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24-48 hrs

Ards will develop ..l.after initial illness or injury

Abnormalities in lungs with ards

Abnormal surfactant,interstitial edema


Moderate dowry rate,metastic tendency oblong 180 days

Alveolar cells on prolonged ards pt

Hyperplasia and swelling of type 2 cells


Usually intubation and mechanical vent,cpap,peep


A form od response failure from pulmonary injury of various xauses

Ards aka

Pump lung shock lung wet lung

Ards anaomic alterations are similar to someone with

Hyaline membrane disease

Ards pt with alveolar consolidation and atelectasis should be treated with


Atelectasis chest assessment

Increase tactile fremitus,dull note,crackle,bronchial sounds,whisperednpectoriloquy


Are encapsulated Nd grow slowly

Benign tumors

Grow slowly,are encapsulated

Best way to manage tu or in rt main bronchus during scope



During a bronchoscopy if tumor found in rt man bronchus best way to manage is

Breathing high percent of u2 with a block in left bronchus

Can lead to atelectasis

Burns septicemia and hemorrhagic pancreatitis

Can lead to ards

Causes of ards

Pneumonia,airation narcotic od,near drowning,fat embolism,shock,fluid overload,sepsis,trauma thorax,smoke inhale,inhale tpxins,oxygen toxicity,airway burn,mech ventHemorrhagic pancreas

Causes of obstructive atelectasis

Foreign body tumor mucus plug

Causes of palm fibrosis

Asbestos,silicosis,berylliosis,black lung coal miners siderosis


Is using anti cancer drugs to tx small cell

Chest assessment of ild

Pleural friction rub increased vocal fremitus
Pleural effusion honeycombing cavity formation ,granulomas,interstitial thickening

Clinical manifestations of ards

Low or norm pul cap wedge pressure,tachycardia,intercostal retractions,cyanosis

Coal workers interstitial lung disease aka


Common secondary infection with ards

Klebsiela pseudomonas staph


Microscopic exam of sputum

Drugs that may cause interstitial fibrosis


Five to six

Size Difficult to see on xray

Found in alveoli of ards pt

Debri,fibrin,hyaline membrane

High risk interstitial Lung disease sarcoidosis

African American women,20-30 age

Hilar region

Small cell is found here

Idiopathic pulmonary fibrosis

Is intertitial inflammation wo granuloma formation

If appropriate timely tx

Ards has survival rate of 60%

Interstitial LNG disease chest assessment

Pleural friction rub,increased vocal fremitus

Interstitial lung disease and asbestosis have

Pleural plaques,secretions,bronchospasm

Interstitial lung disease sclerosis affects

Skin, lungs

Interstitial lung disese can be caused by

Anticancer drugs

Lg cell carcinoma

Grow rapidly early metastatic doubling time 100 days


Removal of whole lobe


Cause necrosis and invade tissue

Malignant tumors

Invade surrounding tissues,cause necrosis

Mediastinal cancer

Affects swallowing and hoarseness weakness bone pain seizure and wt loss


Scope inserted thru incision in neck


Incision in chest to see if cancer spread to lymph nodes

Misc interstitial lung disease types

Good pastries,alveolar protein Lydia,chronic eosinophilia pneumonia

Most common tx for sm cell carcinoma


Non obstructive atelectadis

Is from surgery pun thorax pl effusion paralysis ards fibrosis

Non small cell cancer types

Lg cell,squamous,adenocarcinoma

Obstructive atelectasis

Obstructs gas flow between trachea and alveoli

Onehun fourty

Types of pulmonary fibrosis

Palliative care

Treat symptoms make comfy

Palliative therapy

Is to make pt comfortable

Pawp measured with swan gantz

This is low in ards pt less than 18 mmhg

Peripheral and central region of lunf

Adenocarcinma is found here

Peripheral central lungs

Lg cell carcinoma is found here

Pft of atelectasis

Decreaase ic,decrease vc

Ph goal ards


Photodynamic therapy

Uses chemical injected in blood stream and absorbed by cells


Removal of all lung


Pulmonary fibrosis caused by inhaling inorganic dust and particulate matter

Procedures to obtain lung tissue

Bronchoscopy needle aspiration thoracentesis thoractomy

PTA with prolonged vent support of fio2. More than 50

Are likely to develop fibrosis

Pulmonary fibrosis

Aka ham man rich pneumoconiasis

Pulmonary fibrosis can be

Obstructive or restroctive

Quitting smoking

Reduces risk one third to obe half


Second leading cause of cancer


Remove part of lung

Respirations with ards

Crackles and bronchial sounds Dyspnea,insp intercostl and suprasternal reyractions


Is fibrosis that effects esophagus

Signs of fibrosis

Cough,dyspnea,ground glass,irregular opaciies

Signs of metastatic cancer

Weakness,bone pain,seizures,wt loss

Small cell

Aggressive cancer ,grows rapidly,mestasazize early double time 30 days

Small cell aka

Oat cell

Some Interstitial lung diseases



Most common form of bronchogenic carcinoma


Has double time 100 days And invades tissue in epithelium

Structural damage in bronchogenic carcinoma

Airway obstruction,destruction of airways and alveoli,atelectasis

Symptoms advanced cancer

Sob,chest pain,hemoptysie,wheeze hoarse,chronic cough wt loss fatigue pneumonia bronchitis

Two types non cell carcinoma

Squamous adenocarcinoma kg cell

Two types of cancer

Non cell small cell

Tx or telectasis

Antibiotic withdraw air or fluid is,u2,mech vent hyperinflation cpt

Tx to treat palm fibrosis


Unknown etiology of pulmonary fibrosis is called


Used to diagnose fibrosis

Xray,ct,MRI,pft,bronchi alveolar lavage,lung biopsy

Vent strategy with ards

Small tidal volume high rr

With bronchogenic carcinima

There can be airway obstruction destruction of airways and alveoli and atelectasis

Xray atelectasis

Fissure lines,shift elevated diaphragm,opacities platelike denities

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