Disorders

Question 1

what is the gold standard diagnostic test for sleep apnea

Answer 1

polysomnogram

Question 2

what is the minimum % acceptable for the FEV1/FVC ratio at which if it dropped below would indicate an obstructive dz

Answer 2

70%

Question 3

What are the examples (mnemonic) of obstructive resp. dz

Answer 3

CBABE (cystic fibrosis, bronchitis (chronic) asthma, bronchiectasis, and emphysema

Question 4

examples of restrictive dz

Answer 4

fibrosis, scoliosis, neuromuscular defect (EB)

Question 5

can get air in but not out

Answer 5

obstructive (flow)

Question 6

can’t get air in, can get air out

Answer 6

restrictive (volume)

Question 7

describe a primary etiology for pneumothorax (non lung dz)

Answer 7

tall, thin, M 10-30 yrs (Smoking, FH, or rupture of subpleural blebs)

Question 8

Describe a secondary cause of pneumothorax (lung dz)

Answer 8

Pseudomonas jiroveci, complication of COPD, asthma, CF, TB, sarcoidosis)

Question 9

what does a paraneumonic effusion refer to

Answer 9

exudates of bacterial pneumonia

Question 10

which diagnostic procedure would you use tfor suspected pleural effusion

Answer 10

thoracentesis

Question 11

what are some causes of pleural effusion? (5 total)

Answer 11

increased fluid w/ nml cap, secondary to increased hydrostatic p. or decreased oncotic p.; abnl cap perm. decreased lymph clearance; infxn of pleural space(empyema), bleeding into space

Question 12

what is the diagnostic procedure for pneumothorax

Answer 12

chest xray showing pleural line

Question 13

how would you tx a pneumothorax

Answer 13

for cases <15% hemithorax observe w/ O2 otherwise chest tube and if fail=tube thoracostomy

Question 14

what are PE findings w/ pneumothorax

Answer 14

decreased BS, tactile fremitus, movement of chest;

Question 15

what would u find with tension pneumothorax

Answer 15

tachycardia, hypotension; mediastinal/tracheal shift

Question 16

what are some PE findings w/ a pleural effusion

Answer 16

large-dullness to percussion, decreased/absent BS over effusion, possible breath & egophony just above effusion if compressive atelectasis, pleural friction rub

Question 17

what do you suspect with analyzing chemistries (PFP/SP>.5 or PF LDH to S LDD>.6 or PF LDH > 2./3

Answer 17

Exudate (cancer or bacteria pneumonia)

Question 18

if chemistries are normal for a thoracentesis what would you suspect

Answer 18

transudate

Question 19

what causes 90% of transudate pleural effusions

Answer 19

heart failure

Question 20

what disease process would be indicated by a costophrenic blunting on chest xray

Answer 20

pleural effusion

Question 21

signs/sx with pleural effusion

Answer 21

dyspnea, cough, chest pain

Question 22

what is the pathophys behind hyaline membrane dz

Answer 22

lung dz caused by surfactant defeciency

Question 23

what age population is affected by RDS Hyaline membrane dz

Answer 23

premature infants <32 weeks..

Question 24

what are the risk factors for hyaline membrane dz

Answer 24

premature gestation, C-delivery w/ out being in labor, perinatal asphyxia, being the 2nd of twins

Question 25

how would you tx hyaline membrane dz

Answer 25

antenatal steroids, early postnatal surfactant therapy, & gentle ventilation to redue barotrauma to immature lungs

Question 26

sleep apnea is defined by a pause in breathing lasting >/= to and a drop in airflow >/= to

Answer 26

10 seconds,

w 90% drop in airflow