Things I always forget Flashcards
High Frequency oscillatory ventilation
HFOV - very high RR, very small tidal volumes
*helps lower risk of distention in ARDS
Extracorpeal membrane oxygenation
ECMO - supports hypoxemia without the potentially injurious ventilator setting sometimes needed in severe ARDS
“a treatment that uses a pump to circulate blood through an artificial lung back into the bloodstream… provides heart-lung bypass support outside of the body”
Viruses that are most associated with acute cough
influenza A and B, rhinovirus, adenovirus, echovirus, RSV, parainfluenza, coronavirus
Side effects of antitussives
confusion, nausea, constipation
Three main causes of chronic cough in non smokers, normal CXR, with no ACE I
- GERD
- Asthma
- Upper Airway Cough Syndrome (UACS)
Massive hemoptysis causes death via
asphyxiation
MRC Dyspnea Scale
- no trouble except with strenuous exercise
- SOB when hurrying at level or walking up slight hill
- walks slower than most on level, stops 1 mile, or 15 min
- stops for breath after walking 100 yards or few min
- too breathless to leave house or SOB when undressing
How do patients describe dyspnea with:
a. Asthma
b. HF
a. chest tightness
b. air hunger/suffocating
Risk factors of head/neck cancers
- alcohol
- tobacco
- EBV
- HPV
- marijuana
- pollutant exposure
Sx of cancer of nasopharynx
epistaxis, otis media
Tumor stagins
T1 - less then or equal to 2cm
T2 - greater then 2cm but less then 4cm
T3 - greater than 4cm
T4A - invasion of skin, mandible, ear canal, fascial n.
T4B - invasion of skull, pterygoid plates, encases carotid a.
When should you use sputum cytology to check for lung cancer?
pts with poor pulmonary function who cannot tolerate invasive procedures
If there is malignancy in non small cell lung cancer, what can’t you do?
surgery
What two features characterize benign pulmonary nodules?
- no growth in 2 years
- calcification in a diffuse, central, or laminar pattern
*malignant nodules are greater then 2 cm, have speculated edges, located in upper lobes
Gold Criteria for COPD
- I Mild: FEV1/FVC < 70%; FEV1 > 80%
- II Moderate: FEV1/FVC <70%; 50 < FEV1 < 80%
- III Severe: FEV1/FVC <70%; 30% < FEV1 < 50%
- IV Very severe: FEV1/FVC <70%; FEV1 < 30% or FEV1 < 50% with chronic respiratory failure
When do you give oxygen therapy to someone with COPD?
arterial PO2 = 55 mmHG
or
oxygen saturation = 88% with or without hypercapnia
or
arterial PO2 = 59 mmHG or oxygen saturation = 89% if they have pulmonary HTN, cor pulmonale, edema due to RHF, or hematocrit >55%
Drugs that cause Parenchymal lung disease
- amiodarone
- methotrexate
- nitrofurantoin
many patients with severe or chronic DPLD develop what?
pulmonary HTN
What is needed to diagnosis of OSA?
polysomnography (PSG)
Leading causes of pleural effusions
HF, pneumonia, cancer
- transudative: suggests HF
- exudative: suggests cancer
CURB-65
Confusion
Urea nitrogen >19.6 mg/dL
Respiration rate >/= 30
BP <90 mmHG or <60 mmHg and 65 or older
PH can only be confirmed via
right heart catheterization or direct measurement of mean pulmonary artery pressure
When is IGRA preferred?
when pts have gotten the BCG vaccination or those that are unlikely to return for TST interpretation
- for kids 5 and younger, use TST over IGRA
- neither test can distinguish b/t latent or active TB
Triad of fat embolism
hypoxemia, neuro changes, petechial rash
*onset 24-48 hrs after event
