Acute respiratory distress syndrome: Clinical (To be retired)

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Acute respiratory distress syndrome: Clinical (To be retired)

Medical and surgical emergencies

Cardiology, cardiac surgery and vascular surgery

Advanced cardiac life support (ACLS): Clinical (To be retired)

Supraventricular arrhythmias: Pathology review

Ventricular arrhythmias: Pathology review

Heart blocks: Pathology review

Coronary artery disease: Clinical (To be retired)

Heart failure: Clinical (To be retired)

Syncope: Clinical (To be retired)

Pericardial disease: Clinical (To be retired)

Valvular heart disease: Clinical (To be retired)

Chest trauma: Clinical (To be retired)

Shock: Clinical (To be retired)

Peripheral vascular disease: Clinical (To be retired)

Leg ulcers: Clinical (To be retired)

Aortic aneurysms and dissections: Clinical (To be retired)

Cholinomimetics: Direct agonists

Cholinomimetics: Indirect agonists (anticholinesterases)

Muscarinic antagonists

Sympathomimetics: Direct agonists

Sympatholytics: Alpha-2 agonists

Adrenergic antagonists: Presynaptic

Adrenergic antagonists: Alpha blockers

Adrenergic antagonists: Beta blockers

ACE inhibitors, ARBs and direct renin inhibitors

Loop diuretics

Thiazide and thiazide-like diuretics

Calcium channel blockers

cGMP mediated smooth muscle vasodilators

Class I antiarrhythmics: Sodium channel blockers

Class II antiarrhythmics: Beta blockers

Class III antiarrhythmics: Potassium channel blockers

Class IV antiarrhythmics: Calcium channel blockers and others

Positive inotropic medications

Antiplatelet medications

Dermatology and plastic surgery

Blistering skin disorders: Clinical (To be retired)

Bites and stings: Clinical (To be retired)

Burns: Clinical (To be retired)

Endocrinology and ENT (Otolaryngology)

Diabetes mellitus: Clinical (To be retired)

Hyperthyroidism: Clinical (To be retired)

Hypothyroidism and thyroiditis: Clinical (To be retired)

Parathyroid conditions and calcium imbalance: Clinical (To be retired)

Adrenal insufficiency: Clinical (To be retired)

Neck trauma: Clinical (To be retired)

Insulins

Mineralocorticoids and mineralocorticoid antagonists

Glucocorticoids

Gastroenterology and general surgery

Abdominal pain: Clinical (To be retired)

Appendicitis: Clinical (To be retired)

Gastrointestinal bleeding: Clinical (To be retired)

Peptic ulcers and stomach cancer: Clinical (To be retired)

Inflammatory bowel disease: Clinical (To be retired)

Diverticular disease: Clinical (To be retired)

Gallbladder disorders: Clinical (To be retired)

Pancreatitis: Clinical (To be retired)

Cirrhosis: Clinical (To be retired)

Hernias: Clinical (To be retired)

Bowel obstruction: Clinical (To be retired)

Abdominal trauma: Clinical (To be retired)

Laxatives and cathartics

Antidiarrheals

Acid reducing medications

Hematology and oncology

Blood products and transfusion: Clinical (To be retired)

Venous thromboembolism: Clinical (To be retired)

Anticoagulants: Heparin

Anticoagulants: Warfarin

Anticoagulants: Direct factor inhibitors

Antiplatelet medications

Thrombolytics

Infectious diseases

Fever of unknown origin: Clinical (To be retired)

Infective endocarditis: Clinical (To be retired)

Pneumonia: Clinical (To be retired)

Tuberculosis: Pathology review

Diarrhea: Clinical (To be retired)

Urinary tract infections: Clinical (To be retired)

Meningitis, encephalitis and brain abscesses: Clinical (To be retired)

Bites and stings: Clinical (To be retired)

Skin and soft tissue infections: Clinical (To be retired)

Protein synthesis inhibitors: Aminoglycosides

Antimetabolites: Sulfonamides and trimethoprim

Antituberculosis medications

Miscellaneous cell wall synthesis inhibitors

Protein synthesis inhibitors: Tetracyclines

Cell wall synthesis inhibitors: Penicillins

Miscellaneous protein synthesis inhibitors

Cell wall synthesis inhibitors: Cephalosporins

DNA synthesis inhibitors: Metronidazole

DNA synthesis inhibitors: Fluoroquinolones

Herpesvirus medications

Azoles

Echinocandins

Miscellaneous antifungal medications

Anthelmintic medications

Antimalarials

Anti-mite and louse medications

Nephrology and urology

Hypernatremia: Clinical (To be retired)

Hyponatremia: Clinical (To be retired)

Hyperkalemia: Clinical (To be retired)

Hypokalemia: Clinical (To be retired)

Metabolic and respiratory acidosis: Clinical (To be retired)

Metabolic and respiratory alkalosis: Clinical (To be retired)

Toxidromes: Clinical (To be retired)

Medication overdoses and toxicities: Pathology review

Environmental and chemical toxicities: Pathology review

Acute kidney injury: Clinical (To be retired)

Kidney stones: Clinical (To be retired)

Adrenergic antagonists: Alpha blockers

Neurology and neurosurgery

Stroke: Clinical (To be retired)

Seizures: Clinical (To be retired)

Headaches: Clinical (To be retired)

Traumatic brain injury: Clinical (To be retired)

Neck trauma: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Spinal cord disorders: Pathology review

Anticonvulsants and anxiolytics: Barbiturates

Anticonvulsants and anxiolytics: Benzodiazepines

Nonbenzodiazepine anticonvulsants

Migraine medications

Osmotic diuretics

Antiplatelet medications

Thrombolytics

Opioid agonists, mixed agonist-antagonists and partial agonists

Opioid antagonists

Pulmonology and thoracic surgery

Asthma: Clinical (To be retired)

Chronic obstructive pulmonary disease (COPD): Clinical (To be retired)

Venous thromboembolism: Clinical (To be retired)

Acute respiratory distress syndrome: Clinical (To be retired)

Pleural effusion: Clinical (To be retired)

Pneumothorax: Clinical (To be retired)

Chest trauma: Clinical (To be retired)

Bronchodilators: Beta 2-agonists and muscarinic antagonists

Pulmonary corticosteroids and mast cell inhibitors

Rheumatology and orthopedic surgery

Joint pain: Clinical (To be retired)

Anatomy clinical correlates: Clavicle and shoulder

Anatomy clinical correlates: Axilla

Anatomy clinical correlates: Arm, elbow and forearm

Anatomy clinical correlates: Wrist and hand

Anatomy clinical correlates: Median, ulnar and radial nerves

Anatomy clinical correlates: Bones, joints and muscles of the back

Anatomy clinical correlates: Hip, gluteal region and thigh

Anatomy clinical correlates: Knee

Anatomy clinical correlates: Leg and ankle

Anatomy clinical correlates: Foot

Acetaminophen (Paracetamol)

Non-steroidal anti-inflammatory drugs

Glucocorticoids

Opioid agonists, mixed agonist-antagonists and partial agonists

Antigout medications

Assessments

Acute respiratory distress syndrome: Clinical (To be retired)

USMLE® Step 2 questions

0 / 7 complete

Questions

USMLE® Step 2 style questions USMLE

of complete

A 62-year-old man presents to the emergency department after being pulled out of a frozen lake. The family reports the patient was fishing when he suddenly fell through the ice; he was extricated 10 minutes later. The patient has a past medical history of heart failure with preserved ejection fraction and hypertension. His temperature is 34°C (93.2°F), pulse is 45/min, respirations are 22/min, blood pressure is 110/94 mmHg, and oxygen saturation is 85% on room air. Physical examination shows a male patient who is shivering, appears pale, and is cool to the touch. The patient can speak one- to two-word sentences at a time, but his history is limited by a persistent non-productive cough and altered mental status. The patient is subsequently intubated for airway protection and admitted to the intensive care unit on mechanical ventilation. A chest x-ray and laboratory results are demonstrated below:  

 
Reproduced from: Wikipedia
 
Laboratory value  Result 
Blood Gases, Serum 
pH  7.49 
 PCO2  24 mmHg 
 PO2  53 mm Hg 
 Cardiac Enzymes, Serum 
 Brain Natriuretic Peptide (BNP)  <100 ng/dL (N = <100) 
 Troponin  <.03 ng/dL 
Which of the following is a recommended treatment strategy for the management of this patient’s condition?

Transcript

Content Reviewers

Rishi Desai, MD, MPH

Contributors

Sam Gillespie, BSc

Acute respiratory distress syndrome, or ARDS is a condition where there’s inflammation throughout the lungs leading to pulmonary edema.

The main site of injury in ARDS is the alveolar-capillary membrane.

Now, any damage to the alveolar epithelium or the capillary endothelium increases the permeability of the alveolar-capillary membrane, causing fluid to move into the alveoli.

Oxygen and carbon dioxide have to travel across this fluid, so it acts as a barrier against normal gas exchange.

The fluid also dilutes out the surfactant molecules coating the alveoli, and as a result the alveoli are less able to remain open and compliant, so they become stiff.

If the injury continues, the alveoli eventually collapse.

Now, the pulmonary edema from ARDS causes the same problems as pulmonary edema from congestive heart failure, but because the triggering events are different, the term non-cardiogenic pulmonary edema is often used for ARDS.

Now, ARDS is not a primary lung disease, rather it arises as a complication of a systemic injury that causes widespread inflammation which results in damage to the alveolar-capillary membranes within the lung.

The most common underlying systemic cause of ARDS is sepsis, which causes systemic inflammation in response to an infection.

But other insults include trauma, severe burns, near-drowning, disseminated intravascular coagulation or DIC, acute pancreatitis, massive blood transfusions, aspiration of gastric contents, and toxic smoke inhalation.

Summary

Acute respiratory distress syndrome (ARDS) is a potentially life-threatening condition that occurs when the lungs are unable to provide sufficient oxygen to the bloodstream. Symptoms of ARDS can include rapid breathing, shortness of breath, chest pain, and extreme fatigue. ARDS is most often caused by another underlying condition, such as pneumonia, sepsis, or trauma.

Elsevier

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