deck 11 Flashcards
(51 cards)
FEV1/FVC threshold for obstructive
70
combivent
albuterol + ipratropium
iptratropium drug class
anticholinergic
iptratropium vs. tiotropium
ipratropium slower acting
drugs best at reducing exacerbations in COPD
anticholinergics
vaccine all COPD patients need
pneumovax
when to give O2
O2 sat below 88 (while ambulating)
When to prescribe ABX for COPD exacerbation
SOB
Increased sputum volume
Increased sputum clearance
Why you use anticholinergics in COPD
- vagal nerve causes bronchoconstriction
- basically bronchodilation
COPD exacerbation treatment
- steroids (pred 40 x 5 days)
- office nebulizer
- ## antibiotics (azithromycin x 5 days), which has been shown to reduce inflammation in airways
asthma categories and inhaler use
severe persistent = several times per day
moderate persistent = daily
mild persistent = more than 2 days per week
intermittent = less than 2 days per week
asthma categories and nighttime symptoms
severe = more moderate = more than 1 a week mild = 3-4/month intermittent = less than 2/month
salmeterol
long acting beta agonist
singular used for…
asthma w/ allergic component
setting of aspergillum infection
prolonged neutropenia
presentation of invasive pulmonary aspergillosis
fever + pleuritic chest pain + hemoptysis
CT scan of invasive aspergillosis
nodules with surrounding ground-glass opacities (“halo sign”)
first step in anaphylaxis management
IM epinephrine
solitary pulmonary nodule CXR algorithm
- if on previous x-ray, monitor with x-rays for 2-3 years then stop if stable.
- if no previous imaging, get chest CT. If benign features –> serial CT. If indeterminate or suspicious for malignancy –> biopsy/PET. If suspicious for malignancy –> surgical excision.
positive bronchodilator response defined as
greater than 12% increase in FEV1
squamous cell carcinoma presentation
- smoking history + hypercalcemia + hilar mass
- usually causes other paraneoplastic syndromes such as ACTH production + SIADH
ABG findings suggestive of CHF
hypoxia, hypocapnia, respiratory alkalosis
causes of recurrent pneumonia
1) lung malignancy
(recurrent pneumonia in the same location of the lung suggests localized airway obstruction, which can lead to impaired bacterial clearance and predisposition to infection. Causes of localized airway obstruction include external bronchial compression due to lymphadenopathy, expanding neoplasm, or vascular anomaly)
increased breath sounds just means
crackles and ego phony present