MRCP UK EXAMINATIONS

NEUROLOGY

SURGERY

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Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]

The nurse is assessing a patient who has been admitted with possible acute respiratory distress syndrome (ARDS). Which findings would distinguish ARDS from cardiogenic pulmonary edema?

A	Elevated white blood count
B	Elevated troponin levels
C	Elevated myoglobin levels
D	Elevated B-type natriuretic peptide (BNP) levels

Explanation:

Detailed explanation-1: -ARDS is a Non-Cardiogenic Pulmonary Edema (NCPE). The NCPE in ARDS is ultimately a result of capillary permeability secondary to cellular damage, inflammatory cascades, and over inflation by mechanical ventilation resulting in endothelial permeability.

Detailed explanation-2: -Chest sonography: a useful tool to differentiate acute cardiogenic pulmonary edema from acute respiratory distress syndrome.

Detailed explanation-3: -The time course of ARDS may help in differentiating it from typical pulmonary edema. Chest x-ray features usually develop 12-24 hours after initial lung insult as a result of proteinaceous interstitial edema. Within one week, alveolar pulmonary edema (hyaline membrane) occurs due to type 1 pneumocyte damage.

Detailed explanation-4: -Cardiogenic pulmonary edema is caused by increased pressures in the heart. It’s usually a result of heart failure. When a diseased or overworked left lower heart chamber (left ventricle) can’t pump out enough of the blood it gets from the lungs, pressures in the heart go up.

There is 1 question to complete.