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SAPE October 2015 > PULM > Flashcards

PULM Flashcards

1
Q

For what conditions would you consider measuring ABGs?

A
  • COPD
  • HF
  • DM
  • drug OD
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2
Q

What are the normal pH, CO2 and HCO3 levels for blood in ABG testing?

A
  • pH: 7.35-7.45
  • CO2: 35-45
  • HCO3: 22-26
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3
Q

What pH, CO2 and HCO3 levels for blood in ABG testing indicate acidosis?

A
  • pH: less than 7.35
  • CO2: >45
  • HCO3: less than 22
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4
Q

What pH, CO2 and HCO3 levels for blood in ABG testing indicate alkalosis?

A
  • pH: >7.45
  • CO2: less than 35
  • HCO3: >26
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5
Q

Signs & Sxs:

  • Productive cough
  • Pleuritic chest pain
  • Hemoptysis
  • Fever/chills/night sweats
  • Malaise, weight loss
  • Painless adenopathy
A

TB

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6
Q

Signs & Sxs:

  • Cough, sputum production
  • Dyspnea, wheezing
  • Hemoptysis
  • Frequent infxs
  • AM headache
  • Pedal edema, weight loss
A

COPD

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7
Q

Signs & Sxs:

  • Normal vitals
  • Decreased breath sounds
  • Decreased tactile fremitus
  • Localized pleural friction rub
  • Mediastinal shift if massive
A

Pleural effusion

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8
Q

Signs & Sxs:

  • Dyspnea, pleuritic chest pain
  • HoTN, tachyardia, S3 gallop
  • Cough, hemoptysis
  • Anxiety and apprehension
  • Acute cor pulmonale
  • Distended neck veins
A

Pulmonary embolism

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9
Q

Signs & Sxs:

  • Dyspnea, orthopnea, PND, DOE, tachypnea
  • Cough, pink/frothy sputum
  • Diaphoresis, fatigability
  • Bibasilar rales, wehezing
  • Hypoxemia
  • Signs of fluid overload
  • Elevated JVP, S3
A

Pulmonary edema

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10
Q

Signs & Sxs:

  • Productive cough, may last several weeks
  • Sputum
  • Smokers have prolonged cough
  • Rales, rhonchi, wheezing
  • Injected pharynx
  • Fever, tachypnea
A

Acute bronchitis

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11
Q

Signs & Sxs:

  • Cough
  • Wheezing, prolonged expiration
  • Chest tightness, tachycardia
  • Rhonchi lung sounds
  • Use of accessory muscles (SCM, scalenes of neck)
A

Asthma

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12
Q

Signs & Sxs:

  • Cough, dyspnea, thick sputum, tachypnea
  • Fever, chills
  • Chest pain
  • Cyanosis
  • Consolidation
A

Community acquired pneumonia

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13
Q

What type of pneumonia:

  • walking
  • non-productive cough
  • fever
  • slow course
  • young
A

Mycoplasma pneumo

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14
Q

What type of pneumonia:

  • rust colored sputum
  • rapid fever onset
  • CXR shows lobar consolidation
A

Strep pneumo

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15
Q

What type of pneumonia:

  • pleuritic chest pain
  • hemoptysis
  • hyponatremia
A

Legionella pneumo

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16
Q

How is acute bronchitis diagnosed?

A
  • diagnosis of exclusion

- rule out pneumonia, asthma, exacerbation of COPD, common cold

17
Q

Labs/Testing/Imaging for Pneumonia

A
  • CXR
  • sputum gram stain/culture
  • CBC with dif
  • lytes
  • BUN/Cr
  • glucose
18
Q

What causes pleural effusion?

A
  • fluid leaks in (trauma)
  • secretion of extra fluid (TB, lung abscess)
  • CHF, pneumonia, malignancy, pulmonary embolism
19
Q

Diagnostic Imaging for Pleural Effusion

A
  • CXR

- US

20
Q

Tx for Pleural Effusion

A

-diagnostic thoracentesis (US guided, cell count, gram stain/culture)

21
Q

How is asthma severity determined?

A
  • sxs: # of days per week or month
  • night time awakening per week
  • SABA use
  • lung function (spirometry, LFTs)
22
Q

How is COPD diagnosed?

A

spirometry/LFTs

-FEV1/FVC ratio is less than 70% in COPD

23
Q

FEV1 in Mild/Stage 1 COPD

A

FEV1 > 80%

24
Q

FEV1 in Moderate/Stage 2 COPD

A

FEV1 50-80%

25
Q

FEV1 in Severe/Stage 3 COPD

A

FEV1 30-50%

26
Q

FEV1 in Very Severe/Stage 4 COPD

A

FEV1 30-50% PLUS chronic resp failure

27
Q

What labs/tests/imaging are used in diagnosing pulmonary embolism?

A
  • Well’s criteria
  • gold standard: pulmonary angiogram
  • CXR
  • ABG, D-dimer
  • VQ scan, spiral CT
  • EKG: S1Q3T3 pattern
  • check PT, PTT, CBC
28
Q

Labs/Tests for Pulmonary Edema Diagnosis

A
  • Lytes
  • Renal function tests
  • CBC with diff
  • EKG, cardiac enzymes
  • BNP
  • ABG
  • drug levels
29
Q

What are risk factors for TB?

A
  • homeless
  • ethnic minority or immigrant from a country with high TB incidence
  • prisoner
  • HIV positive
  • immunosuppressed
30
Q

How is TB diagnosed? (Be specific about the test results.)

A

tuberculin skin test (TST):
-5 mm is + if HIV, recent contact, old TB on CXR, organ transplant
-10 mm is + if recent TB country, IV drugs, resident/employee high risk,kids under 4 y.o
-15 mm is + if no risk factors
[also, quantiferon gold TB test; if positive do CXR; culture sputum and AFB smear]

SAPE October 2015 (12 decks)

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