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EM PULMONOLOGY > PULMO > Flashcards

PULMO Flashcards

1
Q

The most common infectious cause of acute exacerbation of bronchitis

A

Respiratory viruses

Respiratory viruses such as influenza A and B, parainfluenza, respiratory syncytial virus, and coronavirus have all been attributed to acute bronchitis.

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2
Q

Chronic Bronchitis

A

Productive cough for 3 months each year for 2 consecutive years, often with dyspnea and partially reversible airway obstruction.

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3
Q

Acute exacerbation of Chronic Bronchitis

A

Change in the characteristic of a productive cough that has lasted for more than 3 months for 2 consecutive years

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4
Q

Hallmarks of upper respiratory cough syndrome previously termed “postnasal drip.”

A

Rhinorrhea and repetitive throat clearing

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5
Q

Fever is common in patients with ________________ and is less common with ________________

A

Fever is common in patients with viral respiratory illnesses and is less common with pertussis infection

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6
Q

Acute Bronchitis

A

cough of at least 5 days duration and can persist up to 20 days

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7
Q

risk factor for penicillin resistance

A

Immunosuppression from alcoholism or
cancer

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8
Q

Poor prognostic factors in Elderly

A

fever greater than 38.3◦C
leucopenia
immunosuppression
gram-negative or staphylococcal infection
cardiac disease
bilateral infiltrates

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9
Q

Chronic alcoholism

A

S. aureus
S. pneumoniae
Klebsiella pneumoniae
Pseudomonas aeruginosa

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10
Q

distinguishing a chronic obstructive pul- monary disease (COPD) exacerbation from congestive heart failure (CHF)

A

B-type natriuretic peptide level

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11
Q

ACUTE COUGH

A

<3 weeks

Associated with self-limited URTI or bronchial infection

URTI: rhinitis, sinusitis, pertussis
LRTI: bronchitis, pneumonia
Allergic reaction
Asthma
Environmental irritants
Transient airway hyperresponsiveness
Foreign body

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12
Q

Hallmark of acute bronchitis

A

PRODUCTIVE COUGH

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13
Q

SUBACUTE COUGH

A

3-8 weeks

postviral airway inflammation with bronchial hyperresponsiveness
mucus hypersecretion
upper airway cough syn- drome (postnasal discharge),
asthma

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14
Q

Most likely cause of subacute cough

A

Postinfectious cough

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15
Q

CHRONIC COUGH

A

> 8 weeks

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16
Q

MCC of Chronic cough

A

(1) smoking, often with chronic bronchitis; (
2) upper airway cough syndrome (formerly postnasal discharge);
(3) asthma;
(4) gastroesophageal reflux; and
(5) angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker therapy

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17
Q

Feeling of difficult, labored, or uncomfortable breathing “Shortness of breath,” “breathlessness,” or “not getting enough air”

A

Dyspnea

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18
Q

Rapid breathing

A

Tachypnea

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19
Q

Dyspnea in the recumbent position

A

Orthopnea

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20
Q

Orthopnea that awakens the patient from sleep

A

Paroxysmal nocturnal dyspnea

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21
Q

Dyspnea associated with lying on one side (lateral decubitus position) but not the other side
Patient lies on the side of the more affected lung where gravity increases blood flow to the worse lung and reduces it to the better lung

A

Trepopnea

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22
Q

Dyspnea in the upright position
Results from:
Loss of abdominal wall muscular tone
Right-to-left intracardiac shunting (patent foramen ovale)

A

Platypnea

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23
Q

Hyperventilation; minute ventilation in excess of metabolic demand

A

Hyperpnea

24
Q

Combined the subjective sensation of dyspnea with signs indicating difficulty breathing

A

Respiratory distress

25
Q

Occurs when the lungs and ventilatory muscles cannot move enough air in and out of the alveoli to adequately oxygenate arterial blood and eliminate carbon dioxide

A

Ventilatory or respiratory failure

26
Q

excludes heart failure

A

BNP (<100 picograms/mL) or NT pro-BNP (<300 picograms/mL)

27
Q

Treatment of Hiccups

A

SWIF the hiccups

Sugar
Water
Ice
Foreign body

*Swallow a teaspoon of sugar
*Drink water quickly
*Sip ice water
*Remove foreign body from ear

28
Q

approved for treatment of intractable hiccups

A

Chlorpromazine

29
Q

Pleural fluid (ml) required to be detectable on an upright chest xray

A

150-200ml

30
Q

limit therapeutic thoracentesis acute drainage to 1.0 – 1.5 L to prevent

A

Reexpansion pulmonary
edema

31
Q

Light Criteria

A

1 or more = EXUDATE

PROTEIN (P/S) = >0.5
LDH (P/S) = >0.6
LDH (P>S) = >2/3

**Serum albumin difference: >1.2g/dl or 12g/L

32
Q

HIGH Protein (Transudative vs Exudative)

A

Exudative

33
Q

LOW Protein (Transudative vs Exudative)

A

Transudative

34
Q

Massive or severe hemoptysis

A

100 mL to >1000 mL per 24 hours
Midpoint value: 600 mL per 24 hours

35
Q

most commonly affected in hemoptysis

A

BRONCHIAL ARTERIES

36
Q

Intubation in Hemoptysis

A

Larger-diameter ET to allow for bronchoscopy
Affected lung is in a dependent position to prevent spilling of blood into the unaffected side
Preferentially intubate the main bronchus of the unaffected lung

37
Q

Visualization of the more peripheral and upper lobes

NOT provide optimal suctioning and does NOT allow for local treatment

A

Fiberoptic bronchoscopy

38
Q

Cannot fully view the upper lobes and peripheral lesions
Greater suctioning
ability than fiberoptic bronchoscopy

A

Rigid bronchoscopy

39
Q

Tamponade the bronchus of the AFFECTED lung

A

FORGARTY CATHETER

40
Q

Most effective treatment of massive hemoptysis

A

bronchial artery embolization

41
Q

Most common pathogen causing pneumonia in alchoholics

A

S. Pneumoniae

42
Q

Most common cause of acquired immune deficiency AIDS-related death in pregnant women

A

Pnemocystis Pneumonia

43
Q
A
44
Q

Acute pulmonary infection in a patient who is not
hospitalized or residing in a long-term care facility ≥14 d before presentation

A

Community-acquired pneumonia

45
Q

New infection occurring ≥48 h after hospital admission

A

Hospital-acquired pneumonia

46
Q

New infection occurring ≥48 h after endotracheal intubation

A

Ventilator-acquired pneumonia

47
Q

Healthcare–associated pneumonia

A

Patients hospitalized for ≥2 d within the past 90 d
Nursing home/long-term care residents
Patients receiving home IV antibiotic therapy
Dialysis patients
Patients receiving chronic wound care Patients receiving chemotherapy Immunocompromised patients

48
Q

Rust-colored; gram-positive encapsulated diplococci

A

Streptococcus pneumoniae

49
Q

Purulent; gram-positive cocci in clusters

Patchy, multilobar infiltrate; empyema, lung abscess

A

Staphylococcus aureus

50
Q

Brown “currant jelly”;
thick, short, plump, gram-negative, encapsulated, paired coccobacilli

Upper lobe infiltrate, bulging fissure sign, abscess formation

A

Klebsiella pneumoniae

51
Q

Gram-negative coccobacilli

A

Patchy infiltrate with frequent abscess formation

52
Q

Short, tiny, gram-negative encapsulated coccobacilli

Gradual onset, fever, dyspnea, pleuritic chest pain; especially in elderly and COPD

Patchy, frequently basilar infiltrate, occasional pleural effusion

A

Haemophilus influenzae

53
Q

Multiple patchy nonsegmented infiltrates, progresses to consolidation, occasional cavitation and pleural effusion

Few neutrophils and no predominant bacterial species

A

Legionella pneumophila

54
Q

Gram-negative diplococci found in sputum

Diffuse infiltrates

Indolent course of cough, fever, sputum, and chest pain; more common in COPD patients

A

Moraxella catarrhalis

55
Q

Patchy subsegmental infiltrates

Few neutrophils, organisms not visible

A

Chlamydophila pneumoniae

56
Q

Interstitial infiltrates (reticulonodular pattern), patchy densities, occasional consolidation

Few neutrophils, organisms not visible

A

Mycoplasma pneumoniae

57
Q
A

EM PULMONOLOGY (1 decks)

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