Podcast: Play in new window | Download

<< Click here to get 40 Pulmonology questions straight from my book The Final Step >>

Other Pulmonary Disease

Acute Respiratory Distress Syndrome (ARDS)

• Severe inflammation of the lung tissue which impairs gas exchange secondary to acute injury secondary to pulmonary edema
• Without treatment 90% of patients will die

Things associated with the onset of ARDS

• The majority of ARDS cases are seen in these settings
  • Sepsis
  • Severe trauma
  • Aspiration of gastric contents
• Other possible settings for ARDS
  • Near drowning
  • Inhalation of toxins
  • Shock
  • Burns
  • Pancreatitis
  • Disseminated intravascular coagulation (DIC)
  • Thrombotic thrombocytopenia (TTP)
  • Pneumonia
  • Miliary TB
  • Lung contusion
  • High altitude exposure

Clinical Presentation

• Onset within 12 – 24 hours
• Acute onset dyspnea
• Acute onset tachypnea
• Frothy red sputum

Labs, studies and physical exam findings

• Diffuse crackles
• Hypoxemia that does not respond to oxygen
• Chest x-ray
  • May be normal
  • Bilateral opacities with no other explanation

Treatment

• Intubation and mechanical ventilation
• Treat underlying causes

Hyaline Membrane Disease/Respiratory Distress Syndrome

• Occurs in premature infants due to insufficient production of surfactant

Clinical Presentation

• Tachypnea
• Tachycardia
• Retractions
• Nasal flaring
• Apnea

Labs, Studies and Physical Exam Findings

• Chest x-ray
  • Decreased lung volume
  • Diffuse atelectasis giving a ground glass appearance

Treatment

• Prevention
  • Steroids are given if there is a risk of delivery before 34 weeks gestation
• Oxygen
• Positive airway pressure
• Intubation
• Surfactant spray

Foreign Body Aspiration

• More frequent in children and elderly

Clinical Presentation

• Wheezing
• Drooling
• Dyspnea
• Foul smell

Labs, Studies and Physical Exam Findings

• Chest x-ray showing air trapping

Treatment

• Removal of foreign body under anesthesia if necessary
• Heimlich

Study Tip – Set the stage

<< Click here to get 40 Pulmonology questions straight from my book The Final Step >>