Resp

Question 1

When is it appropriate to initiate biPAP for COPDe or Asthma

Answer 1

Look for an acute or acute on chronic respiratory acidosis on VBGs + clinical criteria (so bronchodilator failure, working hard to breathe).

Question 2

What are the settings on BiPAP that you care about

Answer 2

Inspiratory pressure (iPAP)
Expiratory pressure (ePAP)
ST (backup resp rate)

Question 3

When do you use a high vs low EPAP

Answer 3

High epap for heart failure vs low epap for COPDe

Question 4

For patients with exacerbations of COPD, what is the guidline recommended therapy?

Answer 4

Triple therapy ICS, LABA and LAMA + pulmonary rehab

Question 5

What is the recommendtaion for inhaled steroid dosing for COPD

Answer 5

Start on a low-moderate dose (advair 125 or symbicort 100) as the risk of pneumonia is dose-dependent

Question 6

28yo with recurrent lung infections

Answer 6

Cystic fibrosis

Question 7

What is the diagnosis

Answer 7

Bullous emphysema

Question 8

What are the parallel lines at the bottom of this cxr? What is the anatomical reason?

Answer 8

Kerly B; interlobular septal thickening (eg pulmonary edema