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NP > Adult - Respiratory II > Flashcards

Adult - Respiratory II Flashcards

1
Q

What are the five conditions which may cause significant night sweats?

A 
TB
menopause
AIDS
lymphoma
endocarditis
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2
Q

What are the signs and symptoms of TB?

A 
majority of people are ASYMPTOMATIC
if present:
weight loss
night sweats
low grade fever
cough
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3
Q

What is the typical cough progression in TB?

A

dry cough progressing to productive and sometimes blood tinged

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4
Q

What are the two tests definitively diagnostic for TB?

A

culture

CXR - small, homogenous infiltrate in upper lobes

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5
Q

Is TB reportable?

A

yes

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6
Q

What is INH?

A

the abbreviation for isoniazid

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7
Q

What is the medication regimen for TB?

A 
RIPE
R - Rifampin
I - Isoniazid (INH)
P - Pyrazinamide 
E - Ethambutol
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8
Q

When can the 4th drug in the TB regimen be dropped?

A

if the isolate is fully suceptible to RIF and INH

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9
Q

How long are the drugs given in TB?

A

INH and RIF for at least 6 months

pyrazinamide for 2 months

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10
Q

How is TB therapy monitored?

A

Weekly sputum smears and cultures for the first 6 weeks

Then monthly until negative cultures documented

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11
Q

Continued positive TB cultures after what time frame would raise the suspicion of drug resistance?

A

3 months

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12
Q

What baseline studies should be obtained prior to starting TB drug therapy?

A

LFTs
CBC
serum creatinine

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13
Q

What lab work must be monitored weekly while on INH?

A

LFTs

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14
Q

What needs to be monitored in people taking ETHAMBUTOL?

A

visual acuity

red-green color perception

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15
Q

PPD reading of 5 mm considered positive in what populations?

A

HIV patients
contacts of a known cause
those with typical TB presentation on CXR

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16
Q

PPD reading of 10 mm considered positive in what populations?

A

immigrants
high risk groups
health care workers

17
Q

PPD reading of 15 mm considered positive in what populations?

A

all others

those not in any high prevalence groups

18
Q

FVC
stands for -
defined -
significant in -

A

forced vital capacity

volume forcefully expelled after max inspiration

significant in OBSTRUCTIVE diseases

19
Q

FEV1
stands for -
defined -
significant in -

A

forced expiratory volume in 1st second

volume expelled in 1st second of FVC maneuver

significant in OBSTRUCTIVE diseases

20
Q

FEF 25-75
stands for -
defined -
significant in -

A

forced expiratory flow in middle 50%

max mid-expiratory airflow rate

significant in OBSTRUCTIVE diseases

21
Q

PEFR
stands for -
defined -
significant in -

A

peak expiratory flow rate

max rate achieved in FVC maneuver

significant in OBSTRUCTIVE diseases

22
Q

TLC
stands for -
defined -
significant in -

A

total lung capacity

volume in lungs after max inspiration

significant in RESTRICTIVE diseases

23
Q

FRC
stands for -
defined -
significant in -

A

functional residual capacity

volume left after passive exhalation

significant in RESTRICTIVE diseases

24
Q

RV
stands for -
defined -
significant in -

A

residual volume

volume remaining after max exhalation

significant in RESTRICTIVE diseases

25
Q

What are the PFTs which reflect AIRFLOW RATE?

A

FVC
FEV1
FEF 25 - 75
PEFR

26
Q

What are the PFTs which reflect VOLUMES?

A

TLC
FRC
RV

27
Q

Which type of PFTs are decreased in obstructive diseases?

A

the airflow rate measures

28
Q

Which type of PFTs are decreased in restrictive diseases?

A

the volume measures

29
Q

What are examples of OBSTRUCTIVE diseases?

A

asthma

COPD

30
Q

What are examples of RESTRICTIVE diseases/conditions? (6)

A 
pneumonia
pleural effusion
pulmonary fibrosis
lobectomy
morbid obesity
pregnancy
31
Q

What is a pleural effusion?

A

a buildup of fluid between the lungs and chest cavity in the pleural space

32
Q

Clear fluid in pleural effusion is called what?

A

transudate

33
Q

Cream colored fluid in pleural effusion is called what?

A

exudate – contains protein

34
Q

Pus found in pleural effusion is called what?

A

empyema

35
Q

Blood in pleural effusion is called what?

A

hemorrhagic

36
Q

What is the typical Xray finding in pleural effusion?

A

loss of costophrenic angle to blunting or shadows

no shark fins

37
Q

What is the difference between pleural effusion and infiltrate?

A

pleural effusion is fluid between the lung and chest wall in the pleural space

infiltrate is a general term meaning an abnormal substance that accumulates gradually within cells or body tissues

38
Q

What is atelectasis?

A

collapse of all or part of the lung - develops when alveoli become deflated

39
Q

What is tactile fremitus?

A

“99” - ulnar surfaces of hands on back

increased in consolidation (pnumonia)

decreased in pleural effusion

NP (76 decks)

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