Atelectasis

Question 1

what is atelectasis

Answer 1

loss of lung volume due to inadequate expansion

Question 2

does atelectasis lead to ventilation perfusion imbalance (leading to hypoxia)

Answer 2

yes

Question 3

it involves segment or …. or ….

Answer 3

lobe or lung

Question 4

if cause is removed is it reversible

Answer 4

yes

Question 5

types of atelectasis

Answer 5

resorption (obstructive), compression , contraction , microatelectasis

Question 6

resorption atelectasis due to

Answer 6

foreign body, mucus plug due to bronchitis or asthma or cystic fibrosis , post surgery , tumor

Question 7

mediastinal shift in each type of atelectasis

Answer 7

resorption same side
compression opposite side
contraction and microatelectasis no shift

Question 8

compression atelectasis causes

Answer 8

air or fluid in pleural cavity

Question 9

what happens to diaphragm in compression atelectasis

Answer 9

elevated

Question 10

contraction atelectasis causes

Answer 10

post inflammatory scarring, fibrotic changes

Question 11

is contraction atelectasis reversible

Answer 11

usually irreversible

Question 12

microatelectasis cause

Answer 12

loss of surfactant

Question 13

microatelectasis location

Answer 13

generalized

Question 14

where is microatelectasis usually seen

Answer 14

acute or neonatal respiratory distress synd

Question 15

grossly and microscope ate.

Answer 15

gross: shrunken purple sub crepiant nodular lung

micro,: slit like alveoli, congested septae and hyaline mem in micro

Question 16

ARDS caused by many conditions

Answer 16

true

Question 17

clinical manifestation of ARDS

Answer 17

Hypoxemia hypercapnea
diffuse bilateral pulmonary infil
acute onset of severe dyspnea

Question 18

direct etiology of ARDS

Answer 18

Pneumonia
toxic inhalation
aspiration of gastric contents

Question 19

why do some ppl have gastric aspiration

Answer 19

ppl with disability or chronic alcoholics or coma (ma 3andhom gag reflex)

Question 20

indirect etiology of ARDS

Answer 20

sepsis 
pancreatitis 
multiple transfusion 
drug overdose 
multiple trauma

Question 21

risk factor of ards

Answer 21

multiple predispose conditions
old age
chronic alcoholics
metabolic acidosis

Question 22

what is pathognomic for ARDS

Answer 22

DAD diffuse alveolar damage

Question 23

pathogenisis of ards (start with imbalance)

Answer 23

imbalane in pro inflam and anti inflam mediators
nuclear factor kabba is pro inflam that activates macrophages
macrophages release IL 1 IL8 and TNF
these select isolate and activate neutrophils
neutrophils release protease leukotriene oxidant and PAF
lead to endothelium and epithelium injury and DAD

Question 24

what later happens in ARDS pathogenisis

Answer 24

macrophage derived fibrogenic factors released ( IL-1 IL8 TGF and PDGF )
Recruit fibroblasts
clotting cascade

Question 25

how pathogenisis of ARDS counteracted

Answer 25

by anti protease anti oxidant and anti inflammatory (IL-10)

Question 26

acute phase of ARDS

Answer 26

``` Exaudate in alveoli altered diffusion atelectasis neutrophil infiltration hyaline membrane ( cellular debris dysfunction surfactant and exaudate pulmonary HTN ```

Question 27

organizing phase of ARDS

Answer 27

Organize exaudate pneumocyte type 2 prolif lymphocyte infiltrate

Question 28

fibrosis phase of ARDS

Answer 28

loss of lung architecture emphysema like extensive fibrosis intimal prlif in microcirculation leading to vascular occlusion and pulmonary HTN honey comb apperance

Question 29

which phase of ARDS has lymphocyte

Answer 29

organizing

Question 30

which phase of ARDS has neutrophils

Answer 30

acute

Question 31

clinical picture of ARDS first 72 hours

Answer 31

severe dyspnea nd hypoxemia and cyanosis

Question 32

clinical picture of ARDS after 72 hours

Answer 32

bilateral severe pneumonia and bilateral pulmonary infiltrate , multisystem failure , DIC