Flashcards in Respiratory 4 Deck (43):
a risk factor for allergic rhinitis is if serum IgE is >100 before what age?
what is the most common allergic dz in the US
what class of allergic rhinitis is symptoms <4 weeks
what class of allergic rhinitis is symptoms >4 days/ week AND >4 weeks
Persistent (primary perennial)
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
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
when is histamine released from basophils?
Who is at greatest risk of asthma?
65 years and above
What are some symptoms of asthma?
recurrent shortness of breath
recurrent chest tightness
what is the inflammation like in asthma?
what cells produce mucous and cause plugging
does normal spirometry to lack of reversibility rule out asthma?
will asthmatics have low diffusion capacity?
No (will be abnormal with emphysema)
what are leukotriene meds used for?
add to albuterol for exercise induced
add if they have allergies
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.
may be more beneficial in children, exercise induced
mast cell stabilizers (cromolyn, nedocromil)
patients with nasal polyps are more likely to be sensitive to what?
ASA and NSAIDs
in an asthma exacerbation, what is the pH initially?
if the pH is decreased in an asthma exacerbation what can that indicate?
impending respiratory failure
is wheezing a good sign in asthma?
Yes, because silent chest is worse during exacerbation
most common cancer for men?
exposure to what can cause lung cancer?
Tumors that originate in the _______ can attain a very large size before producing symptoms
When tumors arise in a _______ region of the lung symptoms arise early.
what is the most common type of histology of central tumors?
most common symptoms of lung cancer
dyspnea (COPD association)
Edema in the face, neck, arms, JVD
Superior Vena Cava Syndrome
first thing for evaluation of lung cancer
CXR (can't see lesions <5 mm)
CT with or without contrast is best for lung cancer.
With contrast and look at liver and adrenals (metastasis)
what is the most common classification of lung cancer?
(small cell is the worst though)
Stage one is a tumor less than what size?
only way to cure lung cancer?
removal of the cancer
what do you do for stage III NSCLC
Non-resectable Stage IIIa and IIIb
Combined chemo-radiation improves survival
Tx for stage IV NSCLC
Chemotherapy improves survival (by 20-40% at 12 months) and QOL if good performance status
Small Cell Cancer is very _________, surgery usually not an option.
which type lung cancer do you do surgery on?
non small cell
Isolated rounded lesion in the lung parenchyma, usually < 3 cm
Solitary pulmonary nodule
when is a pulmonary nodule more likely to be malignant
increasing in size
where are lymphomas seen?
anterior or middle mediastinum
what is a slow growing malignant tumor with a good survival rate?
If a lesion is stable in size for _________ years, it is likely not malignant.
Benign causes of pulmonary nodules
Granulomas (tb, spores from forest)