Pulmonary Oedema

Question 1

cardiogenic pulmonary oedema (CPO), symptoms

Answer 1

due to an increase in hydrostatic pressure of the pulmonary capillary blood secondary to left ventricular dysfunction or failure arising eg:
- hypertension
- MI
- ischaemic heart disease.

Symptoms:
- enlarged heart size
- high BNP (heart can’t pump properly)

HEART disease = CPO

Question 2

non-cardogenic pulmonary oedema (NCPO), symptoms

Answer 2

due to leakiness of alveolar-capilary membrane are often associated with inflammation.
- near drowning experience
- mechanical ventilation
- lung infection

Symptom
- normal heart
- Low BNP (no heart problem)

Random events = NCPO

Question 3

mechanisms that lead to pulmonary oedema (PO)

Answer 3

FII
- fluid build up in the capillaries of the lungs
- increases pressure in capillaries forces fluid out of the capillaries and into alveoli.
- increased fluid within alveoli decreases exchange of o2 and co2.

cellular level
- decrease in lymphatic drainage
- increase in capillary permeability
- increase in capillary hydrostatic pressure

Question 4

causes of PO and how they give rise to PO

Answer 4

HAICADP
- hypertension
- acute respiratory distress syndrome (ARDS) - a severe medical condition causing widespread inflammation in the lungs can be triggered by COVID or influenza
- inhalation of toxic gases
- cardiomyopathy - deterioration of heart function
- asthma
- drug damage to endothelial cell layer in lung
- prolong exposure to high altitudes

Question 5

how gas exchange in the lung alveoli become impaired in PO?

Answer 5

• increased fluid within the alveoli which decreases o2 exchange. (o2 leaves alveolar)
• damage to alveolar capillary membrane and epithelial cells.

Question 6

cellular events that lead to CPO (3)

Answer 6

• a increased hydrostatic pressure
• transport of Na+, Cl- and H2o is drives removal of alveolar edema
• protein poor fluid in alveoli

Question 7

cellular events that leads to NCPO (5 p)

Answer 7

• a normal hydrostatic pressure
• disrupted epithelial barrier
• broken transport of Na+, Cl- and H2o.
• white blood cells enter (macrophages and neutrophils)
• protein rich edema fluid

Question 8

symptoms of PO (7)

Answer 8

DIHCIFS
Dyspnea - shortness of breathing and breathing is hard
Inability to lie down
Hypoxia - decreased o2 in blood
Coughing - pink froth (blood in lung)
Inspiratory crackles and wheezes - due to water in alveoli
Fast heart rate, pale and sweating - due to activation of SNS(sympathetic nervous system)

Question 9

what histological changes that could occur in PO patient?

Answer 9

• signs of infection
• decrease level of consciousness + vomiting
• trauma
• accidental exposer to chemicals
• details of medications and ingestions

Question 10

Treatment for PO

Answer 10

• mask up patient with o2
• patient in a sitting position to reduce venous return.
• morphine (pain reduction and reduce sympathetic activity)

Question 11

Pulmonary oedema and common cause?

Answer 11

• too much fluid in lungs.
• common cause is congestive heart failure.

Question 12

diagnosis of PO

Answer 12

• blood o2 saturation levels - pulse oximetry
• chess x-ray - fluid in lungs and around , large heart and white on x-ray is fluid
• ultrasounds of heart (ECHO) - weak heart, narrow heart valves and fluid around heart.
• BNP (brain natriuretic peptide) - indicate heart failure

Question 13

what measures are done to exclude myocardial infarction from treatment and diagnosis CPO?

Answer 13

ECG and troponin