Acute respiratory distress syndrome is a tested topic on the USMLE Step 1 and beyond. You will need to know how to manage patients with ARDS when you graduate from medical school. When reviewing ARDS, you should make sure you know the pathophysiology (including its effect on intrapulmonary shunting), the various medical conditions that can cause ARDS (eg. sepsis, trauma), the characteristic ABG values, PaO2/FiO2 ratio, imaging findings on chest Xray, the importance of pulmonary capillary wedge pressure (PCWP) in ruling out other causes, and the ARDSNet protocol, including best ventilator settings (tidal volume, PEEP, plateau pressure, CO2, PaO2, pH), and finally, the mortality associated with this condition.
Here are some helpful resources to help you get familiar with ARDS.
Let me know if you have any questions.