Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
19 Cards in this Set
- Front
- Back
|
What is hemodynamic edema?
|
Pulm cap hydrostatic pressure increases secondary to elevated EDP in LV, fluid is directed into interstitium.
|
|
|
Acute vs Chronic Pulmonary Edema:
Pathologic Features |
Acute: noninflammatory, no fibrosis; distended alveolar capillaries, ephilic
Chronic: thick alveolar walls with fibrosis, HEMOSIDERIN-laden macs in alveoli (brown)--bc macs have engulfed RBCs |
|
|
How do the pathologic features of edema due to microvascular injury differ from hemodynamic edema?
|
Leakage from capillaries includes proteins and inflammatory cells
Exudation vs transudation Fibrosis! |
|
|
Acute Lung Injury:
AKA Cause Presentation |
Noncardiogenic Pulmonary Edema
Caused by alveolar epithelial and endothelial damage; inc'd vasc perm and inflammn Rapid onset of severe respiratory insufficiency with cyanosis |
|
|
ARDS vs Acute Lung Injury:
General Specific causes of ARDS |
ARDS is a more severe form of ALI
Can result from direct/indirect lung injury (multi-system organ failure) Direct causes: pneumonia, aspiration (gastric contents), contusion, fat embolus Indirect: Sepsis, trauma with shock, cardiac bypass, transfusion of blood products |
|
|
What is diffuse alveolar damage?
Effects? |
DAD:
Compromised integrity of alveolar endothelium and epithelium Effects: Inc'd vasc perm, exudate in interstitium and alveoli Loss of surfactant due to damage of Type II pneumocytes microthrombi Loss of diffusion capacity |
|
|
Pathologic features of diffuse alveolar damage.
|
Gross: heavy, dark, red, no air
Micro: congestion, necrosis, edema, hemorrhage, nphils Hyaline membranes |
|
|
When are hyaline membranes present in alveoli?
|
When there's lack of surfactant; occurs in DAD and premature birth
|
|
|
When would a newborn carried to term display hyaline membranes in the alveoli?
|
Newborns carried at or near term can develop Diffuse Alveolar Damage (ARDS) on the basis of sepsis, meconium aspiration, or prolonged shock
|
|
|
Transfusion Related Acute Lung Injury:
What is it? Cause |
Acute resp failure within 6 hours of transfusion (must rule out circulatory overload before diagnosis!)
Due to preformed Abs in donor plasma against pt's WBCs in plasma-rich products Most common in plasma in multiparous women! |
|
|
Pulmonary Embolism:
Source of thrombus Likelihood of infarct Symptoms (large vs small emboli) |
Mostly from fragmented DVT in leg, occluding according to size
Rarely benign or malignant tumor emboli Bc of bronchial circuln, chance of infarct is 10%; when do occur, they are hemorrhagic Large embolus-->acute cor pulmonale and sudden death Repeated small emboli-->pulm HTN and chronic cor pulmonale |
|
|
Pulmonary Embolism:
Nonthrombotic sources |
Bone marrow, fat (can go to peripheral organs, especially brain!), amniotic fluid, air, foreign bodies
|
|
|
Fat Embolism:
Source of fat Effects |
Fat from BM with long bone fractures
Some fat globules go through lung to peripheral organs (like brain) Chemical (acts as irritant) and obstructive effects, results in thrombocytopenia, hemolytic anemia |
|
|
Air Embolism:
Sources |
Air entering circulation during delivery, CV catheterization, surgery, injection in arteries, veins, body cavities
Air will airlock in RV and won't enter circulation |
|
|
Pulmonary Hypertension:
General Causes (2) Specific Causes |
Dec'd cross-SA of pulm vasc OR inc'd flow
Specific: Congenital/acd'q heart dz (Eisenmenger syndrome, Mitral Stenosis) Thromboembolism Pulm obstructive and interstitial dz; hyphoscoliosis Drugs: appetite suppressant meds; aminorex, fenfluramine, phentermine Cocaine Collagen vasc dz (scleroderma) Viruses (HIV, HHV-8) |
|
|
What is primary pulmonary HTN?
|
Pulmonary HTN when no secondary cause can be established, i.e., idiopathic.
|
|
|
Mutations in bone morphogenetic protein receptor 2 (BMPR2) signaling pathway can result in _______.
|
Primary Pulm HTN
|
|
|
Microscopic changes of pulmonary hypertension.
|
Intimal and medial thickening
Plexogenic (plexiform) lesions--side branching off arteriole |
|
|
What is a dilatation lesion?
|
More advanced form of plexiform lesion (side branches off the side branches)--severe pulm HTN
|
