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42 Cards in this Set
- Front
- Back
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What is the definition of Acute Respiratory Distress Syndrome (ARDS)?
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• a diffuse pulmonary parenchymal injury associated w/ noncardiogenic pulmonary edema
• results in severe respiratory distress and hypoexmic respiratory failure |
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What is the pathologic hallmark of ARDS?
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diffuse alveolar damage
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How is ARDS clinically diagnosed?
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• acute onset
• bilateral infiltrates • pulmonary artery wedge pressure < 19 mm Hg • PaO2/FIO2 ratio < 200 (ARDS) OR < 300 (acute lung injury) |
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What are predisposing conditions that can cause ARDS?
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• direct pulmonary injury (ex. pulmonary infection, aspiration)
• indirect injury (ex. sepsis, pancreatitis, multiple trauma) |
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Name and describe the 3 phases of ARDS
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• Exudative phase: injury to endothelium and epithelium w/ inflammation and fluid exudation
• Fibroproliferative phase: influx & proliferation of fibroblasts and other cellular elements; injury may resolve or become persistent • Fibrosis phase: healing phase; resolution of inflammation & development of varying degrees of pulmonary fibrosis |
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What are the 2 major types of lung cancer? Which one is more common?
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• non-small cell lung cancer (more common)
• small cell lung cancer |
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What are the 3 types of non-small cell lung cancer?
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• squamous cell carcinoma
• adenocarcinoma • large cell carcinoma |
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What is the #2 leading cause of lung cancer?
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radon
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What is the most common primary cancer that metastasizes to the lung?
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breast cancer
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Which types of lung cancer typically arise near the hilar region?
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• squamous cell carcinoma
• small cell carcinoma |
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Which type of lung cancer typically arise in the periphery of the lung?
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adenocarcinoma
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Name some syndromes assoicated w/ lung cancer
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• Horner's syndrome
• Pancoast's syndrome • Superior vena cava syndrome |
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What causes Horner's syndrome?
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an apical lung tumor (called a Pancoast's tumor) that compresses the brachial plexus
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What is the classic triad of Horner's syndrome?
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• ptosis
• miosis • anhidrosis |
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What is Pancoast's syndrome?
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Horner's syndrome combined with pain in the arm and shoulder because of invasion of the brachial plexus
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What causes SVC syndrome?
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• obstruction of the venous drainage of the head and neck
• results in swelling and CNS symptoms |
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What is mesothelioma?
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• malignancies involving mesothelial cells
• mesothial cells normally line the body cavities (ex. pleuro, peritoneum, pericardium, and testis) |
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Most pleural malignant mesotheliomas are associated with exposure to what?
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asbestos
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What can mesothelioma on chest x-ray show?
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• obliteration of the diaphragm
• nodular thickening of the pleura • decreased size of the chest • radiolucent sheetlike encasement of the pleura • loculated effusion in more than 50% of patients |
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What is the most common lethal inherited disease in white persons?
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Cystic fibrosis
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Is cystic fibrosis autosomal dominant or autosomal recessive?
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autosomal recessive
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Give 2 general examples of interstitial lung disease
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• sarcoidosis
• pneumoconiosis |
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Which disease is a noncaseating granulomatous disease of unknown etiology?
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sarcoidosis
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What are extrapulmonary manifestations of sarcoidosis?
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• arthritis
• cranial nerve palsies • enlarged lymph nodes • erythema nodosum • fatigue/malaise • visual loss • weight loss |
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What are lab and radiographic findings of sarcoidosis?
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• increased Ca++, ESR, & total protein
• bilateral hilar and paratracheal adenopathy • pulmonary infiltration with a diffuse "ground glass" or a more nodular appearance |
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Give examples of pneumoconiosis
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• asbestosis
• silicosis • coal worker's pneumoconiosis |
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True/False: Productive cough and wheezing are usually not associated with asbestosis
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• The correct answer is: True
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What does chest xray typically show on patients with asbestosis?
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diffuse linear opacities in the lower lungs and thickened pleura
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Which is the oldest occupational lung disease?
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Silicosis
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Silicosis is associated with what industries?
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• granite cutting
• metal mining • pottery making • soap production |
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Patients with asbestosis are at an increased risk for developing what? people with silicosis?
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• asbestosis » increased risk for lung cancer and mesothelioma
• silicosis » increased risk for TB |
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What are chest xray findings in patients with silicosis?
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• multiple small nodules and calcifacation of the hilar lymph nodes
• "egg shell" calcifications |
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What is the definition of a pulmonary abscess?
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necrosis of the pulmonary tissue and formation of cavities containing necrotic debris or fluid caused by microbial infection
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Lung abscess most frequently arises as a complication of what?
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aspiration pneumonia
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What is the treatment for a pulmonary abscess?
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Clindamycin for 4-6 weeks
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What skeletal abnormality leads to chronic deterioration in lung function?
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• kyphoscoliosis
• causes reduced lung volumes and increased stiffness of the chest wall |
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What is the definition of drowning?
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death from asphyxia within 24 hours of submersion in water
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What is the definition of near-drowning?
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• survival beyond 24 hours after a submersion episode
• can still be fatal, but will die after 24 hrs |
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What are the 2 ways that people drown (or near-drown)?
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• by aspirating water
• laryngospasm |
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What is the A-a gradient?
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• the difference between the partial pressure of O2 in the alveoli (A) and in the artery (a)
• PAO2 - PaO2 • gives us an idea of how well the oxygen is moving from the alveoli to the arterial blood |
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What is the normal A-a gradient?
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• 5-25 mm Hg
OR • (Age + 10)/4 OR • (Age/4) +4 |
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What can cause an increased A-a gradient?
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• pulmonary embolism
• diffusion defects • right to left shunts • increased age • supine posture |
