B4-058 Acute Lung Injury and ARDS

Question 1

abnormal accumulation of extravascular fluid in lung parenchyma

Answer 1

pulmonary edema

Question 2

intra-alveolar and interstitial accumulation of fluid and congestion of alveolar capillaries

Answer 2

pulmonary edema

Question 3

Answer 3

pulmonary edema

Question 4

• left-sided heart failure leads to increased pulmonary venous pressure
• protein poor transudate

Answer 4

cardiogenic pulmonary edema

Question 5

CXR

• Kerley B lines
• butterfly/batwing sign
• cardiomegaly

Answer 5

cardiogenic pulmonary edema

Question 6

• hemosiderin- laden macrophages accumulate in alveoli
• deposition of hemosiderin in interstitium
• microhemorrhages

Answer 6

chronic cardiogenic pulmonary edema

Question 7

• damage to alveolar epithelium and endothelium increased vascular permeability
• protein-rich exudate

Answer 7

pulmonary edema due to alveolar wall injury

Question 8

direct causes of pulmonary edema due to alveolar wall injury

4

Answer 8

• infection
• aspiration
• inhalation
• radiation

Question 9

indirect causes of pulmonary edema due to alveolar wall injury

3

Answer 9

• SIRS
• drugs/toxin
• transfusion reaction

Question 10

if diffuse, this injury may cause ARDS

Answer 10

pulmonary edema due to alveolar wall injury

Question 11

• impaired gas exchange
• reduction in lung compliance

Answer 11

pulmonary edema

Question 12

• edema fluid within interstitium and alveoli
• capillary congestion
• hemosiderosis in chronic CHF

Answer 12

pulmonary edema

Question 13

• rapid onset of life threatening respiratory insufficiency
• severe progress hypoxemia
• bilateral opacities on CXR
• exclusion of cardiogenic pulmonary edema

Answer 13

ARDS

Question 14

CXR

bilateral opacities

Answer 14

ARDS

Question 15

causes of ARDS

6

Answer 15

• pneumonia
• sepsis
• aspiration
• trauma
• pancreatitis
• transfusion rx

Question 15

the alveolar-capillary membrane is compromised by epithelial and endothelial injury

Answer 15

ARDS

Question 16

Answer 16

acute and organizing diffuse alveolar damage
ARDS

Question 17

what stage of ARDS

• edema
• hyaline membranes
• impaired gas exchange

Answer 17

acute

Question 18

what stage of ARDS

• alveolar pneumocyte hyperplasia
• interstitial fibrosis
• alveolar collapse
• reduced lung compliance
• VQ mismatch

Answer 18

organizing stage

Question 19

what stage of ARDS

• progressive or stable fibrosis
• resolution

Answer 19

fibrotic

Question 20

• hyaline membranes
• interstitial pulmonary edema
• proliferation of type II pneumocytes, fibroblasts, deposition of collagen

Answer 20

ARDS

Question 21

• impaired gas exchange
• alveolar collapse
• reduction in lung compliance
• VQ mismatch

Answer 21

ARDS

Question 22

Answer 22

infant RDS

Question 23

due to surfactant deficiency in immature lungs or congenital deficiency due to mutations

Answer 23

infant RDS

Question 24

hyaline membranes in airspaces

Answer 24

infant RDS

Question 25

risk factors for infant RDS | 3

Answer 25

* male gender * maternal diabetes * C section

Question 26

Answer 26

infant RDS

Question 27

potentially reversible impairment in development of alveolar septation during the saccular stage

Answer 27

bronchopulmonary dysplasia | complication of infant RDS

Question 28

* larger, simplified alveoli with fewer septation on dysmorphic capillary configuration * less surface area for gas exchange

Answer 28

bronchopulmonary dysplasia | complication of infant RDS

Question 29

* decreased levels of VEGF * endothelial cell apoptosis

Answer 29

hyperoxic phase retrolental fibroplasia | complication of infant RDS

Question 30

rebound VEGF levels induce retinal revascularization, retinal detachment

Answer 30

hypoxic phase of retrolental fibroplasia | complication of infant RDS

Question 31

* alveolar collapse, progressive atelectasis * impaired gas exchange * reduction in lung compliance * VQ mismatch

Answer 31

infant RDS

Question 32

decreased lamellar bodies in type II pneumocytes

Answer 32

infant RDS

Question 33

diffuse alveolar damage

Answer 33

ARDS

Question 34

eosinophilic membranes lining alveolar spaces

Answer 34

ARDS | diffuse alveolar damage

Question 35

most common causes of ARDS | 4

Answer 35

* pulmonary infection * shock * sepsis * aspiration

Question 36

complication of high dose oxygen therapy

Answer 36

bronchopulmonary dysplasia

Question 37

defective alveolar septation and abnormal vascular development | fewer, larger alveoli = less surface area

Answer 37

bronchopulmonary dysplasia

Question 38

hyperoxemia, hyperventilation, prematurity, inflammatory mediators, and vascular maldevelopment play a role in the development of

Answer 38

bronchopulmonary dysplasia

Question 39

frothy, pink fluid

Answer 39

pulmonary edema

Question 40

excessive supplemental oxygen used in the management of neonatal RDS is a risk factor for

Answer 40

retinopathy of prematurity

Question 41

abnormal proliferation of the blood vessels in the retina can lead to retinal detachment and blindness

Answer 41

retinopathy of prematurity

Question 42

declining in frequency due to improved ventilation and oxygen techniques

Answer 42

retinopathy of prematurity

Question 43

occurs secondary to heart failure as a result of increased hydrostatic pressure

Answer 43

pulmonary edema

Question 44

fluid accumulates in alveolar septa/interstitium and in the alveolar spaces

Answer 44

pulmonary edema

Question 45

leukocyte mediated injury to alveolar capillary endothelium

Answer 45

ARDS

Question 46

diffuse alveolar damage intitated by injury to capillary endothelium via neutrophils and macrophages

Answer 46

ARDS