Pulmonology Flashcards Preview

Medicine > Pulmonology > Flashcards

Flashcards in Pulmonology Deck (81):
1

Recurrent lung infections
Heavy production of sputum

Bronchiectasis

2

Diagnosis of Bronchiectasis

High resolution chest CT
-tram-tracking
Sputum culture for TB and bacteria

3

Treatment of Bronchiectasis

corticosteroids and macrolides
pharmacologic and chest therapy to loosen secretions

4

Which antibiotic helps to decrease inflammation

macrolides

5

snoring
daytime sleepiness
morning headaches
poor concentration

OSA need nocturnal sleep evaluation

6

dyspnea, cough
Mediastinal mass
elevated AFP and betaHCG

Nonseminomatous germ cell tumor

7

dyspnea, cough
Mediastinal mass
elevated beta HCG
AFP normal

seminomatous germ cell tumor

8

abnormal development of the forgut

bronchigenic cysts

9

chirrosis or viral hepititis
elevated AFP

Hepatocellular carcinoma

10

mediastinal mass
young patient
weight loss
lymphadenopathy

Hodgkin's lymphoma

11

Young patient
bilateral lower lobe emphysema

Alpha One Anti Trypsin

12

Organ systems affected in alpha 1 antitrypsin

Emphysema in the lungs
hepatic fibrosis in neonates

13

Pathophysiology of alpha1 antitrypsin

lack of alpha1antitrypsin causes build up of neutrophil elastase and a bilateral pan lobular emphysema

14

Management of pleural effusion

In a patient with CHF--diuretics
Otherwise thoracentesis to find transudate vs exudative

15

Causes of for pulmonale

COPD
interstitial lung disease
Pulmonary vascular disease
Obstructive sleep apnea

16

Imaging and finding in for pulmonale

ECG: right bundle branch block, right axis deviation, RVH, right atrial enlargement
Echo: pulmonary HTN, dilated right ventricle, Tri regard
Right heart cath: pulmonary HTN.

17

Acute organ insult
hypoxemia unresponsive to O2 therapy
bilateral oppacities

ARDS

18

fever, non productive cough, tachypnea
reticular ground glass opacities on CXR
pulmonary edema and pleural effusions

Eosinophilic pnuemonia

19

Symptoms of theophylline toxicity

CNS: insomnia, headache, seziures
GI: nausea, vomiting
Cardiac: arrythmia

20

Normal to increased FEV1/FVC
Pleural calcifications
decreased DLCO

Interstitial lung disease

21

Factor used to monitor decompensation in asthmatics

pCO2 normally decreased due to hyperventilation in asthma attacks but if normal shows not moving good air.

22

Immunofluorescence showing IgG deposition along the glomerular basement membrane

Goodpasture's

23

nephritic change in kidneys
Cough, dyspnea hemoptysis

Good pastures

24

pathophysiology of good pastures

Antibodies against the alpha3 chain of type 4 collagen which is heavily concentrated in glomerular basement membrane

25

Pathophysiology and findings in interstitial lung disease

increased collagen deposition in peri-alveolar tissues
Normal to increase FEV1/FVC
Decreased DLCO
Increased A-a
decreased lung volumes

26

Classification and Treatment of hypothermia

Classification
Mild: 90-95, tachy and shivering
Moderate: 82-90, brady, hypoventilation, arrythmia
Severe: 82 coma, cardiovascular collapse

Treatment
Mild: Passive warming
Moderate:Active warming
Severe: active warming

27

Most common disorder predisposing to DVT and pathophysiology

Factor Five Leiden
Point mutation cause factor five not to be inactivated by protein C

28

Values in intubation

FiO2 and PEEP influence pO2
tidal volume and RR determine pCO2

29

Medical complication associated with asthma

GERD: increased vagal tone, aspiration, heightened bronchial reactivity

30

Significance of pleural exudate analysis

Low pH or low glucose means need thoracostomy

31

Recurrent PE or PE without cause

Factor five Leiden
Antiphospholipid
Deficiency protein S, C or antithrombin

32

Factors inhibited by Warfarin

Vit K factors 2,7,9,10 reflected in the PT

33

What lab value does warfarin change

PT prolongation

34

decreased breath sounds post intubation
Assymetrical decreased breath sounds

Improperly placed endotrachealtube

35

Most common site of emoblus to lungs

iliac femoral or popliteal veins

36

muscle weakness
Beta 2 agonist use

hypokalemia

37

Risk factors for OSA

obesity
hypothyroidism
men
tonsilar hypertrophy

38

symptoms of OSA

excessive daytime sleepiness
snoring
morning headaches
depression
impotence

39

complications of Hep C

cirrhosis
hepatocellular carcinoma
cryoglobulinemia
glomerulonephritis

40

indications for positive pressure ventilation

COPD severe exacerbations
cardiogenic pulmonary edema
acute respiratory failure
facilitate early intubation

41

contraindictions to peep

medical instability
inability to protect airway
mechanical issues

42

indicaions for inbuation with NPPV

failing two hours of PEEP noninvasive

43

clinical findings in asbestosis

prolonged asbestos exposure
symptoms 20 years later
progressive dyspnea, crackles, clubbing

44

pleural plaques on CXR

asbestosis

45

qualifying for O2 therapy in COPD

1)O2

46

ground glass opacities or haziness in the lower lung fields

hypersensitivty pneumonitis

47

pathophysiology of AERD

aspirin exacerbated respiratory disease
aspirin decreased COX which diverts arachadonic acid to leukotrienes as opposed to prostoglandins

48

treatment of AERD

symptom management
avoidance of nnsaids
zileuton-leukotriene inhibitors
montelukast-leukotriene recpetor anatgonist

49

peripheral lung cancers

adenocarcinoma
Large cell carcinoma

50

central lung cancers

squamous cell carcinoma
small cell carcinoma

51

clinical findings with lung tumors

adenocarcinoma-clubbing, hypertrophic osteoarthropathy
SCC-hypercalcemia
SCLC-Cushings, SIADH, Lambert Eaton
Large Cell-gynacomasteia, galactorhhea

52

criteria for exudate

Pleural protein/serum protein >0.5
Pleural LDH/serum LDH >0.6
Pleural LDH >2/3 upper limit of serum
pH 7.3-7.45

53

elevated pleural fluid amylase

esophageal perforation
pancreatitis

54

conditions causing translative pleural effusions

CHF
Cirrhosis
Nephrotic Syndrome
Peritoneal dialysis

55

chronic productive cough
commonly hemoptysis

bronchiectasis

56

Severe complication of hemothroax

empyema s/p thoracentesis

57

Obesity hypoventilation syndrome

patients who are obese become chronically hypoxic
-erythrocytosis
-cor pulmonale
-respiratory acidosis leading to bicarb retention

58

Management of PE

Stabilize patient
Assess if anticoagulation contraindicated
Yes image and diagnostic filter
No Wells criteria and anticoagulation >4

59

cardianal symptoms of COPD exacerbation

dyspnea
cough
excess sputum production

60

management of acute COPD exacerbation

oxygen
bronchodilators
glucocorticoids
antibiotics for patients with:
2/3 cardinal symptoms
moderate to severe COPD (50-80 and 30-50FEV1)
requires ventilator

61

antibiotics used in COPD

macrolides
fluoroquinolones
amox/clav

62

Signs of respiratory failure in asthma

decreased breath sounds
absent wheezing
mental status change
cyanosis
elevated pCO2

63

influence of glucocortocoids on the immune system

decrease eosinophils
increase neutrophils in serum by mobilizing marginated pool and increasing bone marrow release

64

tumors of the anterior mediastinum

thymoma

65

tumors of the middle mediastinum

bronchigenic cyst
tracheal tumors
pericardial cysts
lymphoma
lymph node enlargement
aortic aneuryms

66

tumors of the posterior mediastinum

neurogenic (meningiocele, enteric cysts, lymphoma, esophageal tumors)

67

ACEi cough MOA

decreased degredation of bradykinin and substance P

68

three major causes of prolonged cough

upper airway cough syndrome
GERD
asthma

69

Obesity hyperventilation syndrome

BMI >30
daytime sleepiness
hypercapnea/hypoxia

70

CURB 65

Assessment for risk in pneumonia
confusion
uremia
respiration >30
Hypotension
Age >65
>2=admission >4=ICU

71

increases the A-a gradient

Interstitial lung diseases
V/Q mismatch (PE)

72

treatment of laryngeal edema

epinephrine
corticosteroids
antihistamines

73

postsurgical
right heart failure
hypotension

Massive PE

74

definition pulmonary hypertension

mean pulmonary arterial pressure greater than 25 at rest and 30 on exertion

75

Digital clubbing
sudden onset arthropathy
RF for pulmonary disease

Hypertrophic osteoarthropathy

76

Desired level of ventilator oxygen

below FiO2 of 40%

77

cruise ship/hotel
fever
Gi symptoms
neurologic symptoms
lung rales and interstitial infiltrates

Legionella

78

Treatment for legionella

Macrolide's
fluoroquinolone

79

Complications of PEEP

Pneumothorax
Hypotension
alveolar damage

80

Signs of hypocalcemia

brisk deep tendon reflexes
seizures
QT prolongation
think of in a patient requiring multiple drug transfusions

81

signs of hypercalcemia

stones-renal
bones-pain
groans- abdominal pain
throats- frequency
psychiatric overtones