Bronchoscopy Flashcards

1
Q

One of the major advantate of RIGID bronch

A

Large OPEN CHANNEL

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2
Q

Size range of RIGID Bronch

A

3 to 7 mm or larger (DIAMETER)

Length: 20 to 50 cm

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3
Q

Defined by the diameter of THE LARGEST INSTRUMENT that will pass
GLASS ROD telescope
Need for GA

With HOLES allowing ventilation of the CONTRAlateral lung
*side and distal tip

A

RIGID BRONCH

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4
Q

Flexible bronch is defined by their
Usual size of pediatric bronch nowadays

A

OUTER diameter

2.8 mm diameter or 3.5 mm

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5
Q

This instrument foces the patient to breathe AROUND the instrument
Rely on fiber glass to transmit image

A

FLEXIBLE bronch

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6
Q

INDICATIONS OF BRONCH

A
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7
Q

Helpful in assessment of tracheostomy and its dynamics and position

A

Flexible bronchoscopy

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8
Q

Assessing aspiration from post larynx to cervical trachea

A

RIGID BRONCH

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9
Q

Assessing Tracheostomy from post larynx to SUBglottic

A

RIGID bronch

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10
Q

Indications of bronch by symptoms

A

*CSA

COUGH >1 month
Stridro >2 weeks
Atelectasis >6 weeks

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11
Q

Contraindications for bronch

A

NO ABSOLUTE
But with relative contraindications:

Bleeding <50, 000
Massive hemoptysis

Severe bronchospasm, obstruction

Hypoxemia

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12
Q

Procedure to distinguish transplan rejection vs infection

A

Tranbronchial biospy

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13
Q

Volume of BAL adult vs pedia

A

5 aliquots of 50 mL
3 aliquots of 100 ml

Pedia
10 to 20 ml in 2 to 4 aliquot (regardless of wt)
Adjust volume based on FRC and body weight (PAPP in 5-20ml fractions)
Adjust volume 3ml/kg (PAPP if less than 20 kilos, divided into 3 equal fractions; if >20kg, 20 ml fractions

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14
Q

Duration of bal

A

1-3 minutes

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15
Q

Lowest possible platelet count where BAL can be done safely

A

20,000 platelets/ml

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16
Q

Temp prior bal fluid processing

A

4 degrees celsius

17
Q

BAL fluid has how many cells and cell diff count

A

100k to 250k cells/ml

Alveolar macrophage 80 to 90%&raquo_space; Lymphocytes 5% to 10%&raquo_space; neutrophils <5%»eosinophil 0to1%

*ALNE

18
Q

% of neutrophils with active bacteria

A

95%

19
Q

this cell infilitrate is common in Alveolitis, Scleroderma,

Asthma, CF, ARDS

A

NEUTROPHILS

20
Q

cells in sarcoidosis and TB, HPneumonitis

A

Lymphocytes

21
Q

Cells increased in P jirovecii,
FBA,
ILD, Drug induced

A

eosinophils

22
Q

bacteria without neutrophils maybe contaminant except

A

neutropenic patients

23
Q

immunocompromised patients ma have these pathogens regardless of numbers

A
24
Q

may not be a true pathogen in immunocomprosed

A

CMV
Herpes

candida
aspergillus

atypical bacteria

25
Q

staining for PAP

A

PAS

26
Q

Gomori-Grocott (met silver)

A

fungi P Jirovecii

27
Q

iron macrophages from pulmo hemorrhage

A

Prussian blue

28
Q

how many hours will macrophage become positive for iron staining

A

50 hours

29
Q

iron will clear if no bleeding

A

12-14 hrs airways
2-4 weeks parenchyma

*normal up to 3%

30
Q

to detect lipid laden macrophages to diagnose aspiration

A

lipid stains (oil red or sudan. iv)

31
Q

Bronchoscopy sizes

A
32
Q

recommends that ebb be taken from

A

subsegmental carina

33
Q

TBB

A

alveolar sample
lung periphery

34
Q

BBB

A

study of bronchial epithelial cells

35
Q

aspirarion of secretion in larger airways

A

bronchial washing

36
Q

preferred site in diffuse lung disease

A

middle lobe or lingula

37
Q

easy to do bal in infants

A

right lower lobe

38
Q

gold standard in diagnosing chronic pulmo aspiration

A

bal