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Hannah CPR > CPR Exam 2 Hubbard DSAs > Flashcards

CPR Exam 2 Hubbard DSAs Flashcards

1
Q

long-term management of pneumothorax

A
  • stop smoking
  • avoid: high altitudes, unpressurized flights, scuba diving

*if successful tx no LT complications associated

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2
Q

confirmation and staging of COPD by GOLD standard uses

A 
spirometry 
*all FEV1/FVC <70%
FEV1 measurement: 
1. mild :  > 80 
2. moderate < 80 
3. severe < 50 
4. very severe <30

*can also test severity via BODE index (BMI, obstruction, dyspnea, exercise intolerance)

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3
Q

imaging of pulm embolism on CXR shows

A
  1. focal oligoemia (“west mark sign”)
  2. wedged shaped density above diaphragm (hampton hump)
  3. enlarged Pulm A.
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4
Q

common TB signs and sx

A

maybe be asx early on

-sx: wt loss, chills, fever, and if advanced, hemopytsis and chest pain

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5
Q

prevention of HCAP

A
  • avoid intubation if possible (if needed prompt extubation through frequent weening trials reduced risk)
  • minimize manipulation of tube
  • hand hygiene
  • semi upright/ upright intubated pts
  • mouth care
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6
Q

when to use O2 tx in COPD

A

very severe COPD
-PaO2 < 55 or O2 sat < 88 %
OR
-PaO2 <59 or O2 sat <89 with pulm HTN/corpulmonale or hct >55%

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7
Q

major risk factor of TB

A

HIV/AIDS

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8
Q

how to tx very severe stable COPD

A
  • SABA
  • 1+ elongating bronchodilator (LABA, tiotropium)
  • ICS
  • long-term Oxygen therapy
  • consider surgery (upper lobe emphysema or low baseline excercise capacity)
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9
Q

manifestation of sleep apnea

A

excessive daytime fatigue, impaired attention, decreased memory, increased risk of MVA

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10
Q

what is the most reliable indicator of degree of dyspnea

A

patient self report via MRC dyspnea Scale
1 = breathlessness only on strenous excercise
3= walks slower than most, stops after 1 mile of walking
5= too breathless to leave house/ breathless when undressing

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11
Q

follow up procedure for TB

A

FU often (monthly)
focus on sign and sx (not labs)
get expert consult if no improvement in 3 months
test close contacts for LTBI

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12
Q

how to tx Cryptogenic organizing pneumonia (COP) in both hypersensitivity pneumonitis and sarcoidosis

A

steroids

sarcoidosis ranges from monitoring –> steroid use

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13
Q

how to tx MDR-TB and XDR-TB

A

MDR - (isoniazid and rifampin resistant)
XDR - (isoniazid and rifampin and fluoroquinolone, and kanamycin and amkikacin resistant)
Tx for both depends on expert consult and specialty testing

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14
Q

most common causes of acute cough

A
  1. viral upper respiratory tract infection (RACE)
  2. viral lower respiratory tract infection (i.e Flu)
  3. pneumonia
  4. acute bronchitis (i.e pertussis)
  5. asthma
  6. acute exacerbation of chronic bronchitis
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15
Q

simple helpful interventions to improve ARDS outcomes

A
  1. daily ventilator liberation screen
  2. proper oral care
  3. DVT prophylaxis
  4. OMM (lymphatic)
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16
Q

biggest risk factor of head and neck cancer

A

tobacco and alcohol

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17
Q

tx and prevention for FES

A

Supportive TX:

  • early correction of fracture
  • mechanical ventilation
  • fluid recusitation
  • O2

Prevention:

  • early immbolixation of fracture
  • intraosseous pressure limitation during bone surgery
  • prophylatic corticosteroids
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18
Q

when to use invasive or noninvasive ventilation with COPD pts

A

noninvasive tx of respiratory acidosis (hyperventilation casusing ph<7.35 and CO2 >45)

*use invasive if respiratory acidosis, plus impaired mental status, hypotension, shock, etc

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19
Q

common causes of COPD exacerbation

A
  1. infection (pneumonia, etc)

2. air pollution

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20
Q

sx of lung cancer

A

hemotypsis , dyspnea, cough, and if small cell lung cancer there is many paraneoplastic syndromes

*small cell is almost exclusively dx in smokers

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21
Q

length of acute vs chronic cough

A

less than 3 weeks = acute
more than 8 weeks = chronic
*in between is sub acute

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22
Q

how to tx pt with hypercapnia and altered mentation/syncope

A

immediate endotracheal intubation

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23
Q

risk associated with recurrent pneumocystitis pneumonia related pneumothorax

A

c/l pneumothorax (both lungs collapse)

**high mortality

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24
Q

determining severity of OSA

A

AHI + degree of sleepiness + any cardiac issues

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25
Q

leading causes of pleural effusion

A

CHF, pneumonia, cancer

imbalance of fluid production and removal bc increased hydrostatic pressure and decreased oncotic pressure

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26
Q

major difference in symptoms of pulmonary edema and pleural effusion and pulmonary embolism

A

edema - acute cough
effusion - dyspnea and chest pain
embolism- cough, dyspnea, pleuritic chest pain, DVT sx

pulm edema can be caused by HF, VHD, pulm HTN, CKD, or nephrotic syndrome. **not caused by pneumonia

embolsim caused by Virchow Triad

pleural effusion commonly caused by HF, pulmonary embolism, kidney failure, trauma, or INFECTION (like pneumonia)

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27
Q

most common causes of Pulm HTN

A
  • Group 2 :left sided heart dz
  • Group 3: secondary lung dz and/or hypoxia (COPD, ILD< Sleep apnea)

other: group 4 = thomboembolic , Group 5 = multifactorial (sarcoidosis, thyroid, etc)

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28
Q

two mechanisms of ILD

A
  • distal lung parenchyma damage by
    1. inflammation with fibrosis (IPF, NSIP)
    2. granulomatous change (COP- sarcoidosis, etc)
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29
Q

how to work up a suspected ACTIVE TB patient

A
  1. acid fast bacilli smear and culture
  2. CXR
  3. TST and IGRA
    * for active or latent: test for HIV if unknown status
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30
Q

tx of pneumonia pleural effusion

A
  • if loculated, pH < 7.2, glucose < 60, gram +, pus THEN abx won’t help alone
    1. abx + chest tube drain
    2. if still not resolved add video assisted thorascopic surgery
  • *TPA and DNAase intrapleural tx improves outcomes
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31
Q

PFTs of ILD show

A

decreased diffusing capacity and decreased lung volume

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32
Q

symptomatic OSA can lead to

A

secondary HTN (via SNS vasoconstriction)

if severe OSA with hypoxemia can lead to secondary erthyrocytosis (elevated HCT) **therefore order CBC

if untx it can lead to heart problems (increase after load and O2 demand, decreased LV compliance–>CHF)

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33
Q

sx of pulmonary HTN ? advanced pulmonary HTN?

A

fatigue, exertion dyspnea, possible chest pain/palpitations

*advanced = left parasternal lift with pulmonary edema

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34
Q

sx of pneumomediastinum

A
  • severe substernal chest pain
  • subcutaneous emphysema
  • Hammans sign (crunching noise with heart beat)
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35
Q

how to tx ARDS

A
  • noninvasive O2 is only temporary
  • invasive mechanical ventilation corrects hypoxemia ( high risk of more alveolar damage by “ventilation induced injury”)
  • add conservative fluid management to ventilation or replace ventilation with ECMO is available
  • HFOV = tx for refractory hypoxemia ( increased RR, low tidal volumes)
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36
Q

CAP out patient dx/tx

A

outpatient:
dx: CXR and pulse ox
tx: <7 days; NL pt: macroclide or doxycycline ; pt with cardiopulmonary dz: respiratory quinolone, or B-lactam + macrolide/doxycycline combo

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37
Q

how to manage acute dyspnea

A
  1. stabilize with O2

2. get CXR to identify underlying cause to tx

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38
Q

massive pleural effusion (entire hemithorax) indicates

A

lung or pleural cancer

usually exudative vs transudative seen in heart or liver failure

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39
Q

imaging order in FES

A

CXR, CT of chest and MRI to see brain when CNS is involved

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40
Q

tx of HCAP

A

if no respiratory failure: ceftriaxone or levofloxacin (respiratory fluoroquinolone)

if risk of MDR (>5 days hospitalized, recent abx) then use antipsuedomonal agent + vancomycin

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41
Q

how to manage pt with hemoptysis

A
  • *get CXR!!

- if chronic sx in >40 yr old male smoker than also get Chest CT and bronchoscopy to rule out malignancy on NL CXR

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42
Q

prognosis predictor of pulm HTN

A

use right sided heart fxn test (exercise test) over PAP measurement

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43
Q

prevention of CAP pneumonia

A

-flu vaccine (> 6 months old)
-pneumnococcal vaccine
*23 valent all pts >65, and <65 if combordities
*13 valent all pts >65, or IC/ cochlear implants
(give 13 first, and then 23 > 8 weeks after; if 23 given first, wait >1 yr for 13 to be administered )

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44
Q

what indicated Legionaares Dz (pneumonia by Legionella)

A

> 50 yo, severe pneumonia, extrapulmonary sx (i.e hyponatremia, HA, diarrhea)

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45
Q

how to tx stable moderate COPD

A
  1. inhaled tx (via metered doe inhaler with spacer device, or nebulizer)
    - SABA = quick relief
    - LABA = monotherapy (possible combined)
    - ipatropium/tiotropium = combined tx
    - methylxanthine (theophylline)= adjunctive to inhaled tx
  2. pulmonary rehab
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46
Q

when to switch to oral Abx in inpatient CAP tx

A

sx improve and no fever twice at least 8 hours apart

*discharge when switch is made

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47
Q

how to dx DVT

A
  1. use WELLS score to determine probability
    - if low- D dimer test. (- rule out, + get US)
    - if high get US
    * venography is the gold standard but rarely used
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48
Q

CXR dx of pleural effusion

A
  1. standard
    * Blunt costophrenic angle (if >250ml)
    * meniscus sign= large amount of fluid opacify lower thorax
  2. decubitus films (on side)
    - measure amount to determine thoracentesis indication (>1cm) and determine if located or free flowing
  3. US -detects locutions and guides thoracentesis
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49
Q

when do you perform thoracentesis of pleural effusion in CHF pts ? what is the major risk ??

A
  1. asymmetric PE

2. pneumothorax is major complication

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50
Q

two top differentials with weight loss and hemotypisis

A

TB (infection) or cancer

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51
Q

when to hospitalize LTBI infection

A

is respiratory distress, hemopytisis, or systemic dz become present

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52
Q

locations on decubitus films in pt with pleural effusion indicates

A

empyema (complication of pneumonia )

see WBC> 50,000; high WBC also seen in complicated parapneumonic effusions

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53
Q

4 most predictive COPD indicators

A
  1. self reported hx of COPD
  2. > 40 pack year hx
  3. age >45
  4. max laryngeal height <4cm
54
Q

CAP in patient DX/TX

A

dx: CXR, 2 blood cultures, routine metabolic panel, pulse ox, CBC; if high risk for drug resistance then culture and stain

tx:
1. administer O2, immediate abx tx (IV abx w/i 6 hrs)
(abx: respiratory quinolone, or B-lactam + macrolide/doxycycline combo )
*use clindamycin if aspiration or lung abscess
ICU pts: alert with isolated hypoxemia or hypercapnia then use noninvasive positive pressure ventilation
ICU pt abx: B lactam + azithromycin/fluroquinolone
>10 days

55
Q

risk factors of pneumonia

A

alteration in anatomic barriers, impairment of humoral/cell-mediated immunity, impaired phagocytic function

56
Q

differentials associated with OSA

A
  • RLD
  • GERD
  • sinusisits
  • epilepsy/narcolepsy
  • hypothryoidism
  • acromegaly
57
Q

labs of pneumothorax show

A

hypoxemia, respiratory alkalosis (hypoventilation), QRS/Twave changes that MIMIC AMI !!

58
Q

management of pts who do not improve on tx within 72 hours of tx onset in CAP pneumonia

A

consider M. TB, fungal, viral, pnuemosystis infection

-order more tests and get consultation

59
Q

most common cause of ARDS

A

sepsis

60
Q

what cancer is EBV related and Mediterranean and Far East Assoc.

A

nasopharyngeal cancer

61
Q

sx of epiglottitis causing UAO. dx tools? tx?

A 
sx: odynophagia (painful swallowing) 
sore throat 
dyspnea and stridor (bc obstruction ) 
hoarseness 
fever
tachycardia

dx: fiberoptic layrngoscopy and maybe throat culture
tx: secure airway and ABX

62
Q

oropharynx cancer is assoc with

A

mainly HPV 16 ( and other high risk HPV 18, 31, 32)

63
Q

complications of spontaneous pneumothorax

A

pnuemomediastinum or subcutaneous emphysema

64
Q

how to tx severe stable COPD

A
  • SABA
  • 1+ elongating bronchodilator (LABA, tiotropium)
  • add ICS (if repeated exacerbations)
65
Q

steps in diagnosing mediastinal mass

A
  1. identify compartment (anterior, middle, posterior)
  2. CT scan (VERY IMP)
    a- barium study if posterior
    b. iodine 131 for goiter
  3. mediastinoscopy or anterior mediastinomy
    (official dx for anterior or middle masses)
    *alternative dx: video assisted thorascopy (can also tx by removal during procedure)
66
Q

T/F Use compression stocking to prevent DVT

A

DO NOT USE COMPRESSION STOCKING IN HIGH RISK PATIENT OF DVT

67
Q

risk factors for OSA

A

male
obese
postmenopausal women

68
Q

how to tx established DVT

A
  1. immediate anti-coag with IV heparin
  2. long term anti-coag with warfarin until INR 2-3 twice more then 24 hours apart
  3. if extensive thrombosis. use thrombolytics with catheter and then 3 months of anti-coags
    * if anti-coag contraindicated then use IVC filter (decreases short term risk, but increases long term risk)
69
Q

ARDS can present similar too

A

acute infectious pneumonia (with interstitial pattern or diffuse airspace dz)
(pneumocystisis, bacterial- CAP)
or other noninfectious DZ

*all present with DAD

70
Q

how to distinguish ARDS from other causes of respiratory distress

A

identify underlying cause/ inciting event.

ARDS is caused by many things but is a dx of exclusion

71
Q

indications of HCAP (healthcare associated pneumonia)

A

pneumonia developing at least 48 hrs after hospitalization

*most common is ventilator associated pneumonia (VAP)

72
Q

tx of recurrent or b/L pneumothorax or pneumothorax with failed thoracostomy drain

A

thorascopy or open thoracotomy (surgery)

73
Q

most common causes of hemoptysis related (acute or chronic) cough

A
  1. infection (bronchitis, pneumonia)

2. malignancy

74
Q

dx of decreased maximum oxygen uptake without identifiable cause

A

deconditioning

75
Q

tx of OSA

A
  1. lifestyle modification !!
  2. steroids/decongestant to tx congestion
  3. if refractory OSA = CPAP
    (CPAP non compliant pts use bi-level PAP nasal ventilation or auto-titrating PAP)
    *alternative = mandibular advancement device
    *unwillingness = surgical tx
76
Q

tx of pneumocystitis related pneumothorax

A

no best tx identifies; use hemlich valve with small bore chest tube so they can go home

77
Q

how to manage pt with CC of chronic dyspnea, unrevealing HX and PE?

A

cardiopulmonary exercise test or arterial blood gas measurement

78
Q

5 management strategies of ARDS

A
  1. low tidal volumes 2. prone ventilation 3. fluid management 4. cardiopulmonary monitoring 5. corticosteroids
79
Q

dx of OSA

A
  1. Epworth Sleepiness Scale (measures daytime fatigue)
  2. STOP-BANG questionnaire (screening tool for likelihood)
  3. polysomnography (PSG) (required for dx)
    * PSG + electroencephalogram most accurately confirms dx!
    - PSG gives AHI; AHI>5 = OSA
  4. asses for obesity hypoventilation syndrome (PaCO2>45)
80
Q

triad of sx seen in fat embolism syndrome

A
  1. hypoxemia
  2. neurologic ABNL (confusion, syncope)
  3. petechial rash (red brown around head neck thorax axilla)
    (1-3 days after appropriate insult with no other cause of dz indicated)

other sx: tachypnea, dyspnea
MIMICS ARDS

81
Q

tx of large primary spontaneous pneumothorax

A
  1. aspiration drainage with small bore catheter
  2. tx symptomatically for cough and chest pain
  3. CXR every 24 hrs
    * placing small bore chest tube attached to one-way heimlich valve can’t prevent tension pneumothorax and be used at home
82
Q

precursor lesions to head and neck cancers

A

erythroplakia and leukoplakia

83
Q

dx criteria for ARDS

A

bilateral (airspace opacities) infiltrate, acute onset, hypoxemia, no heart failure
with FiO2 <200

84
Q

dx of HCAP

A

based on clinical presentation (fever, purulent sputum, decreased oxygen), leukocytosis, and new CXR findings (new/progressive radiographic infiltrates)

85
Q

tx of mild-moderate COPD exacerbation

A

home tx with SABA or SABA + OCS/abx

86
Q

causes of pneumomediastinum

A
  1. alveolar rupture
  2. esophageal/tracheal/ bronchi rupture
  3. dissection of air from neck or ab (spontaneous pneumothorax)
87
Q

more at risk population for primary spontaneous pneumothorax

A

tall, thin males

primary means no underlying cause

88
Q

how to monitor progression or tx response to pulm HTN

A
  1. 6 min walk test
  2. echocardiogram
  3. catheterization
89
Q

tx of venous stasis

A

sx. edema, shiny atrophic skin, ulcers, varicose veins
tx: compression, decrease prolonged standing, UNNA boot (dressed compression boot to decrease edema and promote ulcer healing)

90
Q

signs and sx of pleural effusion

A

sx: dyspnea and chest pain, possible fever (if pneumonia)

- signs: dull percussion, decreased tactile fremitus, decreased breath sounds, pleural friction rub

91
Q

causes of chronic mediastinitis ? sx? tx?

A
  1. histoplasmosis (fibrosing medistinitis )
    sx: compression of structures
    tx: none
  2. TB (granulomatous LN inflammation)
    dx: PPD
    sx: asx
    tx: RIPE anti-tb tx
92
Q

imaging ordered in suspected upper airway obstruction

A

NOT CXR!!!!!

order CT and maybe endoscopy

93
Q

how to identify/ dx severe pneumonia

A

CURB-65
-confusion, urea> 20, RR> 30, BP < 90/60 (hypotensive), age >65
*if meet 2 then hospitalize, if meet 3 then ICU
(classic sx: cough, sputum , fever, chills, crackles, bronchial breath sounds, pleural effusion

94
Q

imaging for ILD

A

CXR= interstitial reticular or nodular infiltrates
HRCT (CRUCIAL) = distribution and extent of dz
*lung biopsy may be needed for confirmation

95
Q

VERY common presentation of IPF

A

progressive dyspnea

96
Q

dx. of pulm HTN via imagine

A

CXR= pulm A. enlargement

Confirmation by right heart catheterization (measures PAP)

97
Q

how to dx Pulmonary embolism

A

Use wells criteria to determine probability
-low risk - d dimer test
- high risk - CT pulm arteriography ( CT angio) *gol standard, or V/Q mismatch scan
(both can dx, but only NL V/Q excludes)

98
Q

how to workup chronic dyspnea

A

1) GET DETAILED HX

- identify chronic conditions, cardiac relations, pulmonary relations, other

99
Q

how to tx malignant pleural effusion

A

(seen with bloody effusions)

-drain by chronic indwelling catheter or pleurodesis (pleural space obliteration)

100
Q

LTBI tx

A

isoniazid daily for 9 month or
rifampin daily for 4 months or
rifampentine + isoniazid 1/week for 3 months
**direct observation

101
Q

when and how to perform a lung cancer screen

A

low-dose CT (LDCT)

if 55-80 yo with >30 yr pack hx

102
Q

most common causes of acute dyspnea (<4weeks)

A 
pulm embolism 
pulm edema 
pneumonia 
UAO 
pneumothorax 
COPD exacerbation
103
Q

tx of secondary (underlying lung dz) , tension, or severe pneumothorax

A 
chest tube ( tube thoracostomy) until lung expands 
*thoracostomy drains space of fluid or air
104
Q

risk factor for laryngeal tracheal stenosis (cause of UAO)

A

prior intubation or tracheostomy

side note: endotracheal intubation with mechanical ventilation is large risk factor for HCAP

105
Q

most common causes of chronic dyspnea (> 4 weeks)

A
  1. COPD
  2. asthma (chest tightness)
    3, ILD
  3. HF (air hunger)
106
Q

causes of acute mediastinitis? sx? tx?

A
  1. esophageal perforation
    sx: ill, chest pain, SOB
    tx: mediastinomy, tear repair, pleural drainage
  2. following median sternotomy
    sx: wound drainage, sepsis, widened mediastinum
    dx: via needle aspiration
    tx: drain, decried, abx
107
Q

tx of severe COPD exacerbation (dyspnea at rest, RR>25, PR >110, accessory M. use)

A
  1. hospitalize with O2 tx

2. SABA, anti cholingeric, oral/ IV CS, abx

108
Q

sx of pulm embolism

A

sx of DVT ( swelling, erythema, tenderness in affected limb) plus dyspnea, cough, pleuritic chest pain

PE: crackles, tachycardia, tachypnea (bc hypoxic), increased S2 pulmonary component

109
Q

sx of pneumothorax

A

chest pain, dyspnea (usually resolves in 24hrs)

  • if small = NL PE
  • if large = decreased breath sounds, decreased tactile fremitus, decreased chest movement on affected side
110
Q

how to tx massive hemoptysis ( >200ml/day)

A
  1. urgent airway management !
  2. urgent bronchoscopy and/or bronchial A. embolization
  3. last resort = surgery
111
Q

tx of pulmonary embolism

A
  • supportive tx of hypoxic, hemodynamic stability in hospital till stable
  • anticoags for 3 months
  • obstructive shock due to PE, or acute embolism and pulm HTN/RV failure -(hemodynamically unstable) thombolytic tx
  • if hemodynamically unstable but thrombotic contraindication then embolectomy surgery
112
Q

how to treat UACS for chronic cough

A

non sedating antihistamines and decongestant

113
Q

dx of pneumothorax

A

CXR = visceral pleural line on expiratory film

**deep sulcus sign = ABNL radiolucent costophrenic sulcus seen on supine pts

114
Q

persistent dry cough with inspiratory crackles leads to dx of

A

ILD

IPF = dyspnea on exertion, dry cough, crackles on inspiration

115
Q

how to tx mild stable COPD

A

SABA inhaled tx as needed

116
Q

active TB tx

A

RIPE for 6 months (reassessment at 2 months)

117
Q

most common causes of chronic cough

A
  1. Upper airway cough syndrome ( post nasal drip)
  2. cough variant asthma
  3. GERD

others: CB, bronchiectasis, ACE-I

118
Q

luekyocytosis in the setting of respiratory distress can indicate what dx

A

pneumonia or sepsis (ARDS)

119
Q

pathophysiology of ARDS exudative stage

A

damage to every level of the alveolar-capillary membrane
1. type 1 pneumocyte damage = impaired barrier
2. type 2 damage = atelectasis and decreased compliance
**barrier damage + increased hydrostatic pressure/decreased oncotic pressure –> proteinaceous pulmonary edema
3. pulm edema–> worsening V/Q mismatch –> physiologic shunt (alveoli are perfused, but ventilation fails; persistent with O2 supplementation)
4. hypoxemia (with vasoconstriction) + microthrombi (decreased pulm circulation) + direct endothelial damage = increased pulm A. pressure –> worsening dead space ventilation
**3 and 4 = increased work of breathing
OVERALL- Acure Respiratory Failure by ARDS is caused by permeability damage and decreased lung compliance

120
Q

what does hypercapnia with tachypnea indicate

A

high CO2 with increased respiration rate means that pt is experiencing impaired ventilation (possibly due to ARDS) and need emergent attention

121
Q

how to dx GERD for chronic cough

A
  1. PPI tx with reassessment in 3 months

2. 24hr esophageal pH test

122
Q

what to order if suspected hypoxemia or hypercapnia

A

O2 saturation and arterial blood gases

123
Q

sx of general airway obstruction ? upper airway obstruction?

A

SOB, noisy breathing, wheezing, decreased breath sounds on auscultation

UAO sx: DOE, SOB, stridor, hoarseness (if laryngeal), mulled voice (if vocal cords)

124
Q

Findings on MRI in Fat embolism syndrome

A

“starfield” pattern of diffuse puntacte hyperintense lesions in brain

125
Q

causes of drug induced ILD

A

amioderone, nitrofurantoin, methotrexate

*MAN

126
Q

sx of laryngotracheal injury (cause of UAO)

A 
stridor (bc UAO) 
dysphonia 
hemotypsis
neurologic sx 
cervical bruising 
hematomas 
pneumothorax 
cervical crepitus
127
Q

virchow triad of risk of VTE

A

hypercoagability
endothelial damage
venous stasis

128
Q

two mechanisms leading to the sensation of dyspnea

A
  1. impaired ventilation ( obstruction, decreased chest wall compliance)
  2. increased respiratory drive ( lund dz, CHF, acidosis, preganancy, behavioral panic attacks, etc)
129
Q

most common cause of HCAP

A

micro aspiration of bacteria of oropharynx / upper airway in ill pts
*VAP
Risk factor: endotracheal intubation with mechanical ventilation

130
Q

tx for IPF

A

no tx to fix

-supplement O2 and tx pulm HTN with vasodilators if chronic or severe

131
Q

dx and tx of pneumomediastinum

A

dx: CXR
tx: none required (O2 supplement decreases recovery time, needle aspiration provides compression relief)

Hannah CPR (7 decks)

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