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PCM III > Final: Concepts in Pulmonary Disease > Flashcards

Final: Concepts in Pulmonary Disease Flashcards

1
Q

This condition presents with a cough of 1-3 weeks with constitutional symptoms. May be preceded by URI, has a ronchi that clears with cough. Usually caused by a viral condition.

A

Acute Bronchitis

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2
Q

How do you treat acute bronchitis?

A

Acetominophen, NSAIDs, cough drops and Dextromethorphan as needed for cough

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3
Q

Would you use Abs for acute bronchitis?

A

Nope

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4
Q

What condition has three distinct phases:

  1. General malaise, rhinorhea, mild cough, low grade fever
  2. Series of severe coughs that can cause emesis or syncope, with characteristic whoop, but besides cough pts feel fine
  3. gradual recovery
A

Pertussis (whooping cough)

  1. Catarrhal
  2. Paroxysmal
  3. Convalescent
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5
Q

What is the best indicator for pertussis in adults?

A

Post-tussive emesis

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6
Q

How do you check for pertussis in first 2 weeks?

A

Culture and PCR

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7
Q

How do you check for pertussis in weeks 2-4?

A

PCR»»Culture

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8
Q

How do you check for pertussis after week 4?

A

Serology only

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9
Q

How do you treat pertussis? When should you administer?

A

Macrolides, within the first 3 weeks!!

-azithromycin or clarithromycin, TMP/SMX if allergic

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10
Q

Is there an immunization for pertussis?

A

Yep, Tdap

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11
Q

When giving a cough suppressant for pertussis, what should you avoid?

A

Opiod based cough suppressants

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12
Q

This condition presents with cough, fever, tachypnea, rales, and infiltrates on chest x-ray (both PA and lateral). On PE there is dullness to percussion, tactile fremitis, and egophony

A

Pneumonia

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13
Q

What are the three parts of the CRB-65 for diagnosing pneumonia?

A

Confusion
Resp Rate >30
BP: SBP <90 or DBP <60

1-2=maybe hospitalize if RF present
3-4=hospitalize

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14
Q

Outpatient treatment for uncomplicated CAP is..

A

Macrolide

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15
Q

Inpatient treatment for complicated pneumonia is..

A

Floroquinolone or macrolide+B-lactam

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16
Q

This condition is associated with an expiratory wheeze in atopic pts. They can have eczema, allergic skin conditions, and allergic shiners.

17
Q

What is needed to diagnose asthma?

A

Spirometry!

-Reversible change in FEV1 greater than 12% or peak expiratory flow of at least 20%

18
Q

If asthma pt has symptoms less than 2 days per week and is woken up less than twice per month, they have _____ asthma and should be treated with?

A

Intermittent asthma is treated with SABA PRN

19
Q

If asthma pt has symptoms more than 2 days per week, but not daily, and is woken up 3-4x per month, they have _____ asthma and should be treated with?

A

Mild asthma treated with daily low dose ICS or low dose ICS as needed

20
Q

If asthma pt has symptoms daily, and is woken up daily they have _____ asthma and should be treated with?

A

Moderate asthma treated with low dose ICS-LABA daily

21
Q

If asthma pt has symptoms throughout the day, and is woken up 7x/week, they have _____ asthma and should be treated with?

A

Severe asthma and is treated with medium dose ICS-LABA daily

22
Q

What should clinicians do before stepping up an asthmatics inhaler dosage?

A

Always check for adherence to asthma therapy

23
Q

When is it okay to step down a patients asthma meds?

A

If they are controlled for 3 months

24
Q

Acute Respiratory failure can present in what two ways?

A

Hypoxic
-cyanotic, restless, confused, tachypnic, HTN, cardiac dysrhytmias

or

Hypercarbic
-hyperemia, HTN, tachycardic, tachypnic, impaired consciousness

25
Q

What labs are a must for Respiratory failure?

A

Arterial blood gasses

26
Q

What will arterial blood gasses show on respiratory failure?

A

PaO2<60mmHg if hypoxic

PaCO2>45mmHg and respiratory acidosis if hypercarbic

27
Q

How do you treat respiratory failure?

A

Noninvasive positive pressure ventilation (NIPPV)

-CPAP (first line for COPD) or BIPAP

28
Q

COPD is associated with what risk factors?

A

Smoking
Occupation (fire fighter, welders)
a1-antitrypsin def

29
Q

Productive cough with sputum production for >3 months in 2 consecutive years is diagnostic of?

30
Q

Gold grade 1-4.. GO

A

1=80%+
2=50-79%
3=30-49%
4=<30% (bad)

31
Q

How can you treat intermittent, mild COPD?

A

short acting bronchodilators

32
Q

How do you treat mild COPD with no exacerbations?

A

Long acting muscarinic antagonists

33
Q

If pt has increased dyspnea, severe airflow obstruction and lung hyperinflation, how would you treat?

A

Combine Long acting muscarinic antagonists with long acting B2 agonist

34
Q

If pt has severe COPD, what agents besides LAMA and LABA can be used?

A

Inhaled glucocorticoids, PDE4i, Macrolides, Xanthines

PCM III (9 decks)

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