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Flashcards in Respiratory 4 Deck (43):
1

a risk factor for allergic rhinitis is if serum IgE is >100 before what age?

age 6

2

what is the most common allergic dz in the US

allergic rhinitis

3

what class of allergic rhinitis is symptoms <4 weeks

intermittent

4

what class of allergic rhinitis is symptoms >4 days/ week AND >4 weeks

Persistent (primary perennial)

5

allergic rhinitis is considered moderate-severe if what at least 1 of what three symptoms are found

Sleep disturbances, Troublesome symptoms
Impairment of daily activities, leisure, and/or sport
Impairment of school or work

6

a central mediator in both the early and late allergic response
Released from presensitized mast cells upon allergen exposure and causes acute symptoms of allergic rhinitis: sneezing, rhinorrhea, itchy nose, nasal congestion

Histamine

7

when is histamine released from basophils?

Late phase

8

Who is at greatest risk of asthma?

65 years and above

9

What are some symptoms of asthma?

Recurrent wheeze
recurrent shortness of breath
cough
recurrent chest tightness

10

what is the inflammation like in asthma?

histamine release
basophil release

11

what cells produce mucous and cause plugging

goblet cells

12

does normal spirometry to lack of reversibility rule out asthma?

No

13

will asthmatics have low diffusion capacity?

No (will be abnormal with emphysema)

14

what are leukotriene meds used for?

add to albuterol for exercise induced
add if they have allergies

15

indicated in for adults and adolescents (12 years of age and above)
with moderate to severe asthma who have a positive skin test or in vitro reactivity to a perennial aeroallergen
whose symptoms are inadequately controlled on inhaled corticosteroids.

Omalizumab

16

may be more beneficial in children, exercise induced

mast cell stabilizers (cromolyn, nedocromil)

17

patients with nasal polyps are more likely to be sensitive to what?

ASA and NSAIDs

18

in an asthma exacerbation, what is the pH initially?

respiratory alkalsosis

19

if the pH is decreased in an asthma exacerbation what can that indicate?

impending respiratory failure

20

is wheezing a good sign in asthma?

Yes, because silent chest is worse during exacerbation

21

most common cancer for men?

prostate

22

exposure to what can cause lung cancer?

Asbestos
Radon
uranium

23

Tumors that originate in the _______ can attain a very large size before producing symptoms

periphery

24

When tumors arise in a _______ region of the lung symptoms arise early.

central

25

what is the most common type of histology of central tumors?

squamous cell

26

most common symptoms of lung cancer

hemoptysis
chest pain
dyspnea (COPD association)
weight loss

27

Edema in the face, neck, arms, JVD

Superior Vena Cava Syndrome

28

first thing for evaluation of lung cancer

CXR (can't see lesions <5 mm)

29

CT with or without contrast is best for lung cancer.

With contrast and look at liver and adrenals (metastasis)

30

what is the most common classification of lung cancer?

Non-small cell
(small cell is the worst though)

31

Stage one is a tumor less than what size?

<3 cm

32

only way to cure lung cancer?

removal of the cancer

33

what do you do for stage III NSCLC

Non-resectable Stage IIIa and IIIb
Combined chemo-radiation improves survival

34

Tx for stage IV NSCLC

Chemotherapy improves survival (by 20-40% at 12 months) and QOL if good performance status

35

Small Cell Cancer is very _________, surgery usually not an option.

chemosensitive

36

which type lung cancer do you do surgery on?

non small cell

37

Isolated rounded lesion in the lung parenchyma, usually < 3 cm

Solitary pulmonary nodule

38

when is a pulmonary nodule more likely to be malignant

>3cm
older age
smoking history
increasing in size

39

where are lymphomas seen?

anterior or middle mediastinum

40

what is a slow growing malignant tumor with a good survival rate?

Carcinoid tumor

41

If a lesion is stable in size for _________ years, it is likely not malignant.

2-3 years

42

Benign causes of pulmonary nodules

Granulomas (tb, spores from forest)
hamartomas

43

If it is metastasis to the lung, what will you usually see

multiple cancers