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Pulmonary Flashcards

(57 cards)

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1
Q

Definition of chronic bronchitis

A

Excessive sputum production with chronic cough on most days for at least 3 months of the year for at least 2 consecutive years

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2
Q

Presentation of chronic bronchitis

A

Blue bloater - obese and cyanotic
RHF
THick sputum

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3
Q

Management of chronic bronchitis and emphysema

A

Smoking cessation
Ipratropium
Albuterol
Keep all vaccines up to date

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4
Q

Presentation of emphysema

A

May be due to alpha-1 antitrypsin
Pink puffer
Cachexia with obstructive PFTs

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5
Q

Stage 1 COPD FEV1 and tx

A

> 80%
Bronchodilator

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6
Q

Stage 2 COPD FEV1 and tx

A

50-80%
Bronchodilator w/ long acting
start thinking about pulm rehab

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7
Q

Stage 3 COPD FEV1 and tx

A

30-50%
Bronchodilator w/ long acting
Pulm rehab
Add steroids

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8
Q

Stage 4 COPD FEV1 and tx

A

FEV1< 30% or right heart failure
Long term O2

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9
Q

6 Steps of asthma treatment escalation

A
  1. SABA PRN (Albuterol)
  2. Add low dose ICS
  3. Add LABA or Med dose ICS
  4. Med Dose ICS and LABA
  5. High Dose ICS and LABA
  6. Oral Steroid

May add Omalizumab at steps 4-6

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10
Q

Management of status asthmaticus

A

May eventually need intubated - Look for cyanosis may not be wheezing
O2, bronchodilators on neb, IV steroids, ventilate

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11
Q

Bronchiolitis

A

RSV - wheezing and cough in children with lymphocytisis
Peri-bronchial thickening
Supportive
Oxygen WITHOUT steroids or bronchodilators

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12
Q

Acute bronchitis

A

Follows a URI
Rare to have dyspnea
Cough after a week of URI
Normal CXR

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13
Q

Epiglottitis

A

Used to be mostly H flu - now strep/staph
Fever, dysphagia, stridor
Cherry red epiglottis, thumbprint XR
ABCs COME FIRST
IV Rocephin and Vanc

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14
Q

Croup

A

Disappears by six - parainfluenza virus
Barking cough and stridor (not as toxic as wpiglottitis)
Steeple sign
Nebulized epi with steroids to prevent rebound

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15
Q

Pertussis

A

Kids under 10
3 stages - cold, cough, convelescence
PCR testing and macrolides

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16
Q

Number one cause of CAP

A

Strep pneumo

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17
Q

Pneumonia with relative bradycardia

A

Legionairres
(Chlamydia and typhod also do this)

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18
Q

Low risk CAP tx

A

Macrolides
FQs - Levo/Moxy
Doxy

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19
Q

High risk CAP tx

A

IV BL (Rocephin) with Macrolide or FQ

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20
Q

Management of atypical pneumonia

A

Macrolides across the boards

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21
Q

Management of aspiration pneumonia

A

RLL more common
Amoxicillin, CLinda, FQ

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22
Q

HAP management

A

Think gram neg, pseudomonas if ventilated
-penem, Zosyn

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23
Q

Gold standard for TB dx

24
Q

5mm PPD induration risk groups

Study These Flashcards
A

Immune compromised/Have had/Exposed
Direct exposure
(HIV, immune suppressed, old TB, Exposure)

25
10 mm PPD risk groups
Have a risk factor for exposure Children under 4 exposed Foreign Countries, Work setting, IVDU
26
15mm PPD risk groups
Everyone
27
Progression of TB workup
PPD -> CXR -> Smear and Cx
28
Management of Latent TB (+ PPD but no active disease)
INH and B6 for 9 months
29
Empyema Management
Rocephin and metronidazole
30
Carcinoid tumor
Lung cancer with flushing Bx to dx Surgery ONLY
31
Squamous cell lung carcinoma
Hypercalcemia Bronch with bx S/C/R
32
Lung adenocarcinoma
Peripheral MC type Lymphadenopathy, hepatomegaly clubbing CEA positive
33
Small cell lung cancer
Most aggressuve w/ SIADH, Cushing, Lambert Eaton Central to outward spread NO SURGERY - use chemo, rad
34
Lambert Eaton syndrome
Reverse MG with SCLC
35
Pulmonary nodule workup - benign
No change in 2 years Calcified
36
Pancoast tumor
Apical lung tumor causing horner syndrome Tx with surgery, chemo rad
37
Tension pnx management
Needle decrompression third intercostal space
38
EKG change for PE
S1Q3T3
39
Test of choice and gold standard for PE testing
Test of choice - spiral CT GS - Pulm angiography
40
Pulmonary hypertension causes
Precapillary - PE, Cong. heart disease, sickle cell Passive - HTN, CHF, MI Reactive - Mitral stenosis
41
Murmur of pulm HTN
Narrow splitting of second heart sound w/ loud pulm component Echo to dx
42
Management of pulm HTN
Lung transplant is curative
43
Management for IPF
Nintedanip (blocks tyrosin kinase receptors) Steroids and N-AcetylCysteine no longer recommended Ling transplant curative
44
Chest tube v needles decompression
ND for tension CT for pnx without tension
45
Asbestosis Jobs and CXR
Insulation and Shipyards Reticular basilar predominance
46
Coal workers pneumoconiosis
Coal miners small nodules upper fields ONLY obstructive pneumoconiosis
47
Silicosis presentation and CXR
Foundry, glass, sandblasting, pottery Nodular upper lobes Restrictive
48
Managment for pneumoconiosis
Steroid and support
49
Sarcoidosis
AA 40 female Cough dyspnea and fatiue Elevated ACE Mediatinal lymphadenopathy Steroids/Methotrexate to tx
50
Keys to ARDS not CHF
Normal cardiac output and pulm wedge pressure PEEP to stabilize
51
Systems affected by CF
Pancreas and lungs
52
CF inheritance pattern
Autosomal recessive
53
CF electrolyte abnormality
Dehydration with hypochloremic hyponatremic metabolic acidosis
54
Management of CF
N-acetylcysteine DNA-ase IN tobramycin Physiotherapy Pancreatic enzyme replacement
55
FB aspiration presentation and management
Chocking followed by wheezing Don't use fingers
56
Hyaline membrane disease
No surfactant in alveoli Grunting respirations Steroids and CPAP
57
3 PFT numbers to look at
Percent predictive (should be above 80%) FEV 1/FVC FVC (Change from baseline for asthma)

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