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Flashcards in Respiratory Deck (46):
1

excess tracheobronchial mucus production resulting in a productive cough that occurs for at least 3 months a year for 2 or more consecutive years

chronic bronchitis

2

abnormal dilatation of terminal airspaces w/ destruction of the alveolar septa

emphysema

3

airway condition that is reversible and there is no associated w/ smoking

asthma

4

what is associated w/ the panacinar form of emphysema

alpha 1 antitrypsin deficiency

5

what type of emphysema is smoking associated w/

centrilobular

6

What type COPD has marked V/Q mismatch?

chronic bronchitis

7

late findings of COPD- chronic bronchitis

weight gain
lethargy
cyanosis

8

how does emphysema typically present

minimal cough/ scant amounts of thin sputum
dyspnea w/ exertion
weight loss (caynosis is rate)

9

lungs sounds w/ chronic bronchitis

coarse rhonchi and wheezes

10

lung sounds w/ emphysema

hyperresonant
decreased breath sounds
increased A-P chest diamester
lowered diaphragms

11

the volume of air that can be exhaled going from maximal inhalation to maximal exhalation

Forced vital capacity (FVC)

12

the volume of air exhaled in 1 second, starting a maximal inhalation

forced expiratory volume in 1 second (FEV1)

13

what is a normal FEV1/FVC

0.75-0.80

14

what is stage I of COPD?

FEV/FVC 80% predicted

15

what stage of COPD is FEV1 30%

Stage III- Severe

16

what stage of COPD is FEV1 50%

Stage II-Moderate

17

what vaccines do people with COPD need?

yearly influenza vaccines
pneumococcal vaccine

18

first line med for COPD

tiotropium bromide

19

COPD patients with PAO2<90% can benefit from what?

continuous supplemental oxygen

20

How is TB spread?

respiratory route- droplets formed by coughing , usually requries several months of close contact

21

Risk factors for TB

older age
low socioeconomic status
recent immigration from 3rd world country
HIV positive

22

symptoms of TB

fever, chills, night sweats
anorexia
fatigue
cough
hemoptysis (advanced dz)

23

pulmonary findings w/ tb

dullness w/ decreased fremitus or distanct hollow breath sounds

24

M. tuberculosis stains positive in a what stain?

acid-fast

25

what is considered a positive TB skin test in someone form a low-risk group

>15 mm

26

what is considered a positive TB test in a moderate risk individual (recent immigration, IV drug user)

>10 mm

27

what is considered a positive TB test in an HIV-infected individual or patients w/ organ transplants receiving >15 mg of prednisone a day

>5 mm

28

first line drugs for TB

isoniazid (INH)
fiampin
pyrazinamide
ethambutol
streptomycin

29

chemoprpolyaxis fo recent skin test onverters

daily INH

30

what is the vaccine for TB that is not recommended for routine use in the US

BCG vaccine (live attenuated strain of Mycobacterium bovis)

31

what is a whole blood test for the diagnosis of latent TB?

QuantiFERON-TB Gold

32

after how many weeks of treatment are TB patients usually noninfectious

2 weeks

33

TB med that produced red-orange discoloration of body fluids

rifampin

34

TB med that can cause red-green color blindness

ethambutol

35

Diagnosis of cystic fibrosis

elevated sweat chloride >60 on 2 occcasions

36

what organ systems does CF mainly affect

lungs
pancreas

37

Pulmonary manifestations of CF

persistent, productive cough
hyperinflation of the lung fields
PFTs consistent w/ obstructive airway dz
clubbing seen in moderate disease states

38

what causes most cases of acute bronchitits?

viruses

39

what suggests acute bronchitis

presitence of cough for mroe than 5 days , and cough generally persists up to 2-3 weeks

40

Is fever common in acute bronchitits?

No, it suggests either influenza or pneumonia

41

Indications for chest x-ray w/ acute cough

pulse >100/ min
respiratory rate >24
temp >38

42

how should acute bronchitits be treated?

symptomatic treatment- NSAIDs

43

what differs pneumonia from bronchitits?

pneumonia patients more liekly to have high fever, experience dyspnea and shills, ahve chest pains

44

If symptoms of a URI persist for more than a week what abx can be started for 10-14 days?

amoxicillin or TMP/SMX

45

ABX to give for outpatient CAP <60

erythromycin
Azithromycin
Doxycycline (less expensive)

46

For patients >60 what are good abx choices for pneumonia

Fluoroquinolone (ex- levofloxacin)
2nd gen cephalosporin