Others Flashcards
(38 cards)
1
Q
Cor Pulmonale Etiology
A
- Enlarged RV resulting from pulm HTN (due to lung disease)
2
Q
Cor Pulmonale Pathophys
A
- RV dilation and hypertrophy
- R heart failure
3
Q
Cor Pulmonale Sx
A
- Chronic, slow progressing
- Peripheral edema
- SOB
- JVD
- Hepatomegaly
4
Q
Cor Pulmonale Dx
A
- CXR: widening of pulm arteries
- EKG: flat or inverted T waves
5
Q
Cor Pulmonale Tx
A
- Treat hypoxemia/acidosis: O2, diuretics, vasodilators
- Surgery: VAD, transplant
6
Q
Pulmonary HTN Etiology
A
- Hypoxia
- Acidosis
- Emphysema
- PE
- Sickle cell
- Mitral stenosis
- LV Failure
7
Q
Pulmonary HTN Pathophys
A
- Vasoconstriction in pulm arteries
8
Q
Pulmonary HTN Sx
A
- SOB
- Cough
- CP
- Hemoptysis
- Fatigue
- Syncope
9
Q
Pulmonary HTN Dx
A
- R heart cath
- ECHO
10
Q
Pulmonary HTN Tx
A
- O2, diuretics, anticoagulant, exercise
11
Q
Pleural Effusion RF
A
- Transudative: CHF**, cirrhosis, nephrotic syndrome
- Exudative: TB, PE
12
Q
Pleural Effusion Etiology
A
- Transudate
- Exudate (pus, blood, lymph fluid)
13
Q
Pleural Effusion Pathophys
A
- Accumulation of fluid in pleural cavity
14
Q
Pleural Effusion Sx
A
- SOB, pleuritic CP, cough +/- fever/chills
15
Q
Pleural Effusion Dx
A
- Diminished breath sounds
- Dullness to percussion
- Decreased tactile fremitus
- Labs
- CXR
16
Q
Pleural Effusion Tx
A
- Treat underlying cause
- Thoracentesis
17
Q
Pulmonary Embolism RF
A
- Male, AA, preg, obesity, age, oral contraceptive, recent travel
18
Q
Pulmonary Embolism Etiology
A
- Thrombus breaks off
19
Q
Pulmonary Embolism Sx
A
- Key sx: dyspnea (at rest or w/ exertion), pleuritic CP, cough
- Other sx: orthopnea (laying down), calf/thigh pain or edema, wheezing
20
Q
Pulmonary Embolism Tests
A
- CBC, CMP, PT/PTT/INR
- D-dimer (sensitive, not specific)
- ECG
- Chest radiograph (Hampton’s hump)
- CT angio
- VQ scan
- Contrast enhanced pulm angio (gold standard)
21
Q
Pulmonary Embolism Dx
A
- Well’s Criteria: low/medium/high suspicion of PE, not diagnostic, used to guide workup
- PERC r/o criteria: must meet all 8 criteria
22
Q
Pulmonary Embolism Tx
A
- Stable: supportive +/- anticoagulant
- Unstable: resp support, anticoag, IV fluids, +/- TPA or embolectomy
23
Q
Pneumothorax Types
A
- Primary Spontaneous (smokers, younger people)
- Secondary Spontaneous (COPD, CF)
- Traumatic
- Tension (mechanical ventilation or resuscitation, EMERGENCY)
24
Q
Pneumothorax Tx
A
- CXR first then chest tube
- Except tension pneumo–chest tube first then CXR
25
ARDS Stages
1. Exudative: acute inflam
2. Proliferative: 7-10 days later, chronic inflam w/ myofibroblasts
3. Fibrotic: diffuse fibrosis
26
ARDS Etiology
- Injury or infection
| - Acute diffuse inflam leads to syndrome
27
ARDS Pathophys
- Impaired gas exchange
- Increased lung weight (from edema)
- Loss of aerated tissue (filled w/ fluid)
- Reduced lung compliance
- Pulm HTN
28
ARDS Sx
- Rapid development of resp failure
- Bilateral (often diffuse) crackles
- Hypoxia
29
ARDS Dx
- Within 1 wk of injury/illness: bilateral opacities on imaging (CXR, CT)
- Edema cannot be explained by HF or excess fluid (BNP, ECG)
- Severe hypoxia (P/F <300)
- Sick contacts?
30
ARDS Tx
- Treat underlying cause
| - Supportive tx
31
ARDS Prognosis
- Mortality has been improving w/ use of low tidal volume ventilation (less stretching of lungs=less inflam)
- Obesity is protective
32
ARDS PaO2/FiO2 ratio
<300 = ARDS
| - Lower ratio = more severe
33
Bronchiolitis Obliterans Epi
- Non-reversible
| - Rare
34
Bronchiolitis Obliterans Etiology
- Occurs after acute injury due to exposure (inhaled toxins, drug rxn, chemo, RA)
35
Bronchiolitis Obliterans Pathophys
- Inflam of small airways
| - Constriction of smooth muscle
36
Bronchiolitis Obliterans Sx
- Dyspnea and cough (slowly progressive)
37
Bronchiolitis Obliterans Dx
- H/o RA or toxin exposure (work/hobby hx)
- Bronchoscopy (helpful for culture and biopsy)
- Surgical lung biopsy is only definitive dx
38
Bronchiolitis Obliterans Tx
- Remove causative agent
- STOP SMOKING
- Symptomatic tx w/ bronchodilator and O2
- Lung transplant (otherwise terminal dx)
