COPD Flashcards
Define emphysema
enlargement of distal airways
destruction of acini
absence of fibrosis
DLCO in emphysema
reduced
Sensitivity of CXR for COPD
not good
Indications for oxygen therapy in COPD
PaO2< 55 or SpO2 < 88%
or
PaO2<90% if pulmonary HT,Polycythemia,heart failure is present
Vaccinations in COPD
influenza
pneumococcal
Indication for LVRS in emphysema
upper lobe predominant emphysema
DD for acute exacerbation of COPD
pneumothorax pneumonia pleural effusion CCF cardiac ischemia pulmonary embolism
Role of antibiotic therapy in Acute exacerbation of COPD
increased dyspnea, sputum volume, and sputum purulence
pts with a need for mechanical ventilation
Components of BODE index
BMI
FEV1
MMRC grading
Exercise tolerance(distance walked in 6 min)
Infections predisposing to asthma
RSV
rhino virus
Drugs that can cause exacerbation of asthma
Aspirin and other NSAID
betablockers
Conditions associated with asthma
Rhinosinusitis polyps OSA obesity vocal cord dysfunction GERD
Definition of reversibility in asthma
Improvement in FEV1 of 12% and 200 cc after 2 to 4 puffs of short acting bronchodilator therapy
Methacholine challange is considered positive if there is a drop in FEV1 of
20%
LTRM should be strongly considered for patients with
aspirin induced asthma
cromolyn is first line for
exercise induced asthma
mech ventilation principles in asthma
large ET tube >7.5 low tidal volume low RR prolonged expiratory phase with high inspiratory flow permissive hypercapnia
side effects of SABA
tremor anxiety tachycardia low K+ and Mg+ long QT mild lactic acidosis
adverse effects of ziluton
reversible hepatitis
risk factors associated with OSAS
obesity nasal block hypothyroidsm acromegaly adenoidal or tonsillar hypertrophy retrognathia micrognathia macroglossia Vocal cord paralysis
DD for daytime sleepiness
OSAHAS
Periodic limb movement disorder
narcolepsy
sleep deprivation
AHI of more than _______ with symptoms indicates sleep apnea
5
contraindications to mandibular repositioning devices
TMJ dysfunction
bruxism
full dentures
inability to protrude mandible
Complications of uvulopalatopharyngoplasty
nasopharyngeal stenosis
foreign body stenosis
change in voice
velopharyngeal insufficiency
