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CPD Vocab > 7 Lungs 2 > Flashcards

7 Lungs 2 Flashcards

0
Q

CBC results

A

Acute bronchitis: elevated lymphocytes

Bacterial pneumonia: elevated neutrophils

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1
Q

Auscultation results for pt with emphysema vs chronic bronchitis

A

Emphysema: crackles upon expiration

Chronic bronchitis: crackles upon inspiration

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2
Q

Klebsiella

A

affects alcoholics, malnourished, DM. necrotizing lobar pneumonia. Relative Bradycardia and current jelly sputum

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3
Q

Abnormal breath sounds

A

Decreased (smoker, obese, emphysema, pleural effusion), absent (collapsed lung), bronchial (loud and harsh, areas of consolidation)

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4
Q

Adventitious breath sounds

A

Ronchi, crackles, wheezing, stridor

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5
Q

Auscultation findings over consolidation

A

Egophany, bronchophony, whispered pectoriloquy

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6
Q

Stridor and SOB DDX

A

Epiglottitis–hot potato voice, high fever, drool, emergency
Foreign body–no hx of URI or fever, sudden
Retropharyngeal abscess–swelling back of throat, follow infxn
Diphtheria–grayish membrane over pharynx/larynx

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7
Q

Laryngotracheobronchitis

A

Croup. Parainfluenza virus, adenovirus, RSV
Children 6mos to 3 years. Prodrome of URI w low fever, cough then hoarse voice, seal-like cough, respiratory stridor at night

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8
Q

Acute bronchitis

A

Self limited inflammation of bronchus from viral infection. Ssx: cough > 5 days w sputum. PE: afebrile/low, wheezing, ronchi, normal percussion and transmission voice tests

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9
Q

Productive cough DDX

A

Acute bronchitis, chronic bronchitis, pneumonia, post nasal drip, GERD, asthma

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10
Q

Pathophysiology of typical lobar pneumonia

A

Stage 1: congestion
Stage 2: red hepatization
Stage 3: grey hepatization
Stage 4: resolving

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11
Q

Community acquired pneumonia

A

Risks: level of consciousness, smoking, alcohol, lung disease, malnutrition, old age, immuno compromised
Organisms: RSV, parainfluenza virus, influenza, adenovirus, S pneumoniae, H flu, S aureus, group a strep, M catarrhalis, klebsiella, legionella, M pneumoniae, Chlamydophila, P aeruginosa

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12
Q

Nosocomial pneumonia

A

Ventilator assoc, healthcare assoc (IV therapy, chemotherapy, dialysis, nursing home)

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13
Q

Legionella pneumophila

A

concomitant GI symptoms of nausea and vomiting. Outbreaks from aerosolized organisms
Sx in elderly, smokers, immunocompromised, alcoholics, pts w pre existing condition

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14
Q

Sputum in various bacterial pneumonias

A

Pneumococcus: bloody, rust colored
Pseudomonas, Haemophilus, pneumococcal: green
Anaerobic infxns: foul smelling
Klebsiella: viscid, currant jelly

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15
Q

Bacterial pneumonia PE findings

A

Look sick/pallor, high fever, tachy/bradychardia, bronchial breath sounds, Egophany, dullness, tachypnea, cyanosis, wheezes/ronchi/crackles, tactile fremitus, pleural friction rub

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16
Q

If bacterial pneumonia doesn’t resolve..

A

Comborbiites: alcoholism, COPD, CHF, CKD, malignancy, DM, HIV
Age >65 yrs, neoplastic disease
Klebsiella, legionella, S aureus, S pneumoniae, TB, fungi
Misdiagnosis of connective tissue disease, sarcoidosis, pulmonary embolism, pulmonary edema, drug induced lung disease

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17
Q

Viral pneumoniae SSX

A

Malaise, headache, myalgia, cervical LA, chest pain, sore throat, cough w scant sputum

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18
Q

Mycoplasma pneumonia

A

Walking pneumonia. Looks like URI. Don’t look sick, erythematous TM, no early findings on auscultation

19
Q

Friction rub on auscultation…

A

Hold breath and listen again! If +… Pericardial. If - pleural

20
Q

Histoplasmosis

A

Chronic cough, nodular lesions, crackles, wheezes, Ohio and Mississipii river valleys and Southeast, caves, PCR, calcified hilar lymph nodes

21
Q

Loud sounds on inspiration DDX

A

Laryngotracheobronchitis, epiglottitis, retropharyngeal abscess

22
Q

Pneumocystis jirovecii pneumonia

A

rare in general pop, affects immunocompromised. gradual onset malaise, weight loss, night sweats, dry cough

23
Q

Coccidiomycosis

A

Deserts of SW. “sometimes it’s ripe, and the wind blows, and you get it”. Self-limited, most cases subclinical.
in immunocompromised, may disseminate–>erythema nodosum, meningitis, endocarditis, osteomyelitis

24
Q

Allergic Bronchopulmonary Aspergillosis

A

when pts with asthma get worse. Eosinophilic pneumonia. Sputum with brown flecks

25
Q

Acute pulmonary histoplasmosis PE

A

crackles or wheezes, pericardial friction rub, erythema multiforme/nodosum

26
Q

Chronic Pulmonary Histoplasmosis PE

A

crackles, wheezes

27
Q

Chronic Progressive Disseminated Histoplasmosis

A

ulcers on buccal mucosa, tongue, gingiva, larynx; vision loss; hepatosplenomegaly

28
Q

Aspiration caused pneumonia

A

sudden onset, severe symptoms, high mortality

29
Q

Lipoid aspiration

A

oil causes inflammation and secondary infection. CXR reveals infiltrates throughout lung–difficult to recover

30
Q

Pulmonary Tuberculosis Groups with Higher Prevalence

A

homeless/marginally housed, correctional facilities/shelters, health care workers serving at risk pop, children exposed to at risk, foreigners/travel to endemic area, elderly

31
Q

TB etiology

A

Mycobacterium tuberculosis. person-to-person inhalation of airborne droplet nuclei, must be constant exposure

32
Q

primary TB infection

A

inflammatory reaction holds organisms back. Only 10% of affected develop active. If not active, not contagious!

33
Q

Active TB SSx

A

chronic productive cough (yellow/green, am), hemoptysis, malaise, fatigue, anorexia/wt loss, low grade fever, night sweats

34
Q

Active TB PE

A

fever, hypoxia, cachexia, tachycardia, LA, decreased breath sounds, crackles

35
Q

TB Imaging

A

ipsilateral hilar adenopathy often w atelectasis in upper lobes.
Normal CXR does NOT r/o TB

36
Q

Miliary TB

A

Hematogenous and lymphatic spread to target organs

37
Q

Latent TB Infection and reactivation

A

Asymptomatic, bacteria alive and inactive, walled off. Lesions in posterior segment of RUL

38
Q

TB Tests

A

Purified Protein Derivative–Mantoux Test

QuantiFERON Gold–IFN gamma release assay

39
Q

Multi-Drug Resistant TB

A

develops in the course of TB treatment with inappropriate doses/incomplete dosing

40
Q

TB DDX

A

pneumonia, lung abscess, pulmonary mycosis, CA, non-TB mycobacterium, histoplasmosis, coccidiomycosis, silicosis, sarcoidosis

41
Q

Pleurisy SSx

A

sudden onset of pain, rapid/shallow breaths, splinting of chest, SOB, painful cough

42
Q

Pleurisy PE

A

fever if infectious cause, limited chest motion, decreased breath sounds, pleural friction rub, dullness to percussion, decreased tactile fremitus

43
Q

Pleurisy DDX

A

acute abdomen, intercosta neuritis, costo-chondritis, herpes, MI, pneumothorax, pericarditis

44
Q

Pleural Effusion Liquid Types

A

lymph: chylothorax
pyogenic: empyema
blood: hemothorax
serous: hydrothorax

45
Q

Pleural Empyema SSx

A

fever, cough, fatigure, SOB, chest pain, bad breath

if severe–>dehydrated, bloody/brown sputum, high fever, coma

46
Q

Pneumothorax

A

air/gas in pleural cavity between visceral and parietal pleura–>collapse of lung on affected side
Spontaneous or traumatic

CPD Vocab (9 decks)

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