First Aid Pulmonary Flashcards
clinical signs of asthma?
- cough
- episodic wheezing
- accessory muscle use
- dec breath signs, low O2 sat at late stage
treatments for COPD?
COPD
Corticosteroids
Oxygen (goal: 88 - 92%)
Prevention
Dilators (b2 agonists, anticholinergic)
clinical symptoms of COPD exacerbation?
wheezing, cough, sputum
treatments for COPD exacerbation?
antibiotics (doxy, azithromycin)
bronchodilator (albuterol, ipratropium)
steroids (PO: prednisone, IV: methylprednisone)
6 meds for asthma exacerbations
ASTHMA
albuterol steroids theophylline humidified O2 magnesium anticholinergics
5 etiologies for obstructive lung dz?
ABCT
Asthma
Bronchiectasis
Cystic fibrosis/COPD
Tracheal or bronchial obstruction
the 1st step of management for pt suspicious of asthma
PFT
what is the next step of normal PFT from pt suspicious of asthma?
methacholine challenge test
if a pt suspicious of asthma has dec PFT, what is the next step?
give albuterol to reverse the symptoms
what other med must be given to asthma pt with long acting b2 agonist?
corticosteroids
how do you define severe asthma?
FEV1
treatments for severe asthma?
high dose inhaled corticosteroids + long acting inhaled beta 2 agonists
what are the light’s criteria for plueral effusion?
- pleural protein/serum protein > 0.5
- pleural LDH/serum LDH > 0.6
- pleural fluid LDH: more than 2/3 the upper limit of normal serum LDH
*an effusion is exudate if any of the above criteria is met.
clinical hallmarks of theophylline toxicity?
nausea, vomiting, headahce, anxiety, diarrhea, and cardiac arrhythmia
treatments for complicated parapneumonic effusions/empyemas?
chest tube drainage in addition to antibiotic therapy or pleurodesis
3 bugs that cause COPD exacerbations?
Haemophilus influenza
Moraxella
Strep pneumoniae
CHADSVASc for anticoagulants?
C: CHF H: HTN A: age more than 75 D: DM S: Stroke or hx of TIA V: Vascular dz (PAD, MI) A: age > 65 Sc: Sex --> female
more than 2, give anticoagulant
define sleep apnea
2’ to disturbances in breathing during sleep that lead to excessive daytime somnolence and sleep disruption
define acute respiratory distress syndrome?
- hypoxemia
- dec lung compliance
- noncardiogenic pulmonary edema
- PaCO2/FiO2 ratio less than 300
pathogenesis of ARDS?
endothelial injury
causes of ARDS?
sepsis, pneumonia, aspiration, multiple blood transfusions, inhaled/ingested toxins, and trauma
what are the 4 diagnosis criteria for ARDS?
- acute onset (less than 1 week) of resp distress
- PaO2/FiO2 5 cm H2O
- bilateral pulmonary infiltrate on CXR
- resp failure not completely explained by heart failure
treatment for ARDS?
- mechanical ventilation with low tidal volume (4-6 cc/kg) to minimize ventilator induced lung injury
- use PEEP to recruit collapsed alveoli
what are the goals of PaO2 and SaO2 for treating ARDS?
55 mmHg, 88%
medications for acute exacerbation?
inhaled beta 2 agonist (albuterol) and anticholinergics (ipratropium), inhaled corticosteroids, antibiotics
3 childhood paths associated with asthma?
- multiple episodes of croup
- URI with dyspnea
- Eczema
3 causes for transudative pleural effusion?
- CHF
- Cirrhosis
- Nephrotic syndrome
7 causes for exudative pleural effusion?
- Pneumonia
- TB
- Malignancy
- PE
- Collagen vascular dz (rheumatoid arthritis, SLE)
- Pancreatitis
- Trauma
clinical definition of emphysema?
productive cough > 3 months X 2 yrs
clinical definition of chronic bronchitis?
terminal airway destruction and dilation
treatment for tension pneumothorax?
- needle decompression
2. chest tube placement
most common cause of 1’ spontaneous pneumothorax?
rupture of subpleural apical blebs
best initial treatment approach for spontaneous pneumothorax?
observation with supplemental oxygen
what is a common precursor to acute resp distress syndrome?
pancreatitis
what is the next best step of management of pts suspecting of acute lung transplant rejection?
lung biopsy to rule out infection such as CMV
clinical characteristics of asthma exacerbation?
- tachypnea
- tachycardia
- diminished breath sounds
in a very severe asthma, will you hear wheezing?
no, b/c the air movement is so limited
treatments for severe asthma exacerbation whose FEV1 is less than 50% predicted?
- high dose beta agonist
- anticholinergic nebulizer every 20 min for 1 hr continuously
- systemic corticosteroid and oxygen to achieve O2 sat at least 90%
in what groups of ppl is an area of induration 10 mm or greater is considered a positive PPD for tuberculosis?
- health care workers
- homeless
- residents in developing countries
- chronic illness pt
image findings of asbestosis?
linear opacities at lung bases and interstitial fibrosis
image findings of silicosis?
eggshell calcification
what dz risk are you at with silicosis?
inc risk of TB
which pneumoconioses requires chronic corticosteroid treatment?
berylliosis
paraneoplastic symptoms of large cell carcinoma?
inc beta hCG –> gynecomastia and milky nipple discharge
