How did the patient presents with Asthma? What are the pertainant findings in Physical Examination?
Short of breath, exposure to trigger and wheezing; Hyperresonant, prolonged expiration, nasal polyps
How is Asthma diagnosed?
Pulmonary function test. FEV1/FVC decrease but reversible with bronchodilators. If normal, induced with methacholine Challenge (FEV1 decreased by 20%)
What are the ICS?
Beclomethasone, Fluticasone, Budesonide
What is done as a first step for asthma exacerbation? What should not be done for exacerbation?
X-ray to rule out something else. Then peak flow (PEFR); PFTs
How is asthma classified?
Intermittent, persistent (mild, moderate, severe), refractory
When should a patient with asthma exacerbation be intubated?
When they start wheezing, decreased lung sounds, respiratory acidosis due to increasing CO2
What is the first step in a patient who you suspect has lung cancer?
CXR If a tumor mass is obviously present then use the CT scan to localize it then Biopsy
If a biopsy is already done and it is positive what should be done next?
Stage with PET-CT Scan
After biopsy and staging what should be done?
PFT to see if patient is can tolerate surgery
How will the patient presented with carcinoid tumor?
Wheezing, diarrhea, flushing
How will the patient will pleural effusion present?
Exertional dyspnea and Orthopnea; Finding Pleural effusion on accident on x-ray
What is the best way to diagnose pleural effusion?
Biopsy, Gram stain, cytology
What is the treatment for pulmonary embolism?
IVF, O2, Anticoagulation
When is TPA used in PE?
In massive PE, hypertension
If the well’s criteria is less than 2, what should be done to completely rule out pulmonary embolism?