonia occur?

A

When the infection gets past the mucociliary elevator

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11
Q

Why are the lungs an ideal breeding ground for pathogens in pneumonia?

A

Moist warm environment

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12
Q

What are the types of pneumonia?

A

Community acquired

Health care associated

Ventilator associated

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13
Q

How can you prevent pneumonia?

A

Flu vaccine

Clean equipment

Wash hands

Position in semirecumbent position

Activity helps clean lungs

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14
Q

What is the onset of bacterial pneumonia?

A

Abrupt

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15
Q

What is the key sign of bacterial pneumonia?

A

Productive cough

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16
Q

What will you see on imaging for bacterial pneumonia?

A

Lobar segmental consolidations

Pleural fluid

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17
Q

What are the 4 stages of bacterial pneumonia?

A

Congestion (24hrs)

Red hepatization (2-3 days post consolidation)

Grey hepatization (2-3 days post RH)

Resolution (2-3 days post GH)

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18
Q

What is consolidation in the lungs?

A

Region of normally compressible lung tissue that has filled with liquid instead of air

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19
Q

What does the lung look like in the red hepatization phase?

A

Consistency of the liver due to hyperemia and exudate in the lungs

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20
Q

What is the onset of viral pneumonia?

A

Insidious (gradual)

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21
Q

What is on imaging for viral pneumonia?

A

Diffuse airway changes

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22
Q

Bronchiolitis obliterans

A

Acute inflammatory injury due to a diffuse destruction of bronchioles

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23
Q

What causes bronchiolitis obliterans?

A

Infection

Toxic gas exposure

Collagen disorder

Chronic bronchitis

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24
Q

Why do pediatrics get bronchiolitis obliterans?

A

Severe lower respiratory airway infection

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25
Cryptogenic organizing pneumonia
Diffuse interstitial lung disease that primary affects the alveolar walls (also affects distal bronchioles, respiratory bronchioles, and alveolar ducts)
26
What is pleural effusion?
Excessive collection of fluid between the parietal and visceral pleura
27
What does pleural effusion create?
Restrictive lung defect, V/Q mismatch, and increase work of breathing
28
What are signs of pleural effusion?
Decreased breath sounds Decreased chest expansion Pleural rub (early)
29
What can result in severe cases of pleural effusion?
Mediastinal shift
30
What is transudative pleural effusion?
Non infectious, results from mechanical factors influenced by rate of formation of pleural fluid
31
What occurs in transudative pleural effusion?
Heart failure Pulmonary embolism Decrease lymphatic drainage Decrease osmotic pressure
32
What is exudative pleural effusion?
Caused by infection (pneumonia, malignancies, or tuberculosis)
33
What type of cough is in transudative pleural effusion?
Non productive
34
What type of cough is in exudative pleural effusion?
Productive cough
35
What is the most common bones fractured in the chest due to trauma?
Ribs 4-10
36
What is indicated if there is an upper rib fracture (ribs 1-3)?
High energy trauma (hardest to break)
37
What is at an increased risk associated with lower rib fractures?
Intra abdominal injury
38
What often results in an unstable chest wall?
Fractures in two locations on the same rib of 3 or more adjacent ribs
39
What happens in flail chest?
Chest wall falls in during inspiration Chest wall falls out during expiration
40
What is at risk with flail chest?
Lacerated organs (kidney, liver, lungs) and possible respiratory failure
41
What is pneumothorax?
Air or blood in the pleural space due to a breach in the parietal or visceral pleura
42
What happens in pneumothorax?
Ipsilateral lung collapses causing hypoxia
43
What does continued pressure increase in pneumothorax lead to?
Mediastinum shift toward contralateral lung and compresses it worsening the hypoxia
44
What are symptoms of early pneumothorax?
Dyspnea, sudden sharp pain, tachycardia, decrease breath sounds and chest expansion
45
What are the symptoms of late pneumothorax?
Decreased BP and tracheal shift
46
What is primary pneumothorax?
Spontaneous occurrence with no underlying lung disease (more common in young tall thin males)
47
What is secondary pneumothorax?
Associated with underlying lung disease like COPD
48
What is iatrogenic pneumothorax?
Due to diagnostic or medical procedure
49
What is traumatic pneumothorax?
Results from penetrating or non penetrating chest trauma
50
What occurs in tension pneumothorax?
One way valve forms allowing air into pleural space but not out (Mediastinal shift away from affected lung) (medical emergency)
51
What is the third most common cause of death in hospitalized patients?
Pulmonary embolism
52
Who does pulmonary embolism usually occur in?
Patients with previous thrombosis or at risk of it (starts in LEs and moves to lungs)
53
What can pulmonary embolism lead to?
Cor pulmonale
54
What is scoring of wells?
>6= high 2-6= moderate <2= low
55
What is pulmonary edema?
Abnormal fluid in extravascular components of lungs
56
What is pulmonary edema due to the failure of?
Capillary and alveolar epithelium to protect respiratory system pulmonary lymphatics to clear fluid
57
What are causes of pulmonary edema?
LV heart failure Acute lung injury Pulmonary embolism Drowning
58
What is acute respiratory distress syndrome?
Acute onset of severe noncardiogenic pulmonary edema, hypoxemia, and the need of ventilation
59
What is a common cause of respiratory failure in critically ill patients?
Acute respiratory distress syndrome
60
What are the most common causes of acute respiratory distress syndrome?
Pneumonia Sepsis Aspiration of gastric content or severe trauma
61
What occurs in acute respiratory failure?
Inadequate gas exchange
62
What is type 1 acute respiratory failure?
Hypoxia without hypercapnia (low PaO2 and normal PCO2)
63
What is type 2 acute respiratory failure?
Hypoxia with hypercapnia (low PaO2, high PCO2, and low pH)
64
What is treatment of acute respiratory failure?
Respiratory support to correct PaO2 and PCO2 (CPAP or mechanical ventilation)
65
What does prolonged mechanical ventilation result in?
Rapid onset of diaphragmatic atrophy and weakness
66
How long on mechanical ventilation until significant atrophy in both slow and fast fibers?
12-18 hours
67
What does the rate of mechanical ventilation induced atrophy and weakness exceed?
Phrenic Denervation

Cardiopulmonary (20 decks)

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