Block 56: Lung Flashcards
Bronchiectasis
bronchial thickening and dilation to due to a recurrent cycle of bacterial infection, inflammation and tissue damage
In young patient, most common underlying etiology for bronchiectasis is
cystic fibrosis
where in the lung is bronchiectasis due to cystic fibrosis located
upper lung lobe
common side effect of systemic glucocorticoids seen in labs
leukocytosis with neutrophilic predominance
what lab value is expected for hypersensitivity reaction
eosinophilia
MOA of ACE
metabolism of kinins and substanceP
destruction and permanent damage of the conducting airway occurs in
bronchiectasis
pt with COPD and acute-onset shortness of breath, hypoxia and unilaterally decreased breath sounds likely has? most common cause?
secondary spontaneous pneumothorax
- alveolar blebs
risk factors for obstructive atelectasis
- foreign body aspiration
- malignancy
- severe pneumonia ( mucus plug)
pts develop what after a fat embolsm
- respiratory distress
- neurological abnormalities
- petechial rash
acute dyspnea and hypoxia after motor vehicle collision likely has what
pulmonary contusion
- he was prone to blunt thoracic trauma
clinical feature of pulmonary contusion
intra-alveolar hemorrhage and edema
some clinical features to look for in pulmonary embolism
- pleuritic chest pain
- tachypnea
- atrial fibrillation
triad for cardiac tamponade
- distant heart sounds
- hypotension
- jugular venous distension
pleuritic chest pain
pain when you breathe, cough and sneeze
Peak airway pressure equation
Airway resistance + plateau pressure
plateau pressure equation
elastic pressure + positive end-expiratory pressure (PEEP)
How is PEEP calculated
end-expiratory hold maneuver
lung compliance
ability to expand
how does pneumonia cause hypoxemia
right-to-left intrapulmonary shunting
V/Q mismatch
how is theophylline meabolized
cytochrome oxidase in liver
antibiotic known to decrease theophylline clearance
ciprofloxacin
patient with acute presentation of dyspnea, chest pain, tachycardia, hypoxia, and clear lung sounds has
PE
most common cause of community-acquired pneumonia
strept. pneumoniae
on the vent, what influences O2? which one are you more likely to reduce to decrease O2
FiO2 (this one) and PEEP
on vent what, influences CO2
RR and TV
what tumor produced both alpha fetoprotein and human chorionic gonadotropin tumor marker
Nonseminomatous germ cell tumors
3 most common causes of chronic cough a
- postnasal drip
- asthma
- GERD
MOA of Chlorpheniramine
H1 Antihistamine receptor blocker
asthma patient that has sore throat, morning hoarsness, worsening cough only at night, and increased need for her albuteral inhaler following meals also has what
GERD
when are antibiotics given in COPD patient
- moderate to severe exacerbation of COPD
- pts needing mechanical ventilation
what causes clubbing
magakaryotcytes are not broken down in lungs, and then get stuck in fingers
- hypoxia does not cause clubbing
what does CT show for pulmonary embolism
wedge-shaped infarction
development of clubbing and sudden-onset joint artropathy in chronic smoker suggests? what can cause this
hypertrophic osteoarthropathy
- any lung cancer
Name 2 ways you can increase oxygenation on a vent? which one would you increase in ARDS patient and why?
FiO2 and PEEP
- PEEP: prevent alveolar collapse during respiratory cycles and my also reopen some alveoli
If high levels (greater than 60%) of FiO2 is required to maintain oxygen, how do you increase the amount of oxygen a patient gets on the vent
PEEP
Aspirin-exacerbated respiratory disease is most often seen in patient with a history of
asthma or chronic rhino-sinusitis with nasal polyposis
clinical symptoms of aspirin-exacerbated respiratory disease
bronchospasm
nasal congestion
following aspirin ingeston
what type of reaction is aspirin-exacerbated respiratory disease
non-IgE mediated
psuedoallergic drug reaction
where are bronchogenic cysts located
middle mediastinum
where are thymoma’s found
anterior mediastinum
where are all neurogenic tumors located in the mediastinum
posterior mediastinum
PE for lung consolidation
dullness to percussion
increased intensity of breath sounds
increased tactile fremitus
percent predicted obstructive pattern FEV1/FVC
less than 70%
predicted restrictive pattern FEV1/FEV
greater than 70%
what organs are involved in granulomatosis with polyangiitis
- upper and lower respiratory tract infection
- renal involvement
- glomerulonephritis
