5-uWorld Flashcards
strategy to prevent vent-associated pna
oral care with antiseptic solution
“fleeting pneumonias” think ____
ABPA
bronchial colonization of _____ is very common in Vent patients and therefore Tx is ____
candida
No treatment!
keep ET tube cuff pressure ___ to prevent ____
> 20mmHg
aspiration
in ABPA, IgE levels are ___
> 400
ABPA is commonly occuring in these lung problems ____ & _____ and can lead to THIS lung problem
Asthma , CF
Bronchiectasis-central(can lead to this)
This specific type of fungal pneumonia is rare and Tx with intifungal is not indicated
Candida
(candida growing on Cx from respiratory secretions is NOT and indication that this is Invasive candidiasis)
Causes of a real Candida Pna are due to _____ and not _____
Tx
Cause is due to DISSEMINATION (from below) and not ASPIRATION:
- osteomyelitis
- septic arthritis
- endocarditis
Tx:
micafungin or fluconazole
normal PCWP
12-14
normal central venous pressure
8-12 mmHg
normal JVP
6-8 cm
JVP ___ above sternal angle is considered Jugular venous distension
> 4cm above sternal angle
normal PA pressure
<20 mmHg
good second line agent after levophed as a vasopressor
epinephrine
good seond line agent after levophed as an agent for anaphylactic shock
epinephrine
good seond line agent after levophed as an agent for bradicardia
dopamine
patient is about to air travel, resting O2 sat is 91%, what is next step?
give supplemental O2 (wo further testing)
patient is about to air travel, resting O2 sat is 91% on 2L O2, what is next step?
tell them to bump their O2 to 3-4L on airplane
patient is about to air travel, resting O2 sat is 96%, what is next step?
NOthing!
patient is about to air travel, resting O2 sat is 94%, what is next step?
IF O2 resting 92-95%
do hypoxia altitude simulation test if has risk factors ie low FEV
otherwise no testing
what is pH level for permissive hypercapnia
pH >7.25
what is a contraindication to high Co2 levels or Acidosis
(in a patient that could benefit from permissive hypercapnia)
cerebral edema
seizures
shock
obesity hypoventilation syndr occurs in patients with BMI ____
> 30
obesity hypoventilation syndr has ___ pattern on PFTs
restrictive
diagnostic imaging of choice for obesity hypoventilation syndr
polysomnography
first line tx obesity hypoventilation syndr
nocturnal NiPPV
others: weight loss, avoid sedative meds
last resort for tx obesity hypoventilation syndr
acetazolamide (respiratory stimulant)
what will you see on labwork and ABGs for obesity hypoventilation syndr
CMP: elevated bicarb
CBC: erythrocytosis
ABG: pCO2>45 and probably hypoxia
definitive diagnosis of PulmHTN if ambiguous findings on echo?
RHCath
