test Flashcards
(121 cards)
1
Q
Throwing up
A
metabolic alkalosis
2
Q
Passed out and not breathing
A
respiratory acidosis
3
Q
Hyperventilating
A
respiratory alkalosis
4
Q
Diarrhea
A
metabolic acidosis
5
Q
DKA, fruity smell
A
metabolic acidosis
6
Q
increased HgB affinity for oxygen
A
shift to the left
7
Q
a. Alkalosis
b. Hypocarbia
c. Hypothermia-preserve oxygen, cold tissues go into a state of hibernation
e. Fetal hemoglobin-grabs to oxygen
f. Carboxyhemoglobin-200 affinity to hemoglobin
g. Methemeglobin- (+3) state, joint together, change in that configuration (+2)
A
shift to the left
8
Q
Decreased HgB affinity for oxygen
A
shift to the right
9
Q
a. Acidosis
b. Hypercarbia
c. Hyperthermia
d. Increased 2,3-DPG
A
shift to the right
10
Q
Group 1
A
pulmonary arterial hypertension-idiopathic
11
Q
Group 2
A
left heart disease-left heart failure, mitral stenosis, and mitral regurgitation
12
Q
Group 3
A
lung disease-ILD, OSA, COPD, anything that causes hypoxemia
13
Q
Group 4
A
Chronic thromboembolic disease-current PE
14
Q
Non-carcinogenic pulmonary edema type
High-altitude pulmonary edema
A
MC cause of death at high altitude
tx:get them down
15
Q
Non-carcinogenic pulmonary edema type
Neurogenic pulmonary edemai.
A
CC: subarachnoid hemorrhage,
16
Q
Non-carcinogenic pulmonary edema type
Reperfusion pulmonary edema
A
clot in lung we just opened up
up to 72 hours post surgery
17
Q
Non-carcinogenic pulmonary edema type
Re-expansionpulmonary edema
A
collapsed lung in pneumothorax
d. Tx: oxygen and possible mechanical ventilation
18
Q
Non-carcinogenic pulmonary edema type
Opioid overdose-induced pulmonary edema
A
heroin
CXR: nonuniform distribution of PE
Tx: supportive and Naloxone (Narcan)
19
Q
Non-carcinogenic pulmonary edema type
Salicylate toxicity-induced pulmonary edema
A
Tx: sodium bicarbonate
20
Q
Non-carcinogenic pulmonary edema type
inhalant-induced pulmonary edema
A
Ex: chlorine gas, ammonia,
21
Q
TV commercials say the med may kill someone with asthma
A
risk vs benefits
22
Q
Steroid use in children and how it affects height
A
Reduces risk of hospitalization
0.5 cm less than the average for the control group.”
23
Q
people with COPD and asthma should always have
A
SABA = albuterol
24
Q
SABA
A
Albuterol
MOA: bronchodilator, decreases bronchospasm
Side effects: tachycardia/arrhythmia/ tremors
25
LABA
Salmeterol, formoterol,
Long acting bronchodilator that are taken on regular basis to reduce symptoms of asthma/COPD over a period of time
Not rescue medication
26
SAMA
Ipratropium
Muscarinic antagonist that cause bronchodilation via inactivation of M1 and M3 in the lungs (normally causes bronchoconstriction but through blocking causes bronchodilation)
27
LAMA
Tiotropium bromide, aclidinium bromide
Muscarinic antagonist that cause bronchodilation via inactivation of M1 and M3 in the lungs (normally causes bronchoconstriction but through blocking causes bronchodilation)
28
sulfa allergies w/ pneumonia
don't give them bactrim
29
Good initial pneumonia drug to start
Azithromycin, Z pack for 5 days
30
COPD recent Dx
FEV1/FVC ratio shows COPD and is 41% of prediction
| i. LAMA or LABA for them as their initial drug therapy
31
Most important thing to slow COPD
Smoking cessation
32
TB drugs
Isoniazid.
Rifampin (or a related “rifamycin” agent).
Pyrazinamide.
Ethambutol.
33
Isoniazid.
High tyramine containing foods
Give them Vitamin B6 to save the liver
slow--> toxicity
34
messes up the eyes
Ethambutol
35
why are you giving all these
| TB
limit resistance
36
What if patient is resistant to a drug in the initial four?
| What do you do?
Stop that drug.
37
green zone:
doing well
Intermittent
SABA as needed
38
yellow zone
```
50-80%
moderate
LABA+low dose of ICS
or medium dose ICS
cromolyn (long kids)
```
39
RED zone
less than 50%
severe
HIGH dose ICS +LABA
omalizumab
40
salmaterol
LABA, maintenance symptom reliver not a rescue medication
41
Montelukast
leukotriene receptor antagonist, prophylaxis of kids 12 m and older, exercise induced asthma
42
COPD with cardinal symptoms
purulence and volume and maybe dyspnea
use ABX
FQ
| Macrolide, 2nd Generation Cephalosporin, Doxycycline, Or Smz-tmp.
43
Physics principle in which a decrease in oxygen tention(pressure) resuts in an increase in the volume
Boyle’s law
44
Poiseuille’s law
Decreased by a factor of 4 in response to bronchodilators (increase the airway diameter=more air into the lungs)
45
LaPlace’s Law
failure of this law=atelectasis
46
Physics principle in which to the total pressure exerted by a mixture of gases equals the sum of the partial pressure
Dalton’s Law
47
Physics principle in which gas in contact with liquid will dissolve in the solution proportionate to its partial pressure
Henry’s Law
48
Muscle responsible for lifting the superior two ribs to increase thoracic cavity size
scalenes
49
3 muscles of inspirations
SCM
scalenes
Diaphragm
50
Principle inspiratory muscle
Diaphragm
51
Severe pain
apneic, hyperventilation
52
Cold water
apneic
53
anemic type
anemia
54
histotoxic
cyanide gas
55
circulatory
| stagnant
MI
56
circulatory, Arterial-venous shunting
sepsis
57
hypoxemic hypoxia
altitude
58
Methemoglobin
1. Ferrous to ferric
2. Cyanosis, muddy blood
3. Methylene blue administration to treat
59
Carboxyhemoglobin
1. CO replaces O2
2. Abnormal behaviors
3. Just started heaters
60
Event where an infant has an episode that is frightening to the observer, such as apnea or cyanosis
Apparent life threatening event
61
Pulmonary condition involving hyper inflammation of the lungs due to terminal airway dilation
Emphysema
62
Causative agent causing pneumonia associated with GI symptoms and hyponatremia , contaminated stagnant water, AC
Legionella
63
thumbprint
epiglottis
64
Fatigue, joint pain, bullous myrinigitis
Mycoplasma = atypical community acquired
| Walking pneumonia
65
medication MC used in patients who have positive PPD test to prevent active TB
isoniazid INH
66
steeple sign
croup
67
MC cause of transudative effusions
CHF
68
anticholinergic medication that causes central bronchodialation
ipratropium
69
Viral infection involving the upper airway characterized by barking cough and stridor
croup
70
accumulation of lymphatic fluid within the pleural space
chylothorax
71
Fluid that is milky (white) and odorless suggests chylothorax
triglycerides
chylothorax
72
causative agent involved in particular severe pneumonia involving alcoholics
klebsiella
73
antivaccination, kid has a fever, stridor, gray psudomembrane
Diphtheria
74
MC agent in acute bronchiolitis
RSV
75
pleural cancer associated with chronic asbestos exposure
mesothelioma
76
granulomatous disorder of unknown etiology that primary affects african americans
sarcoidosis
77
Abnormal dilation and destruction of bronchial wall associated with tram track findings on CXR
bronchiectasis
78
leukotrine modifying medication that is commonly used for asthmatics with allergic rhinitis or aspirin induced asthma, exercise
montelukast
79
PE
i. ECG: sinus tachycardia
ii. CXR: normal
iii. Symptom: dyspnea
iv. Sign: tachypnea
v. Management:
1. Saddle embolus: surgical resection
80
Tension pneumothorax
i. Immediate treatment: needle decompression
| ii. Definitive treatment: treat with chest tube over the top of the lower rib
81
Open Pneumothorax
| tx
i. Three way cover, dressing to prevent tension pneumothorax
82
Contusion Pneumothorax
Do not wrap with ACE
83
Sucking chest wounds
Open Pneumothorax
84
Acute respiratory distress syndrome ARDS
i. MCC: sepsis
ii. Bilateral infiltrates
iii. Hypoxemia refractory O2
85
MCC of respiratory distress in newborn
TTC
| Transient Tachypnea of the Newborn –birth to 24 hours
86
Barking cough treatment
(croup)
| Racemic epinephrine, dexamethasone
87
Peritonsillar abscess
Thickening of the pulmonary walls
88
How do you prevent SIDS
| Sudden infant death syndrome
i. Supine sleeping position"back to sleep"
ii. No co-sleeping
iii. Smoking cessation
89
cystic fibrosis
Thick airway secretions,
Recurrent infections
failure to thrive
90
Cough with expectoration of large amounts of purulent and foul-smelling sputum
bronchiectasis
91
a. AKA: Bronchiolitis Obliterans with Organizing Pneumonia (BOOP)
b. fibrotic scarring of the bronchioles and the alveoli
c. DOES NOT RESPOND TO ANIBIOTICS
d. Manage with corticosteroids
cryptogenic organizing pneumonia
92
Barking cough, stridor (both inspiratory and expiratory), hoarseness, dyspnea+ URI symptoms
Fever usually absent
caused by virus (parainfluenxa virus)
croup
93
MMC by pneumonia
| Frank, purulent fluid (pus in pleural space)w/labs
Empyema
94
transudative MMC
CFH
| clear
95
exudative
infections and maligancy,
| clody d/t more proteins
96
Aspergillus
Exudative is black
97
Pleurisy
d/t mesothelioma
| pain while inhaling
98
Acute bronchitis
MMC: RSV
| After 14 days, can give ABX
99
The recommendation of the U.S. Preventive Services Task Force (USPSTF) does support low-dose CT to screen for lung cancer in patients 55-80 years of age with at least a 30 pack-year history who currently smoke or have quit within the past 15 years.
screened for cancer
100
Asbestosis
| findings
i. CXR/CT: small irregular opacities in lower lungs; pleural plaques; costophrenic blunting; honeycombing
ii. HALLMARK: Lateral view: calcified Hemidiaphragmatic plaques
101
Blue bloaters
chronic bronchitis
chronic productive cough in at least two successive years
PE: decreased breath sounds, increased resonance upon percussion of the lung fields
accesory muscles to breath
tx: smoking cessation, inhaled bronchodialators
102
pink puffer
```
emphysema
hx: smoking
complaining dyspena
pink skin, pursed lip, breathing
barrel chest decreased breath sound and hyperresonance to ausculattion
enlargement of the airspaces
```
103
Bullae, blebs, enlarged lung fields, and flattened diaphragm on CXR should make you think of what diagnosis?
Emphysema
104
Abdominal pain, flushing, second pneumonia
cancer
105
Solitary pulmonary nodules
Malignant
Irregular, speculated
Rapid (may double in 4 months)
Cavitary w/ thickened walls
106
Slight drooping of eye, loss finger feeling
Superior sulcus tumor
107
PET scan usage
Used for cancer screening
| Radioactive sugar to be absorbed by the tumors
108
Idiopathic Interstitial Pneumonias
| what drug
corticosteroids
| steroids
109
Sarcoidosis and hilar adenopathy, erythema nodosums
Lofgren's
110
Best test to tell what type of interstitial lung disease
Biopsy
111
Surgery and decreased breath sounds, tachycardia, tachypnea
Atelectasis
112
Rust colored sputum
streptococcal pneumonia
113
Acute viral bronchitis
| CXR findings
nada
114
AIDS
| pneumonia
Pneumocycsitis jerrovicci (PCP)
115
Platypnea
breathing while sitting up is difficult
116
Pathological types:
Look for changes in size, shape, contours (smoothness), position (does it move), and…
density
117
COPD xray
1. Flat diaphragms
| 2. Hyperinflation
118
Widened mediastinum
Aortic dissection
119
Decubitus
| position
1. Pleural effusions
| 2. helpful to assess the volume of pleural effusion and demonstrate whether a pleural effusion is mobile or loculated.
120
Lateral
1. Triangle shape, on the left ventricle. Only view you can see, it. LATERAL view
2. Important in effusions
121
Fremitus
Increases: Consolidation or Fibrosis
Decreases: Fluid or air (effusion, pneumothorax)
