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STEP 2 CK FIRST AID > Pulmonary > Flashcards

Flashcards in Pulmonary Deck (24):
1

MVA pt comes in with trouble breathing, tachycardia, and trachea deviated to the right?

left pneumothorax

shove a needle in the 2nd intercostal on the left side. Dont bother with at CXR. Don't intubate yet b/c PEEP will make the pneumothorax worse!

Insert a chest tube only if the needle doesn't work.

2

SIRS criteria?

Temp >101.3 or 90
RR >20
WBC >12000 or

3

Where are bronchogenic cysts found?

The middle mediastinum

4

FEV1 and RV for Obstructive disease?

FEV1 will be 120% predicted

I.E. more air is in and it is trapped

5

FVC, RV and FEV1 or Restrictive disease?

FVC 75% predicted
RV = normal until the disease gets severe, then it starts to drop.

I.E. - the lung space is smaller and able to push the little air that it has out easier

6

A kid with asthma who is on daily fluticasone has to use his albuterol inhaler 1x per day. What is the next treatment?

Switch the albuterol to a long term B agonist (salmeterol.()

7

How does ipratropium work in asthma?

Theophylline?

Ipa = AcH R blocker - prevents bronchoconstriction

Theophylline = a methylxanthine that blocks PGE - causing less cAMP breakdown. Bronchodilates. Has a narrow T.I. so its use is limited

8

Mild Intermittent Asthma?

symptoms

9

How many symptoms before pt needs to use salmeterol?

Daily symptoms + >1 night per week symptoms

tx = albuterol, fluticasone, and salmeterol

10

What are the only 2 interventions proven to improve survival in patients with COPD?

Supplemental O2 >90% for >15h per day
Smoking Cessation

11

What kind of lung diseases do myasthenia and sarcoid cause?

Restrictive!

12

What kind of lung disease does amiodarone cause?

Interstitial Lung Disease

13

Lab markers in sarcoidosis?

Hi ACE levels, Hypercalcemia, hypercalcuria
Hi alk phos

14

What will lung pathology look like in Hypersensitivity Pneumonitis?

Alveolar thickening and granulomas

CXR = upper lobe fibrosis

15

Characteristic lung finding in silicosis?
What annual screening do they need?

Eggshell calcifications - will cause a restrictive disease

Need to screen for TB annually

16

What 3 things could an increased Aa gradient suggest?

Shunt
VQ mismatch
Diffusion impairment

17

Algorythm for "Is low PO2 correctable with O2?

Yes = VQ mismatch has occured
No = Shunt has occured

18

ARDS criteria

Acute onset
PaO2/FiO2 ratio

19

What should PO2 and PCO2 be to indicate it is ok to stop mechanical ventialtion?

PO2 should be > 70 (on 40% FiO2)
PCO2 should be

20

What will the heart exam of a pt with a pulmonary embolism sound like?

A loud P2, prominent jugular A waves

21

25 yo black female w/ painful bumps on her shins, weight loss, cough. Exam shows 1cm right axillary lymph node. What is the next best step for dx?

Take a bx of the axillary lymph node. She likely has sarcoidosis, and this is less invasive than a lung bx

22

What is the only lung cancer to not be associated with smoking?

Bronchoalveolar carcinoma

23

What extra symptoms to look for with:
Small Cell Lung Cancer
Squamous Cell Lung Cancer
Large Cell lung cancer
AdenoCA

Small = hi ACTH, SIADH, Lambert Eatooon, peripheral neuropathy
SqCC = hi PTHrP
Large = Gynecomastia
Adeno = thrombophlebitis, nonbacterial verrucous endocarditis

All can cause anemia, acanthosis nigricans, dermatomyositis!

24

What are the causes of transudative and exudative pleural effusions?

Transudative - increased PCWP or decreased oncotic pressure (CHF, cirrhosis, nephrotic)

Exudative - increased pleural vascular permeability (infection, malignancy, pancreatitis, RA/SLE, trauma)