Pulmonary Clin Med Buzz Words Flashcards
(71 cards)
1
Q
Recent sepsis
A
ARDS
2
Q
PaO2/FiO2 <300
A
ARDS
3
Q
Brown mucus plugs
A
Allergic bronchopulmonary aspergillosis
4
Q
Central bronchiectasis on CXR
A
Allergic bronchopulmonary aspergillosis
5
Q
Young patient (<45 YO) with COPD
A
Alpha-1-Antitrypsin deficiency
6
Q
Atopic dermatitis
A
Asthma
7
Q
Allergic rhinitis
A
Asthma
8
Q
Chronic cough + sputum + dyspnea
A
Bronchitis
9
Q
Cobblestoning
A
Post-nasal drip
10
Q
Barking cough
A
Croup
11
Q
Steeple sign
A
Croup
12
Q
Drooling
A
Epiglottitis
13
Q
Epiglottitis TX
A
Secure airway in OR first!
Empiric ceftriazone and rifampin for close contacts
14
Q
Velcro rales
A
Idiopathic Pulmonary Fibrosis
15
Q
Honeycombing + reticular opacities
A
Idiopathic pulmonary fibrosis
16
Q
Drugs that can cause IPF symptoms
A
bleomycin (chemo)
nitrofurantoin (used for UTIs)
amiodarone (used for a-fib)
methotrextate (used in auto-immune disorders)
17
Q
Post-tussive emesis
A
Pertussis
18
Q
Most contagious phase of pertussis
A
Catarrhal stage
19
Q
Eggshell calcifications
A
Silicosis
20
Q
Malignant mesothelioma
A
Asbestosis
21
Q
Rheumatoid arthritis symptoms + respiratory symptoms
A
Caplan syndrome, coal exposure
22
Q
Mosaic attenuation
A
Hypersensitivity pneumonitis
23
Q
Black female patient 20-60 YO
A
Probably sarcoidosis because med school is racist
24
Q
Non-caseating granulomas
A
Sarcoidosis
25
Bilateral adenopathy
Sarcoidosis
26
Ruptured or paralyzed diaphragm
Absolute contraindication for thoracentisis
27
Diagnostic criteria for ARDS that excludes cardiac causes
Capillary wedge pressure <18 mmHg
28
Tx for ARDS
Mechanical ventilation with low TV and PEEP
Restrict fluids/use diuretics
Tx underlying cause
Care for psych concerns after
29
Diagnostic lab for aspergillosis
Elevated IgE (>1000)
30
Tx for allergic bronchopulmonary aspergillosis
Long-term oral prednisone (month - years)
31
How to dx Alpha-1-Antitrypsin deficiency
PFT with obstructive pattern
CXR showing changes at lung bases
*Genetic screening
Low serum [AAT]
32
3 components of asthma pathophys
Airway hyperreactivity
Bronchoconstriction
Inflammation
33
Among asthma/copd meds, what cannot be used alone?
Never use LABA (ex: salmeterol) alone in asthma
34
Tx for bronchiolitis?
Supportive, but admit if severe.
35
Prevention for RSV?
Preterm infants who are less than 1 YO at start of RSV season
BPD patients for 1st year of life
BPD patients for 2nd year of life if still requiring meds 6 months before RSV season
Infants with congenital heart disease
^^ Treat all of these guys with palivizumab
36
Most common etiological agent of acute bronchitis?
Influenza A/B, parainfluenza, coronavirus, rhinovirus, RSV
Mnemonic: PRICR
37
What happens to the compliance in an infant without sufficient surfactant?
Becomes less compliant
38
Tx BPD?
Exogenous surfactant;
Corticosteroids;
Mechanical ventilation with small TV and PEEP
39
What are some meds that can be used for a COPD exacerbation?
Azithromycin (for anti-inflammatory properties)
Prednisone 5 days
Roflumilast
40
COPD control meds, in order from mild to most severe
Start with albuterol (SABA) PRN
Add tiotropium (LAMA)
Progress to ICS/LABA combo (Symbicort, Advair)
Progress to Trelegy - combo ICS/LABA/LAMA
41
What meds can be used to control bothersome acute cough symptoms?
Dexomethorfan
| Benzonatate
42
What meds should be considered with chronic cough with evidence of cobblestoning of the airway?
PND can be treated with topical steroids (flonase) and antihistamines
Consider abx if bacterial sinusitis is present
43
What is the most common etiological agent of croup?
Parainfluenza (influenza a/b tends to be more severe but more rare)
44
What meds should be considered in croup?
Dexamethasone; blow-by O2; humidified air.
If in SEVERE respiratory distress, consider racemic epinephrine.
45
What gene is mutated in CF and what is it's location?
CFTR gene on the long arm of chromosome 7.
46
What drug is used in CF when channels are being biosynthesized but have troubles with maturation?
Ivacaftor
47
Tx of cystic fibrosis?
```
Bronchodilators PRN
Dornase alfa (breaks up DNA in mucus)
Hypertonic saline
Chest vest
Oral corticosteroids
High-dose ibuprofen
Azithromycin
Ivacaftor
```
48
What are the most common etiologic agents of epiglottitis?
HiB in unvaccinated kids
Other Haemophilus spp, S. penumo, or S aureus in vaccinated kids
49
What is the narrowest region of an infant's airway?
Subglottic region
50
What is the tx for chronic IPF?
Nintedanib (suppresses tyrosine kinase = slows repair cascade to reduce scarring)
Pirfenidone (supresses fibrosis by slowing TGF-B pathway
51
What is influenza myositis, who does it primarily affect, and how is it diagnosed?
Complication of flu, associated with influenza B
Usually affects school-age Boys
Causes Bilateral calf pain
Confirm with measurement of creatinine kinase
52
Aside from clinically, how do you dx pertussis?
PCR of nasopharyngeal swab showing lymphocytosis w/in first 2 weeks
53
Tx of pertussis?
Early azithromycin
| Supportive care
54
Prevention of pertussis?
```
DTaP at:
2 mo
4 mo
6 mo
1.5 YO
4-5 YO
```
and with every pregnancy!
55
Patient presents with dullness to percussion, decreased fremitus, and decreased breath sounds. Possible dx?
Pleural effusion.
56
Patient presents with dullness to percusion, increased fremitus, bronchial breath sounds, and egophony. Possible dx?
PNA
57
Patient presents with hyper-resonant percussion, decreased fremitus, and decreased breath sounds. Possible dx?
Pneumothorax or obstructive disorder
58
Light's Criteria
Excessive protein in pleural fluid (>.5 ratio)
Excessive LDH in pleural fluid (>.6 ratio)
LDH > 2/3 upper limit of normal serum LDH
Any of above is exudate
Otherwise, it is transudate
59
Most likely cause of transudate
CHF
60
Tx for CAP in patient with no co-morbidities
```
Doxycycline
OR
Amoxocillin
OR
If S. pneumo resistance <25%, azithromycin
```
61
Tx for CAP in patient with co-morbidities
```
Levofloxacin
OR
Augmentin + azithromycin OR doxy
OR
High-dose amox + azithro OR doxy
```
62
What are the classic risk factors for a PE?
Virchow's triad:
Damage (trauma, infection, inflammation)
Stasis (immobilization, surgery, sitting >4 hr)
Hypercoagulability (including use of oral contraceptives, pregnancy, smoking, or familial causes)
63
Dx of PE?
CT angiography; D-dimer
CXR will likely be normal
EKG should be done
64
Split of S2 may indicate what?
Pulmonary hypertension
65
How is pulmonary HTN diagnosed?
Catheterization is gold standard but echo is more reasonable
66
What are the 4 classifications of pulmonary HTN?
1. idiopathic
2. caused by left-heart dz
3. caused by chronic pulm dz (COPD)
4. caused by thromboembolic dz
67
Tx of pulmonary HTN?
Ca+ channel blockers; heart/lung transplant
68
Tx for sarcoidosis?
Methotrexate; rituximab
69
You're about to do a thoracentesis. Where do you aim?
Over 5th rib and don't take more than 1.5 L max
70
What is a positive TB skin test result for a patient with HIV?
5+ mm
71
What is a positive TB skin test result for a healthcare worker or recent immigrant?
10+ mm
