- reduced inspired oxygen tension - hypoventilation - diffusion limitation - shunt - V/Q mismatch

Block 54, 55: Lung Flashcards by Bina Malapur

Causes of hypoxemia?

reduced inspired oxygen tension
hypoventilation
diffusion limitation
shunt
V/Q mismatch

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what is hypoventilation associated

respiratory acidosis

- normal A-a gradient

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what is normal A-a gradiant

less than 15

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equation for A-a gradient

PAO2 - PaO2

PAO2 = 170 - (CO2/.8)

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what should you worry about a COPD patient given supplemntal oxygen

improves hypoxia but causes CO2 retention

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hypercapnea causes what in the brain

reflex cerebral vasodilation

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what clinical feature makes pericarditis feel better for aptient

leaning forward

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flow-volume curve for fixed upper-airway obstruction

flattening the top and bottom of curve

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how might an immunocompetent patient get aspergilus

history of pulmonary disease

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what does CT show for aspergilloma

cavitary lesion

- pulmonary nodules with surrounding ground-glass opacities (“halo sign”)

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equation for ventilaiton

respiratory rate times tidal volume

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what metabolic disturbance causes hyperventilation

respiratory alkalosis

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when do you use incentive spirometry

prevent atelectasis in bed-bound patients

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most common acid-base disturbance in pulmonary embolism? why?

respiratory alkalosis

- because patient hyperventilates due to decrease O2 and the V/Q mismatch

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Asbestos exposure increases the risk of what

pulmonary fibrosis and malignancy

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most common cause of malignancy diagnosed in patients with exposed to asbestos

Bronchogenic carcinoma

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occupations related to asbestosis exposure

plumber
electrician
carpenter
pipefitters
insulation workers

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PE exam for asbestosis

bibasilar, end-inspiratory crackles

fingernail clubbing

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X-ray for asbestosis

babasilar reticulonodular infiltrates
honeycombing
bilateral pleural thickening

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CT of asbestosis

subplerual linear densities
parenchymal fibrosis
- Plreural plaques are key for asbestosis

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pulmonary fibrosis does what to forced expiratory volume in 1 second/ forced vital capacity ratio

preserved for increased

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first-line treatment for exercise-induced bronchoconstriction if only required few times a week?
exercise daily?

short-acting beta-adrenergic agonist
10-20 min before exercise
Daily exercise: inhaled corticosteriods or antileukotriene agents

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all patients with acute exacerbation of COPD should receive

inhaled bronchodialater ( B2 agonist and anticholinergic)

- systemic glucocorticoids

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what is the diffusion capacity of the lung for carbon monoxide in interstitial lung disease?

decreased but normal in extrinsic causes of restrictive pulmonary physiology

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what are side effects of beta-2 agonists

- hypokalemia ( muscle weakness, arrhthymias, EGK abnormalities) - tremor - palpitations - headache

Diagnose asthma in an adult

- reversible airway obstruction ( 12% or more increase in FEV1) - normal diffusion capacity for CO

complications of positive pressure ventillation

- alveolar damage - pneumothorax - hypotension

best step in management for hyponatermia due to SIADH

Fluid restriction

common complication of small cell lung cancer

hyponetremia due to SIADH

what lung cancer is the most common cause of SAIDH

small cell lung cancer

lung compliance

ability to expand.

are there pulmonary symptoms in wilson diesase

young patient with chronic dyspnea on exertion, decreased breath sounds, slight liver function test abnormalities, and a family history of cirrhosis has

alpha-1 antitrypsin deficiency

why are impaired consciousness, advanced dementia, and other neurologic paitents predisposed to aspiration pneumonia

- impaired swallowing and cough reflex

what happened during endotrachial intubation when there is overinflation of right lung, underventilation of left lung, and asymmetric chest expansion

right mainstem bronchus intubation

when is needle thoracostomy performed

emergency procedure, for life-threatening tension pneumothorax

test of choice in clinically stable patients in whom PE is likely

CT angiography

patient with chronic shortness of breath, productive cough, and evidence of destruction of the lower lung lobes has

alpha-1 antitrypsin deficiency

panacinar eymphysema

usually due to alpha1 antitrypsin defieicny | - destruction of lower lobes

Centriacinar emphysema

smoking induced | - upper lobe of lung destruction

what is considered young age for COPD

less than 45

triad for asperigillosis

fever pleuritic chest pain hemoptysis

Chest X-ray of sarcoidosis? histology of it?

bilateral hilar adenopathy | - noncaseating granulomas on tissue biopsy

loss of elastin in lung matrix occurs in what

alpha-1-antitrypsin deficiency

necrotizing pulmonary vasculitis occurs in

granulomatosis with polyangiitis | - Wegener granulomatosis

Chronic low back pain in an otherwise young healthy man, pain at night, improvement of pain with activity, and elevated erythrocyte sedimentation rate suggests

ankylosing spondylitis

how does ankylosing spondylitis imipact lungs

limits lungs expansion due to diminished chest wall and spinal mobility - mild restrictive pattern - reduce VC, TLC - normal FEV1/FVC - normal or increase FRC, RV

PFT for pulmonary fibrosis vs just restrictive disease

FRC, TLC and RV are also reduced in pulmonary fibrosis

define massive PE

- most likely postoperative pt - PE complicated by hypotension and/or acute right heart strain - jugular venous distension

patient with significant smoking history, hypercalcemia, and a hilar mass

squamous cell carcinoma of lungs

what anticoagulation therapy is sued for severe renal insufficiency

unfractionated heparin

what GFR rate indicates severe renal insufficiency

less than 30 mL/min/1.73 m^2

Transudative effusion caused by

- decreased intrapleural or plasma oncotic pressures | - elevated hydrostatic pressure

exudative effusions caused by

- increased capillary or pleural membrane permeability | - disruptions to lymphatic outflow

pleural fluid shows moderate lymphocytosis, very elevated protein, elevated LDH. what does the patient have

tuberculous effusion

what indicates severe asthma exacerbation with signs of impending respiratory failure? what should you do?

elevated or normal PaCO2 - endotracheal intubation - mechanical ventilation

what should you give during severe asthma exacerbation

- inhaled short-acting Beta agonist - inhaled ipratropium - systemic corticosteroids

how does hypoxemia occur in alveolar consolidation

right-to-left intrapulmonary shunting

define dead space

ventilation of areas of lung that are not perfused with blood

a patient who can fall back asleep quickly after experiencing choking sensation, most likely has what

obstructive sleep apnea

atelectasis

alveolar collapse | - can be due to obstruction

pneumothorax

air in pleural space

Block 54, 55: Lung Flashcards

(62 cards)