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Emergency Medicine EOR > EM - Pulm > Flashcards

EM - Pulm Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

when is it considered bronchiolitis?

A

under 2 years old

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2
Q

MCC of bronchiolitis

A

RSV (Respiratory Syncytial Virus, idk)

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3
Q

s/s of bronchiolitis

A

-increased RR
-retractions
-grunting
-cough
-expiratory wheeze

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4
Q

diagnosis of bronchiolitis

A

mainly clinical

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5
Q

treatment of bronchiolitis

A

-nasal suction
-hydration
Also, Ribavirin

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6
Q

discharge criteria for bronchiolitis

A

-RR <60
-clear airway
-adequate oral intake

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7
Q

MCC of acute bronchitis

A

viral

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8
Q

s/s of bronchitis

A

-cough
-wheezing
-SOB
-dyspnea
-fatigue
-rhonchi that clears with cough

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9
Q

diagnosis of bronchitis

A

clinical

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10
Q

treatment of bronchitis

A

reassurance and symptomatic

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11
Q

etiology of epiglottitis

A

Hib

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12
Q

s/s of epiglottitis

A

-dysphagia
-drooling
-tripod position
-fever
-stridor
-odynophagia

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13
Q

diagnosis of epiglottitis

A

visualization of erythematous epiglottis

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14
Q

managment of epiglottitis

A

-maintain airway
-vanc + rocephin

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15
Q

etiologies of ARDS

A

-sepsis
-aspiration pneumonia

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16
Q

pathophys of ARDS

A

excess fluid leading to…
-impaired gas exchange
-decreased compliance
-increased pulmonary arterial pressure

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17
Q

diagnosis of ARDS

A
  1. PaO2/FiO2<200 (<300 means acute lung injury).
  2. Bilateral alveolar infiltrates on CXR
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18
Q

s/s of ARDS

A

-SOB
-tachypnea
-crackles
-retractions

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19
Q

treatment of ARDS

A

-treat underlying cause
-supp oxygen
-PEEP

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20
Q

s/s of asthma

A

-cough
-chest tightness
-SOB
-difficulty breathing
-wheezing

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21
Q

diagnosis of asthma

A

-in children: 85% or lower FEV1/FVC and >12% improvement after bronchodilator
-in adults: 70% or lower FEV1/FVC and 12% improvement and >200mL

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22
Q

classification of asthma

A

-Mild Intermittant:
Symptoms < 2 times/week, exacerbations brief
-Mild Persistent:
Symptoms > 2 times/week; not every day - exacerbations may produce minor limitation to activities; Use of rescue inhaler > 2days/week, but not daily
-Moderate Persistent:
Daily symptoms and use of inhalers, exacerbations may last for days and produce some limitations to activities
-Severe Persistent:
continual symptoms - frequent exacerbations; Extremely limited activity tolerance

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23
Q

treatment of asthma

A

SABA + ICS

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24
Q

treatment of status asthmaticus

A

intubation, IV fluids, potent systemic bronchodilator, steroids, epinephrine, oxygen

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25
Q

etiology of croup

A

Parainfluenza

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26
Q

clinical findings for croup

A

-barking cough
-inspiratory stridor
-prodromal URI sx

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27
Q

imaging of croup

A

steeple sign

28
Q

management of croup

A

-mild: decadron (dexamethasone)
-moderate-severe: decadron, epi, supportive care

29
Q

s/s of airway foreign body

A

-sudden coughing
-gagging, stridor, cyanosis

30
Q

diagnosis of airway foreign body

A

-xray initially
-bronchoscopy definitive

31
Q

management of airway foreign body

A

-BLS
-laryngoscopy

32
Q

s/s of influenza

A

-fever
-HA
-fatigue
-body aches
-sore throat
-URI sx

33
Q

diagnosis of influenza

A

NP swab

34
Q

management of influenza

A

-supportive care
-tamiflu within 48 hours of sx

35
Q

s/s of pertussis

A

-catarrhal: URI sx for 1-2 weeks
-paroxysmal stage: whoop like cough
-convalescent stage: chronic cough

36
Q

diagnosis of pertussis

A

-clinical diagnosis
-confirmed with culture of nasal secretions

37
Q

treatment of pertussis

A

Azithromycin

38
Q

transudate vs exudate

A

-transudate: fluid that passes through a membrane which filters out all the cells and much protein which yields a watery solution
-exudate: fluid rich in protein and cellular elements that oozes out of blood vessels due to inflammation

39
Q

etiology of transudates

A

-heart failure
-cirrhosis
-PE

40
Q

etiology of exudates

A

-pneumonia
-cancer

41
Q

s/s of pleural effusion

A

-dyspnea
-cough
-pleuritic cp
-diminished breath sounds
-dull to percussion
-sx of underlying cause

42
Q

treatment of pleural effusion

A

-if small and likely benign: observe
-if large or atypical: thoracentesis followed by tube thoracostomy
-if recurrent: pleurodesis

43
Q

how to determine if the fluid is transudative vs exudative

A

if one or more is present, its exudative
-pleural protein/serum protein >0.5
-pleural LDH/serum LDH >0.6
-pleural LDH> 148

44
Q

etiology of primary spontaneous pneumothorax

A

tall, thin males who smoke

45
Q

etiology of secondary pneumothorax

A

pre-existing pulmonary disease

46
Q

MCC of tension pneumothorax

A

cardiopulmonary resuscitation

47
Q

s/s of pneumothorax

A

-pleuritis CP
-tachypnea
-SOB
-diminished breath sounds
-decreased tactile fremitus

48
Q

s/s of tension pneumothorax

A

-severe resp compromise
-tracheal deviation
-displacement of PMI

49
Q

diagnosis of pneumothorax

A

chest x-ray

50
Q

treatment of primary spontaneous pneumothorax

A

-small: supplemental oxygen and observe
-large: aspiration followed by chest tube

51
Q

treatment of secondary pneumothorax

A

chest tube

52
Q

treatment of tension pneumothorax

A

needle decompression

53
Q

MCC of PE

A

DVT

54
Q

risk factors for PE

A

virchows triad (stasis, injury, hypercoagulability)

55
Q

s/s of PE

A

-dyspnea
-pleuritic CP
-cough
-hemoptysis
-tachypnea

56
Q

diagnosis of PE

A

-wells criteria and PERC rules
-if low risk and no PERC: no testing
-if low risk and 1 PERC or intermediate risk: D-Dimer
-if high risk: CTA
-gold standard: pulmonary angiography

57
Q

if CTA for PE has a CI …(Like preggo)

A

VQ scan

58
Q

treatment of PE

A

-oxygen
-ventilatory support
-anticoagulation

59
Q

which anticoagulant to use for PE

A

-unstable: UFH
-stable and cannot take oral: LMWH
-stable and can take oral: DOAC

60
Q

5mm positives for TB skin test

A

-HIV
-recent contact with TB
-CXR findings that suggest TB
-organ transplant
-immunosuppressed

61
Q

10mm positives for TB skin test

A

-people who have come from endemic areas
-drug users
-mycobacteriology lab workers
-people who live or work in high risk congregate settings
-certain medical conditions
-children under 5
-infants or children exposed to adults in high risk categories

62
Q

15mm positives for TB skin test

A

no risk factors

63
Q

s/s of tuberculosis

A

-fever
-chills
-night sweats
-weight loss
-cough
-hemoptysis
-chest pain
-fatigue

64
Q

diagnosis of TB

A

sputum culture

65
Q

treatment of latent TB

A

Isoniazid for 9 months

66
Q

Treatment of active TB

A

Isoniazid
Rifampin
Ethambutol
Pyrazinamide

Emergency Medicine EOR (12 decks)

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