respi Flashcards
(45 cards)
bola que se ve en radiografia y se mueve al reposicionar al pt?
Aspergilloma (one of the forms of chronic pulmonary aspergillosis)
presenta con eosinofilia
Aspergillus colonizes preexisting cavities and forms a fungal ball, which is not attached to the surrounding tissue and can, therefore, be moved by repositioning the patient. CPA is most commonly seen in individuals who are immunocompromised (e.g., due to HIV infection) and those with previous pulmonary pathologies, especially cavitary lung disease (e.g., resulting from tuberculosis).
Chronic pulmonary aspergilloma should be treated with itraconazole or voriconazole, and surgical resection is indicated in patients with aspergilloma.
copious amounts of sputum y cuales son los signos radioogicos
bronchiectasis
x ray: signo del anillo de sello y opacidades lineales paralelas
confirmar dx con TAC
heterophile agglutination test aka monospot test is positive in?
epstain barr virus ( infectious mononucleosis)
which increases risk of nasopharyngeal carcinoma, Burkitt lymphoma, and Hodgkin lymphoma.
EPV shows petequias en paladar
serotonin syndrome sx?
“HARMED”
Hipertermina
Autonomic instability (hipertension, midriasis)
Rigidity
Myoclonus
Encephalopathy
Diaphoresis
foreign body aspiration
2-3 y.o
unilateral wheezing+hyperlucency lung unilateral
acute onset cough, Shortness of breath
80% of cases involve the right main bronchus.
tx: rigid bronchoscopy
fever, foul smelling sputum, lung cavity?
lung abscess
tos ferina sintomas
paroxysmal coughing spells with deep, whooping breaths and posttussive vomiting
un paciente con tos ferina, que se le hace a los contactos?
macrolidos (azitromicina, claritromicina) para:
- todos en la casa
- all exposed individuals who are at high risk of developing severe pertussis (e.g., pregnant individuals in their third trimester, infants < 12 months, persons with immunodeficiency)
- and all exposed individuals who are in close contact with high-risk persons
Tdap vacuna para todos los adultos
atypical pneumonia+target lesions on skin?
eritema multiforme x mycoplasma pneumonia
en algunos casos afecta membranas mucosas
atypical pneumonia (mild respiratory symptoms and diffuse reticular opacities on x-ray)
retropharingeal abscess cual se drena?
drenar si:
- airways compromised (drooling, accesroy mucles of respiration usage, hipoxia, stridor)
- > 2.5 cm
- no mejora a pesar del uso de atb (clinda, ampi-sulbactam)
se ve como posterior pharingeal swealling, si es uvular deviation to contralateral side is peritonsillar abscess
thumb sign on x ray?
epiglottitis
drooling + muffled voice
Since the introduction of the Haemophilus influenzae type b (Hib) vaccine, epiglottitis no longer mainly manifests as a life-threatening illness in children and is now predominantly seen in adults, particularly those with a BMI > 25, a history of diabetes mellitus, coexistent pneumonia, or a preceding upper respiratory infection.
Empiric IV ceftriaxone is used to treat acute epiglottitis, which is usually caused by Haemophilus influenzae type b (Hib) or gram-positive cocci (e.g., Streptococcus pyogenes or Streptococcus pneumoniae).
recurrent sinusitis+hemoptisis+nasal ulcers. Dx?
granulomatosis con poliangitis
c-ANCA
Classic GPA triad: necrotizing vasculitis of small arteries (palpable purpura), upper/lower respiratory tract manifestations, and glomerulonephritis
Features of a high-risk solitary pulmonary nodule?
size ≥ 2 cm, age > 60, and smoking cessation within the last 5 years (or current smoker)
do excision quirurgica
Features of an intermediate-risk solitary pulmonary nodule?
size 0.8 - 2 cm, age 40 - 60, and smoking cessation within the last 5 - 15 years (or current smoker)
do pet scan-biopsy
pleural effusion symptoms?
unilateral percussion+ unilateral decreases on auscultation.
pneumotorax sx?
unilateral hiperresonante+decreased breath sounds
pt con pneumonia lobar como lo acuestas?
“good lung down”
decubito lateral del lado bueno, o sea si tiene neumonia izquierda entonces lo pones en el decubito lateral derecho, mejora la perfusion al lado bueno
dimorphic fungus, exists in a yeast form in body tissue (37°C) and in a hyphal form at room temperature (20–30°C)?
Histoplasma capsulatum
Mississippi, Ohio
Bird or bat droppings.
Sx: atypical pneumonia (e.g., dry cough, dyspnea) and systemic symptoms (e.g., low-grade fever, malaise, joint pain) can occur.
The best initial test in the case of suspected histoplasmosis, especially for patients who are acutely ill, is a urine or serum test for the galactomannan antigen of H. capsulatum.
fungal culture of bronchoalveolar lavage is more specific but takes longer (up to 6 weeks).
Localized pulmonary histoplasmosis is typically treated with itraconazole and disseminated histoplasmosis with amphotericin B.
antigeno en orina de histoplasmosis
galactomanann
sarcoidosis como esta el bronchoalveolar lavage?
increased CD4 T cell in bronchoalveolar lavage
atb para pseudomonas (bacilo gram -)
Drugs effective against Pseudomonas aeruginosa “CAMPFIRE”
Carbapenems:
Aminoglycosides
Monobactams (aztreonam)
Polymyxins (polymyxin B, colistin)
Fluoroquinolones (cipro, levofloxacin)
thIRd and fourth gen cefalosporijnes: 3ra y 4ta gen: ceftazidime, cefepime
Extended spectrum (antipseudomonal) penicillins:(piperacillin)
pp65+ dx y tx?
citomegalovirus pneumonia
tx: galanciclovir iv ( si hay resistencia se usa forscanet iv)
Cytomegalovirus (CMV) is a common cause of atypical pneumonia in post-transplant patients on immunosuppressive therapy
enfisema en pt <50 y.o. posible dx y asociacionismo?
deficiencia a1 antitripciona
enfisema+cirrosis hígado/carcinoma hepatocelular
peumonia atipica+diarrea+hiponatremia.
dx?
legionella
urine antigen
cultivo con agar carbon
tx:fluoroquinona (levofloxacin/moxifloxacina) o macrolidos
