CM 4 Flashcards
sxs of blue bloaters? how to dx COPD? tx COPD guidelines. what if FEV1 = %age?
polycythemia, cyanosis, CO2 rtn. spirometry (not CXR alone), FEV1 <1L or <50%, BODE, hyperexpanded zone 1 alveolar < arterial pressure. avoid risk factors, vax, SABA; LABA; inhaled corticosteroids; O2, surg. 60-80 = inhaled bronchodil; <60 = inhaled LAB/MA, combo therapy; poorly advanced = 3x therapy: BA, MA, ICS
how to dx pleural effusion? complicated exudative pleural effusions = managed via?
US guided thoracentesis. nontunneled pigtail cath under US/CT guidance
how to tx lung abscess? 3 stages of empyema?
abx 1-3mo, CT guided pig cath/percutaneous drain. exudative; fibropurulent - high neu, fibrin, loculated fluid; organized - thick pleural peel -> lungs can’t reexpand
bronchiectasis bacteria vs pathology vs CXR vs tx
Kleb, non/TB, mycoplasma, RSV in peds vs transmural inflam, edema vs bronchial wall thickening & luminal dil vs surg
HCAP bacteria vs tx guidelines. VAP bacteria vs dx vs tx
MDR gram neg, MRSA vs empiric broad spectrum -> cx -> narrow spectrum -> short term 8d therapy. Pseudo, actinobacter vs clinical, rads vs abx
general dx of PNA. how to tx MDR PNA?
serial CXR/CT to eval progress, BAL as alt to cx and rpt mini BAL 4d post therapy. antipseudo ceph, carbapenem, B-lactam/ase inhib; antipseudo FLQ, aminoglycoside; linezolid, vanc
aspiration PNA bacteria vs risk factors vs lying on back vs lying on side
oral pharyngeal anaer (aureus, s pneu, H flu, gram neg) vs periodontal dz, altered consciousness, dec gag reflex & ability to maintain airway -> atelectasis vs sup seg lower lobe vs post upper lobe
what O2 finding = assoc w/ OSA? tx OSA? 4 types of CSA? tx CSA?
SpO2 desat. conservative 1st line (wt loss, avoid supine, stop smoke/alc), C/BiPAP gold standard, surg; no meds. Cheyne Stokes (CHF), chronic opiates (dec resp drive), altitude (lower PaCO2 -> give O2), primary. meds can help underlying, C/BiPAP
3 mechanisms of inhal injury? smoke inhal = trifecta of inhal injury b/c?
asphyxiants (N2, He, H, CH4 displace O2), systemic toxins, lung irritants (ammonia, Cl2, HF, nitrogen dioxide, welding fumes). has all 3 types: consume O2 & give off CO/CN, chemical burn/lung irritant
NSCLC tx: VEGF antag vs EGFR vs ALK vs PDL1 inhib. how to tx SCLC? NSCLC vs SCLC surveillance
beva–mib vs erlot/gefit/afit–mab vs crizo–mib vs pembro, atezo, darva, nivo–mab. chemo, limited gets concurrent XRT, complete response gets prophylactic brain XRT. stop smoke, H/P & CT chest/adrenals q 4-6mo x2y then annual vs f/u 2-3mo x1y, 3-4mo yrs 2-3, 4-6mo yrs 4-5, then annual; H/P & CT chest/adrenals
