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Flashcards in Adult - Respiratory II Deck (39):
1

What are the five conditions which may cause significant night sweats?

TB
menopause
AIDS
lymphoma
endocarditis

2

What are the signs and symptoms of TB?

majority of people are ASYMPTOMATIC
if present:
weight loss
night sweats
low grade fever
cough

3

What is the typical cough progression in TB?

dry cough progressing to productive and sometimes blood tinged

4

What are the two tests definitively diagnostic for TB?

culture
CXR - small, homogenous infiltrate in upper lobes

5

Is TB reportable?

yes

6

What is INH?

the abbreviation for isoniazid

7

What is the medication regimen for TB?

RIPE
R - Rifampin
I - Isoniazid (INH)
P - Pyrazinamide
E - Ethambutol

8

When can the 4th drug in the TB regimen be dropped?

if the isolate is fully suceptible to RIF and INH

9

How long are the drugs given in TB?

INH and RIF for at least 6 months
pyrazinamide for 2 months

10

How is TB therapy monitored?

Weekly sputum smears and cultures for the first 6 weeks
Then monthly until negative cultures documented

11

Continued positive TB cultures after what time frame would raise the suspicion of drug resistance?

3 months

12

What baseline studies should be obtained prior to starting TB drug therapy?

LFTs
CBC
serum creatinine

13

What lab work must be monitored weekly while on INH?

LFTs

14

What needs to be monitored in people taking ETHAMBUTOL?

visual acuity
red-green color perception

15

PPD reading of 5 mm considered positive in what populations?

HIV patients
contacts of a known cause
those with typical TB presentation on CXR

16

PPD reading of 10 mm considered positive in what populations?

immigrants
high risk groups
health care workers

17

PPD reading of 15 mm considered positive in what populations?

all others

(those not in any high prevalence groups)

18

FVC
stands for -
defined -
significant in -

forced vital capacity

volume forcefully expelled after max inspiration

significant in OBSTRUCTIVE diseases

19

FEV1
stands for -
defined -
significant in -

forced expiratory volume in 1st second

volume expelled in 1st second of FVC maneuver

significant in OBSTRUCTIVE diseases

20

FEF 25-75
stands for -
defined -
significant in -

forced expiratory flow in middle 50%

max mid-expiratory airflow rate

significant in OBSTRUCTIVE diseases

21

PEFR
stands for -
defined -
significant in -

peak expiratory flow rate

max rate achieved in FVC maneuver

significant in OBSTRUCTIVE diseases

22

TLC
stands for -
defined -
significant in -

total lung capacity

volume in lungs after max inspiration

significant in RESTRICTIVE diseases

23

FRC
stands for -
defined -
significant in -

functional residual capacity

volume left after passive exhalation

significant in RESTRICTIVE diseases

24

RV
stands for -
defined -
significant in -

residual volume

volume remaining after max exhalation

significant in RESTRICTIVE diseases

25

What are the PFTs which reflect AIRFLOW RATE?

FVC
FEV1
FEF 25 - 75
PEFR

26

What are the PFTs which reflect VOLUMES?

TLC
FRC
RV

27

Which type of PFTs are decreased in obstructive diseases?

the airflow rate measures

28

Which type of PFTs are decreased in restrictive diseases?

the volume measures

29

What are examples of OBSTRUCTIVE diseases?

asthma
COPD

30

What are examples of RESTRICTIVE diseases/conditions? (6)

pneumonia
pleural effusion
pulmonary fibrosis
lobectomy
morbid obesity
pregnancy

31

What is a pleural effusion?

a buildup of fluid between the lungs and chest cavity in the pleural space

32

Clear fluid in pleural effusion is called what?

transudate

33

Cream colored fluid in pleural effusion is called what?

exudate -- contains protein

34

Pus found in pleural effusion is called what?

empyema

35

Blood in pleural effusion is called what?

hemorrhagic

36

What is the typical Xray finding in pleural effusion?

loss of costophrenic angle to blunting or shadows

(no shark fins)

37

What is the difference between pleural effusion and infiltrate?

pleural effusion is fluid between the lung and chest wall in the pleural space

infiltrate is a general term meaning an abnormal substance that accumulates gradually within cells or body tissues

38

What is atelectasis?

collapse of all or part of the lung - develops when alveoli become deflated

39

What is tactile fremitus?

"99" - ulnar surfaces of hands on back

increased in consolidation (pnumonia)

decreased in pleural effusion