Icm Pulmonology 15: Respiratory Failure

Front 1

respiratory failure is defined by ___ and possibly ___

Back 1

PaO2 < 50 mmHg
PaCO2 > 50

Front 2

alveolar gas equation

Back 2

PIO2 = PAO2 + PACO2/R

Front 3

PIO2 in terms of FIO2

Back 3

PIO2 = FIO2*(P_b - P_H2O)

Front 4

2 causes of acute hypoxic respiratory failure

Back 4

diffuse lung lesions
focal lung lesions

Front 5

4 types of diffuse lung lesions

Back 5

cardiogenic
permeability
alveolar hemorrhage
reexpansion (?)

Front 6

3 causes of hypercapnic respiratory failure

Back 6

ventilatory pump failure
increased dead space
increased CO2 production

Front 7

3 causes of ventilatory pump failure

Back 7

reduced central drive
muscle dysfunction
increased workload

Front 8

hypothyroidism can cause ___ respiratory failure from ___

Back 8

hypercapnic
reduced central drive

Front 9

before weaning a pt off of ventilator it's important to check ___ because of ___

Back 9

electrolytes
respiratory muscle dysfunction

Front 10

respiratory workload is increased in ___ (3)

Back 10

obesity
airway obstruction
kyphoscoliosis

Front 11

increased dead space occurs in ___ (4)

Back 11

PE
IPF
pulm HTN
emphysema

Front 12

___ is a blood finding in respiratory failure

Back 12

polycythemia

Front 13

high flow CPAP is used in ___ (2). it prevents ___.

Back 13

pulmonary edema
COPD
atelectasis

Front 14

T/F: PEEP decreases cardiac output

Back 14

true

Front 15

ventilation on stomach helps ___

Back 15

improve V/Q match

Front 16

___% of each breath is dead space ventilation

Back 16

30

Front 17

minute ventilation =

Back 17

respiratory rate x VT

Front 18

PACO2 in terms of Vdot_A

Back 18

PACO2 = VdotCO2*(Pb - 47)/Vdot_A

Front 19

blood O2 content in terms of [Hb]

Back 19

O2 content = 1.34*[Hb]*(O2 sat) + PO2*0.0031

Front 20

when PO2 = 60 mm Hg, Hb sat is ___

Back 20

90%

Front 21

normal A-a difference

Back 21

<15

Front 22

ARDS is a type of ___capnic respiratory failure

Back 22

hypo/normo

Front 23

if a normocapnic hypoxemic respiratory failure with increased ___ is not correctable with O2, ___ is present. otherwise, ___ is present.

Back 23

A-a diff
R-L shunt
V/Q mismatch

Front 24

if a normocapnic hypoxemic respiratory failure has a normal A-a diff, ___ (2) is present.

Back 24

high altitude
reduced FIO2

Front 25

3 symptoms of hypoxemia

Back 25

cyanosis
tachycardia
sweating

Front 26

5 symptoms of hypercapnea

Back 26

flushing
asterixis
papilledema
slurred speech
headache

Front 27

nasal cannula can increase FIO2 to ___%

Back 27

30

Front 28

simple mask can increase FIO2 to ___%

Back 28

60

Front 29

4 elastic causes of increased respiratory workload

Back 29

kyphoscoliosis
IPF
trauma
ankylosing spondylitis

Front 30

if the ratio of ___ to ___ is >___, weaning from ventilation is less likely

Back 30

respiratory rate
VT
100

Front 31

if A-a diff is increased, ___ (2) is present

Back 31

V/Q mismatch
R-L shunt

Front 32

at the highest levels, e.g. O2>___, O2 toxicity can cause ___ (3)

Back 32

1000 mm Hg
CNS toxicity
seizures
pulmonary edema

Front 33

at high levels of O2, e.g. FIO2>___, O2 toxicity can cause ___ (3)

Back 33

0.6
capillary damage
IPF
retrolental fibroplasia

Front 34

an FIO2 below ___ can be tolerated indefinitely

Back 34

0.4

Front 35

4 ways to prevent O2 toxicity

Back 35

PEEP
inverse ratio ventilation
NO
prone position

Front 36

NO is used in ___ (2)

Back 36

ARDS
pulm HTN

Front 37

2 adverse effects of NO

Back 37

methemoglobinemia
NO2 toxicity

Front 38

prone position improves ___

Back 38

V/Q match

Front 39

inverse ratio ventilation means

Back 39

prolonging inspiratory time relative to expiratory

Front 40

edema fluid in ARDS has ___% of plasma protein concentration

Back 40

>70

Front 41

edema fluid in LHF has ___% of plasma protein concentration

Back 41

<50

Front 42

PWP is ___ in ARDS

Back 42

<18 mm Hg

Front 43

infiltrates in ARDS are unilateral/bilateral

Back 43

bilateral

Front 44

PaO2/FIO2 in ARDS

Back 44

<200

Front 45

3 stages of ARDS

Back 45

edema
hyaline membrane
inflammation and fibrosis

Front 46

edma stage of ARDS peaks at ___ days following injury

Back 46

1

Front 47

hyaline membrane stage of ARDS peaks at ___ days following injury

Back 47

3--5

Front 48

fibrosis stage of ARDS peaks around ___ days following injury

Back 48

10

Front 49

ARDS is associated with loss of ___ which can be improved by ___

Back 49

compliance
PEEP

Front 50

4 tx for ARDS

Back 50

inhaled NO
prone position
PGs
CS

Front 51

7 tx for status asthmaticus

Back 51

beta2 agonists
ipratropium bromide
CS
theophylline
MgSO4
heliox
sedation and paralysis