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Medical: 5 Pulmonary: 1

  • 1.

    Not a disease but a pathophysiological condition

    • a)

      High pressure (cardiogenic)

    • b)

      High permeability (non-cardiogenic)

  • 2.

    Epidemiology

    • a)

      Risk factors vary based on type

      • (1)

        High pressure (cardiogenic)

        • (a)

          Acute myocardial infarction

        • (b)

          Chronic hypertension

        • (c)

          Myocarditis

      • (2)

        High permeability (non-cardiogenic)

        • (a)

          Acute hypoxemia

        • (b)

          Near-drowning

        • (c)

          Post-cardiac arrest

        • (d)

          Post shock

        • (e)

          High altitude exposure

        • (f)

          Inhalation of pulmonary irritants

        • (g)

          Adult respiratory distress syndrome (ARDS)

  • 3.

    Anatomy and physiology review

    • a)

      Alveoli

    • b)

      Pulmonary capillaries

    • c)

      Interstitial space and fluid

    • d)

      Pulmonary circulation

    • e)

      Role of surfactant

    • f)

      Hydrostatic pressure

    • g)

      Colloid osmotic pressure

    • h)

      Capillary wall damage

    • i)

      Left sided heart failure

    • j)

      Lymphatic drainage

    • k)

      Pulmonary blood pressures

    • l)

      Starling=s law of the heart

    • m)

      Hypoalbuminemic states (liver disease)

  • 4.

    Pathophysiology

    • a)

      Diffusion disorder

    • b)

      High pressure (cardiogenic)

      • (1)

        Left sided heart failure

      • (2)

        Increase in pulmonary venous pressure

      • (3)

        Increase in hydrostatic pressure

      • (4)

        Engorgement of pulmonary vasculature

      • (5)

        Failure of cough and lymphatics to drain fluids

      • (6)

        Excessive accumulation of fluid in the interstitial space

      • (7)

        Widening interstitial space impairs diffusion

      • (8)

        In severe cases, fluid may accumulate in the alveoli

    • c)

      High permeability (non-cardiogenic)

      • (1)

        Disruption of the alveolar-capillary membranes caused by

        • (a)

          Severe hypotension

        • (b)

          Severe hypoxemia (post-drowning, post-cardiac arrest, severe seizure, prolonged hypoventilation)

        • (c)

          High altitude

        • (d)

          Environmental toxins

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───────────────────────── United States Department of Transportation National Highway Traffic Safety Administration Paramedic: National Standard Curriculum

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