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31 Cards in this Set

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  • Back
Hypoplastic lung consists of _
Carina

Malformed bronchial stump

Absent or poorly differentiated distal lung tissue

Coexisting cardiac, GI, GU and skeletal malformations in 50% of cases
Pathophysiology of hypoplastic lung
Inadequate space in fetal thorax

Any factors affecting the volume and composition of amniotic fluid

Any alteration in critical volume and pressure relationships of amniotic fluid in trachea and lung at 15-28 weeks gestation can induce hypoplasia
- Congenital tracheal malformation
- Uncommon usually cystic mass
- Composed of non functioning primitive tissue
- Doesnt communicate with tracheobronchial tree
Sequestration
2 types of sequestration
Intralobar

Extralobar
EARLY embryologic development of accessory lung bud results in formation of sequesration WITHIN normal lung tissue. The sequestration is encased WITHIN SAME PLEURAL COVERING - usually associated with recurrent localized infections or BRONCHIECTASIS - what type of sequestration
Intralobar
- External to lung
- May be found anywhere in thorax or mediastinum
- LATER development of accessory lung bud
- May give rise to communication with GI tract - what type of sequestration
Extralobar
Pathophysiology of congenital lobar emphysema
Overdistention of air spaces within pulmonary lobe - associated with air trapping and compressive changes in remainder of the lung
2 week old infant presents with complain of food regurgitation and respiratory compromise with feeding. He is found to have aspiration pneumonia, attempt to pass NG tube past esophagus is unsuccessful. X ray shows stomach distended by air
Tracheoesophageal fistula
Calculation of PA O2
(760-47) * 0.21 - 40/08 = 100
In primary lung disease Aa gradient is _
greater than 15
In secondary lung disease Aa gradient is _
less than 15
Most common cause of hemodynamic edema
Increased hydrostatic pressure - L heart failure
Edema is increased in which part of lung
Base (gravity)
Caused by diffuse alveolar capillary damage mediated via neutrophils
ARDS
Patient presents with cyanosis, respiratory insufficiency and severe hypoxemia refractory to O2 therapy
ARDS
Cause of ARDS
Diffuse damage to alveoli
Cause of neonatal RDS
Lack of surfactant
ARDS - restrictive or obstructive disease
Restrictive
Major role in pathogenesis of ARDS
Neutrophils
In ARDS - respiratory acidosis or alkalosis
Acidosis
Major cause of ARDS
Sepsis
Is there heart failure in ARDS
NO NO L HEART FAILURE
Most common characteristic finding of ARDS
Hyaline membrane lining distended alveoli
occurs secondary to blunt or penetrating injury of the lung which results in a one-way valve being created. Air leaks from the lung out into the pleural space and is unable to escape, resulting in increased intrapleural pressure. Intrapleural pressure eventually increases to the point where it interferes with venous return, resulting in blood pooling in capacitance vessels with ensuing cardiovascular collapse and shock.
Tension pneumothorax
Main source of PE
Popliteal veins and larger veins above it - FEMORAL VEIN
What happens to PVR in PE
Increased
Patient collapses and is taken to hospital - there is no palpable pulse however EKG shows normal sinus rhythm, chest x ray shows cor pulmonale
Pulmonary embolism
What type of necrosis in PE
Hemorrhagic
Patient presents with dyspnea and chest pain, he is in state shock, he has fever and labs reveal INCREASED LDH
PE
Gold standard to diagnose PE
Pulmonary angiography
Biopsy of the lung reveals medial hypertrophy - what does it tell you
Pulmonary HTN