Questions and Answers
Clinical manifestations of Pulmonary Embolism - Answer- ✔✔Sudden onset pleuritic
chest pain, dyspnea, tachypnea, tachycardia, unexplained anxiety
Less common- syncope and hemoptysis
Risk factors for PE - Answer- ✔✔Triad of Virchow
Venous stasis, hypercoagulability, endothelial injury
CM of pulmonary edema - Answer- ✔✔Dyspnea, orthopnea, hypoxemia, increased
work of breathing, inspiratory crackles (rales), pink frothy sputum, hypoventilation with
hypercapnea
Causes of pulmonary edema - Answer- ✔✔Left-sided heart failure (most common),
capillary injury, lymphatic blockage
Risk factors for pulmonary edema - Answer- ✔✔Heart disease, ARDS, inhalation of
toxic gasses
What treatment is mandatory for pulmonary edema? - Answer- ✔✔O2 administration
What is flail chest? - Answer- ✔✔Fracture of several consecutive ribs in more than one
place or fracture of sternum and several consecutive ribs
CM of flail chest - Answer- ✔✔Pain, dyspnea, unequal chest expansion,
hypoventilation, hypoxemia
How does flail chest move during respirations? - Answer- ✔✔Inspiration= inward
movement of injured area
Expiration= outward movement of injured area
Types of and causes of pneumothorax - Answer- ✔✔Primary- spontaneous, occurs in
thin males 20-40 or patients with emphysema
Secondary- from trauma, rupture of COPD bleb or bulla, or mechanical ventilation
(especially if it includes PEEP)
Iatrogenic- trans thoracic needle aspiration
Tension- pleural rupture
Define pneumothorax - Answer- ✔✔Presence of air or gas on pleural space from
rupture in visceral pleura. Lung will collapse.
CM of pneumothorax - Answer- ✔✔Sudden pleural pain
, Tachypnea
Mild dyspnea
Absent or decreased breath sounds
Deviated trachea
SOB
Hypotension
Severe hypoxemia
Result of tension pneumothorax - Answer- ✔✔Rupture acts as one way valve- air enters
but is unable to escape. Pressures continue to increase.
Causes complete lung collapse, compression and displacement of heart and great
vessels
Pleural effusion types and causes - Answer- ✔✔Transudative- watery fluid- from
increased hydrostatic or decreased Oncotic pressure
Exudative- WBC and plasma proteins- response to inflammation, infection, or
malignancy
May also be empyema(pus), hemothorax (blood), or chyle (chylothorax)
Causes of hypoxic respiratory failure - Answer- ✔✔Direct injury to lungs
Injury or dysfunction to one or more body systems or organs
Post-op complication secondary to anesthesia or narcotics
PaO2 of hypoxic respiratory failure - Answer- ✔✔</= 50 mmHg
PaO2 of hypercapnic respiratory failure - Answer- ✔✔>/= 50 mmHg
Phases of acute lung injury/ARDS - Answer- ✔✔Inflammatory- (first 72 hours)
inflammatory process is activated, fluid, protein, and blood cells leak into interstition,
gas exchange is impaired
Proliferative- (4-21 days) pulmonary edema resolves, inter alveolar exudate becomes
granular, hypoxia worsens
Fibrotic- (14-21 days) remodeling and fibrosis, impaired lung function may be
permanent
Risk factors for ARDS - Answer- ✔✔Genetic factors, sepsis, multiple traumas, PNA,
burns, aspiration, cardiopulmonary bypass surgery, pancreatitis, drug overdose, smoke
or noxious gas inhalation, O2 toxicity, radiation therapy, DIC
Asthma is what type of hypersensitivity? - Answer- ✔✔Type I, IgE mediated
Atopic disorder