Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Surgery/ER Fall 2013 > EM-Pulm > Flashcards

EM-Pulm Flashcards

1
Q

dyspnea upright

A

platypnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

dyspnea a/w one of several recumbent positions

A

trepopnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

hyperventilation

A

hyperpnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

dyspnea in recumbent position

A

orthopnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

dyspnea that awakens the patient from sleep

A

paroxysmal nocturnal dyspnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

S3 gallop, pulmonary venous congestion on xray, and JVD suggestive of

A

CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what signs DO NOT DISCRIMINATE between heart vs. lung problem?

A

wheezing, exertional dyspnea, orthopnea, PND (paroxysmal nocturnal dyspnea), leg edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

BNP less than 80 pgm/ mL can r/o

A

cardiac cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

basic labs for dyspnea

A

pulse ox, ABG, CXR, spirometry, EKG, CBC, BNP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

specialized labs for dyspnea

A

cardiac stress testing, echo, pulmonary function testing, CT angiography of chest, and cardiopulmonary exercise testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

dyspnea tx

A

treat cause of dyspnea. administer oxygen, maintain airway- keep paO2 above 60 mmHg, and pulse ox above 90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

acute respiratory failure categories

A

oxygenation (hypoxemia) and removal of carbon dioxide (hypercapnia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

hypoxemia vs. hypoxia

A

hypoxemia- decreased oxygen partial pressure in blood. hypoxia- insufficient delivery of oxygen to organs/tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

causes of hypoxia

A

low cardiac output, low hemoglobin, and low oxygen saturation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

causes of hypoxemia

A

hypoventilation, R to L shunt, V/Q mismatch, diffusion impairment, low inspired oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

hypoxemia

A

partial pressure of oxygen in blood less than 60 mmHg. need an ABG to get this value

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

hypercapnia defined as

A

paCO2 greater than 45 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

hypercapnia caused by__, NOT ___

A

caused by alveolar hypoventilation, not by excessive CO2 production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

symptoms of acute hypercapnia

A

increased ICP- headache, confusion, lethargy, seizures, coma (paCO2 over 100 mmHg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

causes of hypercapnia

A

depressed central respiratory drive (drug overdose, brainstem lesions, tetanus), thoracic age disordres (morbid obesity, kyphoscoliosis), neuromuscular impairment (MG, GB), intrinsic lung disease (COPD), and upper airway obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

wheezing a/w

A

asthma or COPD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

acute vs. subacute vs. chronic cough

A

acute- lasts less than 3 weeks. a/w self limited URI or bronchitis. Subacute cough- more than 3 weeks but less than 8, usually postinfectious. Chronic cough- lasts more than 8 weeks, a/w smoking, upper airway cough syndrome, asthma, GERD, ACE/ARB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

central vs. peripheral cyanosis

A

central- cyanosis caused by inadequate pulmonary oxgenation. peripheral- cyanosis peripherally caused by vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

management of acute respiratory failure

A

intubation and mechanical ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what conditions cause exudative vs transudative pleural effusion?

A

exudative- infection or neoplasm (pleural disease). transudative- imbalance between oncotic and hydrostatic pressures, like in CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Patient presents with dyspnea and PAIN with INspiration. Upon PE, there is DULLNESS to percussion and decreased breath sounds. suspect..

A

pleural effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

diagnosis of pleural effusion

A

diagnostic thoracentesis indicated for all cases except if CHF suspected. If CHF, treat for 3-4 days and if effusion does not resolve THEN drain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

how much fluid on decubitus CXR or US is significant in pleural effusion

A

1 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

tx pleural effusion

A

therapeutic thoracentesis- drain no more than 1-1.5 L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

consider bleeding in cough according to vessels

A

bronchial or pulmonary vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Emergent bleeding in sputum/cough results from..

A

bleeding from the bronchial vessels 90% of the time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

mild, moderate, severe hemoptysis

A

mild- less than 20 ml in 24 hours. moderate is 20-600mL in 24 hours. Severe- more than 600mL in 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

chronic, productive, blood streaked cough in patient

A

chronic bronchitis, bronchiectasis, CF, TB, neoplasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

hemoptysis, night sweats, fever, weight loss

A

TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

clustering cases of hemoptysis with fever, cough, chest pain, and fulminate course

A

plague

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

abrupt onset of bloody, purulent sputum

A

pneumonia or bronchitis

37
Q

life threatning hemoptysis treatment

A

intubation with large ET tube, 2 large bore IV’s, pulse ox, type and crossmatch, CXR, CBC, PT, PTT

38
Q

acute bronchitis caused by

A

usually viral- influenza A and B, parainfluenza, RSV

39
Q

common cold caused by

A

rhinovirus, coronavirus, adenovirus

40
Q

SARS (severe acute resp syndrom) caused by

A

coronavirus

41
Q

diagnostic testing in acute bronchitis and URI

A

not indicated in absence of rales and egophony on chest exam. Exception= elderly with cough- get chest xray

42
Q

5 criteria suggestive of pneumonia. if present, get CXR. if all 5 absent, no need for CXR

A
  1. HR over 100. 2. RR over 24. 3. temp over 38. 4. age over 64. 5. chest exam findings of egophony or fremitus
43
Q

influenza tx

A

give antivirals within 48 hours of symptom onset

44
Q

bronchitis tx

A

no need for abx, antitussives, inhaled bronchodilators

45
Q

PNA tx

A

empiric antibiotics, bronchodilators. steroids in severe cases

46
Q

pus in the plerual space

47
Q

localized supparative necrotizing process in the lung parenchyma

A

lung abscess

48
Q

Patient is on empiric abx for PNA. Symptoms are not resolving though- patient is ill, has weight loss, night sweats, anemia, pain with inspiration. PE shows decreased breath sounds, dullness to percussion, decreased fremitus, friction rub, rales. suspect

49
Q

diagnosis of empyema

A

aspiration of grossly purulent fluid on thoracentesis AND at least one of the following: positive gram stain or culture, pleural fluid glucose less than 40 mg/dL, ph less than 7.1, and LDH more than 1000 IU/L

50
Q

3 stages of empyema

A

exudative (easiest to treat), fibrinopurulent (loculations), and organizational (pleural peel)

51
Q

empyema tx

A

pain control, tx of underlying condition (abx if PNA), if early- chest tube drainage. if late- VATS

52
Q

lung abscess commonly caused by….

A

aspiration pneumonia, happens 7-14 days after aspiration

53
Q

lung abscess caused by anaerobic vs. aerobic bacteria

A

anaerobic- immunocompetent. aerobic- immunocompromised

54
Q

lung abscess presentation

A

cough for several weeks, putrid sputum, hemoptysis, fever, weight loss, night sweats, pleuritic chest pain

55
Q

CXR shows air-fluid level and cavitating lesion in the lower lobes. CT shows smaller abscesses in consolidations. diagnosis:

A

lung abscess

56
Q

tx of lung abscess

A

clindamycin and metronidazole. drainage usaully occurs spontaneously. surgical- percutaneous drainage or thoracotomy and resection.

57
Q

what type of bacteria is mycobacterium TB

A

slow growing aerobic rod, acid fast bacilli

58
Q

CXR shows cavitating lesions in UPPER lobe, caseation necrosis, gohn complexes. Sputum for AFB positive. dx?

59
Q

diagnostic tests for TB

A

sputum for AFB (60%), culture for M. Tuberculosis takes 4-8 weeks, CXR showing gohn complexes and cavitating lesions. and TB skin test

60
Q

TB tx

A

four drug (INH, RIF, PZA, EMB) for 8 weeks, followed by 2 drug for 18-31 weeks

61
Q

risk factors for spontaneous pneumothorax

A

marfan body habitus, smoking, male, asthma, COPD, Tb, AIDS, CF

62
Q

spontaneous pneumothorax result from

A

bullae rupture

63
Q

Patient presents with dyspnea, hypoxemia, pleuritic chest pain, decreased breath sounds, decreased fremitus, hyperresonance. EKG shows ST changes and T wave inversion,

A

pneumothorax

64
Q

tx for pneumothorax

A

oxygen. catheter aspiration for small (heimlich valve). Tube thoracostomy for large (Pleurivac)

65
Q

clinical hallmarks of tension pneumothorax

A

tracheal deviation, hypotension, and hyperresonance of affected side

66
Q

how is tension pneumothorax managed?

A

do NOT wait for chest xray. clinical diagnosis. insert 18G needle into pleural space at mid clavicular line in 2 or 3 intercostal space to decompress, then put in chest tube

67
Q

ribs broken in 2 places on the same rib

A

flail chest

68
Q

problematic issue in flail chest

A

pulmonary contusion more than rib fractures

69
Q

tx in flail chest

A

pain control, oxygenation. chest tube if pneumothorax or hemothorax

70
Q

tx of sucking chest would

A

cover would with occlusive dressing on 3 sides, creating a valve

71
Q

is wheezing pathognomonic in asthma

72
Q

asthma classification

A

mild- pulse ox over 92%, peak flow over 80%. moderate- pulse ox over 90%, peak flow 50-80%. severe- pulse ox less than 90%, peak flow less than 50%

73
Q

asthma diagnosis

A

history of asthma, pulse ox, peak flow, cxr to r/o pneumonia, ABG- respiratory acidosis. cardiac workup if dx not certain

74
Q

inflammation of the bronchioles causing bronchoconstriction, increased mucous secretion

75
Q

tx of mild asthma

A

nebulizers, follow up outpatient

76
Q

tx of moderate asthma

A

nebulizerse (albuterol- beta agnosit and ipratropium-anticholinergic) and prednisome, ADMIT

77
Q

tx of severe asthma

A

nebulizerse (albuterol- beta agnosit and ipratropium-anticholinergic) and prednisome, ADMIT. IV steroids, IV magnesium. Intubation and mechanical ventilation if ARF

78
Q

chronic productive cough for 3 months in the year for 2 consecutive years when all other causes of chronic cough have been excluded

A

chronic bronchitis

79
Q

COPD main causes

A

smoking, alpha 1-antitrypsin deficiency, other respiratory irritants (coal, silica)

80
Q

patient presents with wheezing, dypsnea, chest tightness, anxiety. Hypoxia, barrel chested, and clubbing. Has smoking history for last 20 years. suspect

A

COPD (exacerbation)

81
Q

diagnosis of COPD exacerbation

A

pulse ox, cardiac monitoring, CXR, ABG, cardiac workup if indicated

82
Q

mild COPD exacerbation tx

A

smoking cessation counsel, nebulizers, abx if bacterial infection, OP F/U

83
Q

moderate COPD exacerbation

A

smoking cessation counsel, albuterol, ipratropium, prednisone, zithromax

84
Q

severe COPD exacerbation

A

smoking cessation counsel, albuterol, IV steroids. intubation and mechanical ventilation if indicated

85
Q

common causes of PE

A

smoking, BCP, pregnancy, clotting disorder, previous DVT/PE, recent surgery

86
Q

patient presents with tachycardia, tachypnea, hypoxia. may have fever. automatically think—

87
Q

PE labs

A

CBC, d-dimer, troponin, EKG

88
Q

Diagnosis of PE

A

CT angiogram, VQ scan, wells criteria

Surgery/ER Fall 2013 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions