Atelectasis and ARDS Flashcards Preview

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Flashcards in Atelectasis and ARDS Deck (24):
1

causes of obstruction in resorption atelectasis

Mucus/mucopurulent plug following surgery

foreign material

bronchial asthma, bronchitis, bronchiectasis

neoplasm

2

contraction atelectasis

fibrotic changes in lung or pleura prevent full expansion (not reversible)

3

hemosiderin laden macrophages found in

pulmonary edema (heart failure cells)

4

histo compression atelectasis

collapsed, slit-like alveoli

4

manifestations acute lung injury

Pul edema

Diffuse Alveolar Damage

ARDS

5

ARDS presenetation

dypsnea

severe hypoxemia not responsive to O2

Respiratory acidosis

7

clinical presentation resorption atelectasis

Fever+dypsnea within 24-36 hours of collapse

ispilateral trachea deviation

ipsilateral diaphragmatic elevation

absent breath sounds+vocal vibratory sensation (fremitius)

no expansion on inspiration

8

histo neonatal atelactaiss

collapsed parenchyma

reduced open alveoli

open alveolie lined with pink hyaline membrane

8

risk factors ARDS

gram negative sepsis

aspiration

severe trauma

pulmonary infections, heroin, smoke

9

associations decreased neonatal surfactant

premature 

maternal diabetes (fetal hyperglycemia)

Cesarean 

10

pathogenesis ARDS

acute injury to alveoli/capillary

macrophage cytokine release >

PMN chemotaxis > migrate to alveoli > 

fibrin leakage > hyaline membrane

damage to type 2 pneumocytes

Repair by type 2 leads to interstitial fibrosis

10

histology ARDS

hyaline membrane

hyperplastic type 2 pneumocytes

12

neonatal atelactasis due to 

loss of surfactant

14

hormonal drivers of surfactant

increased by cortisol and thyroxine

decreased by insulin

16

surfactant proteins implicated in atelactasis

B and C 

reduce surface tension

17

phases of ARDS

exudative stage: Edema (day 0-3)

exudative stage: Hyaline membranes (day 2-6-14)

proliferative stage: Interstitial inflam (starting day 3, 7-14) 

18

shift in compression atelectasis

away from affected lung

19

atelectasis consequence of complete airway obstruction

resoption atelctasis

19

surfactant stored in 

lamellar bodies

20

clinical presentation + xray neonatal altelactasis

RD within hours of birth

hypoxemia and respiratory acidosis

Ground glass CXR

21

non cardiogenic pulmonary edema from acute alveolar capillary damage

ARDS

22

air or fluid accumulation in pleual cavity > increased pressure > collapses lung

compression ateletasis

23

most common cause of post surgery fever

resorption atelectasis

24

pathogenesis resorption atelectasis

obstruction >

> no air reaches alveoli >

> resorption of air trapped in distal spaces through pores of Kohn >

> collapse