Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clinical Medicine Lecture - Professor Kramer > Respiratory Treatments Exam 4 > Flashcards

Respiratory Treatments Exam 4 Flashcards

(84 cards)

Start Studying
1
Q

ASTHMA

A

acute - SABA , oral steroids
chronic intermittent - SABA
chronic persistent - Low dose ICS, Low Dose ICS w/ LABA, Medium dose ICS w/ LABA, High dose ICS w/ LABA, High dose ICS w/ LABA w/ oral steroids

DO NOT GIVE LABA W/O A STEROID BBW OF DEATH

obstruction, bronchial hypersensitivity, inflammation

Atopic triad and GERD = comorbids

Drugs - NSAIDS, ASA, ACE, beta agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Acute Symptom Treatment of Bronchiolitis Obliterans

A

Corticosteroids

Azithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Typical treatment of pneumoconiosis

A

Supportive Care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Typical treatment for Sarcoidosis

A

Long term Corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Immunosurpressive therapy for sarcoidosis

A

Methotrexate
Azathioprine
Infliximab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Typical treatment for Idiopathic Pulmonary Fibrosis

A

Corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Only definitive treatment for Idiopathic Pulmonary Fibrosis

A

Lung transplant (50% 5 year survival)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

CXR of Bronchiolitis obliterans

A

Bilateral ground glass infiltrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Will see Small opacities in upper lung upon CXR

A

Coal Worker (Pneumoconiosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

CXR findings for silicosis

A

Hilar egg shell opacities, silicotic nodules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

CXR findings of Asbestosis

A

Linear streaking at lung base and honeycombing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ACE- elevation
Lung Crackles
Uveitis
Malar rash (Lupus pernio)

A

Sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Bilateral hilar adenopathy

A

Sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Amiodarone, bleomycin, and nitrofurantoin are etiologies of…..

A

Idiopathic pulmonary fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

CXR findings: Idiopathic pulmonary fibrosis

A

Diffuse patchy fibrosis, and pleural based honey coming

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

esosinphillic response to helminth larvae

A

Loffler syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q 
NPPAR: med causes 
Nitrofurantoin
Phenytoin
Ampicillin
Acetaminophen
Ranitidine
A

Pulmonary eosinophilia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Best diagnostic tool for pulmonary eosinophilia

A

Bronchial lavage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Treatments for pulmonary eosinophilia

A
  • remove offending agent
  • treat helminth infxn= albendazole, praziquantel
  • Prednisone ONE YEAR TO LIFE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Main Differential diagnosis:

  • unintentional weight loss
  • Fever
  • Night sweats
A

CANCER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

CXR findings of Pulmonary Eosinophilia

A

Peripheral infiltrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Does pulmonary eosinophila occur more in men or women??

A

Bitches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Asthma patient education

A

improve symptoms
avoid triggers (dust, dander, cold air, drugs)
hydrate!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Asthma short term control (asthma attack)

A

first line - SABA - albuterol

if significant - CS - oral prednisone or IM/IV methylprednisolone

Optional - ipratropium - muscarinic agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Asthma long term control
first line - ICS (budesonide, fluticasone) second line - add a LABA ( salmeterol) Advair
26
Asthma additional treatment
leukotriene inhibitors - montelukast Mass Cell Stabilizers - Cromolyn - for exercise Theophylline ( methylxathine) small TI, like caffeine MAB - omalizumab
27
COPD treatment
Ipratropium Albuterol Oral prednisone ABS frequently needed: azithromycin and tetracycline mucolytics and theophylline
28
Only interventions that naturally alter the course of COPD
smoking cessation oxygen lung volume reduction
29
COPD symptomatic control
ipratropium SABA ICS
30
Patient education with COPD
smoking cessation pneumococcal and influenza vaccine exercise
31
COPD genetic risk factor?
alpha 1 antitrypsin deficiency
32
What PE do we see with chronic bronchitis?
``` productive cough obese mild dyspnea EXPIRATORY RONCHI cyanotic resonant on percussion ``` CXR - not flattened Diaphragm, large heart
33
Emphysema PE?
``` enlarged air sacs and decreased perfusion thin, weight loss exertion dyspnea rare cough no edema Barrel chest - AP diameter is increased Pursed lips Hyperresonance EXPIRATORY RONCHI inspiratory crackles ``` CXR: Small heart flattened diaphragm hyperinflation, bullae and decreased apical lung
34
Bronchiectasis Tx
For acute exacerbations: bronchodilators, ABS for 10-14 days = amoxicillin, augmentin, bacterium (TMP-SMX) and cipro for pseudomonas Long term: bronchodilators chest physiotherapy lung transplant
35
What is Bronchiectasis?
injury or destruction of the bronchi and bronchial walls causing permanent dilation
36
What is mot diagnostic test for Bronchiectasis?
CT chest we will see dilated tortuous airways CXR - tram tracks, crowded bronchial, honey combing foul smelling sputum clubbing and crackles
37
Most common pathogen for non CF patients?
pseudomonas
38
Most common pathogen for non-CF patients?
H. flu
39
Cystic Fibrosis
autosomal recessive, caucasians abnormal CFTR protein results in alter of chloride ions and water creating mucus from exocrine glands and tissue destruction
40
Diagnosis study for CF?
sweat chloride (> 60) PFT - mixed ABG - hypoxia
41
50% cases of _____________ are CF?
bronchiectasis
42
CF CXR shows?
hyperinflation peribronchial cuffing bronchiectasis blebs
43
CF associated symptoms?
``` GI CA osteopenia Pancreatitis Infertility Arthorpathies ```
44
CF PE?
clubbing increased Ap diameter hyper resonant nasal polyps
45
Hypersensitivity pneumonitis Tx: (extrinsic inflammatory alveolitis)
avoid the source | tapered oral steroid for 4-6 WEEKS! (not as long as pulmonary eosinophilia which is 1 year to life)
46
PE for acute hypersensitivity pneumonitis?
``` 4-8 hrs after exposure bibasilar crackles sudden onset cough chills malaise ```
47
Diagnostic test for hypersensitivity pneumonitis?
hypersensitivity pneumonitis ANS panel or biopsy which will show interstitial infiltrates of lymphocytes and plasma cells w/ noncaseating granulomas in the interstitial air spaces.
48
what is hypersensitivity pneumonitis?
non atopic, non asthmatic inflammation disease from inhaled antigen ( bird feces)
49
PE for subacute hypersensitivity pneumonitis?
weight loss dyspnea anorexia
50
Churg-Strauss
Vasculitis/ashtma
51
Common sites of metastasis; cancer
Liver Bone Brain Adrenal glands
52
Tumors that produce hormones create what kind of symptoms
Flushing and diarrhea
53
Octreotide Scintigraphy
Indium labeled hormones bind to somatostatin hormone receptors
54
Most carcinoid tumors are resistant to chemo or radiation Why???
They are slow growing
55
What lobes and lung is most common for cancer?
Right lung | Upper lobes
56
Top three causes of lung cancer
Tobacco Radon Environmental smoke exposure
57
What is more common SCLC or NSCLC
NSCLC
58
What are peripheral tumors?
Adenocarcinoma/large cell carcinoma
59
What are central tumors?
Squamous cell/ small cell
60
SCLC good or bad?
Terrible prognosis, metastasis before we even know we have it
61
NSCLC: Squamous cell
Central | SLOWER metastasis
62
What is the most common lung cancer and where is it located?
``` Adenocarcinoma Bone Brain Liver Adrenal glands ```
63
Large cell
Mostly from smoking Not very common Peripheral
64
symptoms of central tumors
``` Cough Dyspnea Wheezing Hemoptysis pain ```
65
Symptoms of Peripheral tumors
Cough Chest wall pain Pleural effusions Pulmonary abscess
66
Horners syndrome: where are tumors and fun facts about it
MAP Tumors in Apex Thoracic outlet syndrome= compression of the neurovascular bundle as it traverses the thoracic outlet.
67
Pancoast tumor
``` Horners syndrome + Bony destruction 1st /2nd ribs Vertebral bodies Atrophy of hand muscles NSCLC Lung cancers arising in the superior sulcus Pain (usually in the shoulder) ```
68
Lambert-Eaton Myasthenic Syndrome
Myasthenia gravis type symptoms: Ab against voltage gated calcium channel and creates myasthenia gravis like symptoms - Hip and shoulder Girdle weakness - Muscle stiffness
69
Superior Vena Cava Syndrome
- SVC traverses the right side of the mediastinum - Incomplete obstruction or complete - Caused by extrinsic pressure or intravascular thrombosis - Venous distention of the neck and chest wall - Dyspnea - Bending forward or lying down exacerbates sxs
70
Diagnosis for central tumors
Sputum cytology Bronchoscopy
71
Diagnosis for peripheral tumors
Fine-needle aspiration cytology
72
For tumors CT scan of....
- Upper abdomen (liver and adrenal glands) | - Upper chest (mediastinum)
73
Staging for SCLC
- Limited-Stage: limited to one lung and regional lymph nodes - Extensive-Stage: both lungs or other areas of the body
74
Chemotherapy treatment
1st line is usually platinum-based drugs: - Paclitaxel - Docetaxel - Gemcitabine - Vinorelbine
75
Surgical treatment options for tumors
- Thoracotomy: large incision (5-10 in) in the chest is made for tumor removal - VATS: video assisted thorascopic surgery: - Wedge resection: removal of tumor as well as small amount of normal lung tissue - Segmentectomy: removal of segment of the lung (left=8, right=10) - Pneumonectomy: removal of entire lung
76
Maintenance therapies for tumors:
- Erlotinib (Tarceva) – locally advanced or mets NSCLC | - Pemetrexed (Alimta) – non-squamous NSCLC
77
Pearls: Adenocarcinoma
- peripheral - most common - lung cancer from a non smoker think this
78
Pearls: Pearls of Squamous cell
- Central | - 2nd most common
79
Pearls: Large Cell
- rare (5-10%) | - Increased risk with smoking
80
Small cell lung cancer fun facts:
- Aggressive cancer - Usually metastasis by time of dx - Poor prog. - Chemo for treatment - Surgical intervention: poor
81
Pearls Metastasis
liver bone brain adrenal glands
82
Pearls Metastasis work up
CT scan: - Thorax - Abdomen - Pelvis - +/- PET scan
83
What virus causes ARDS?
Coronavirus
84
CXR findings of ARDS?
Initial: unilateral peripheral consolidation | Followed by: b/l pathcy infiltrates

Clinical Medicine Lecture - Professor Kramer (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions