ILD ALV Clinical correlations Flashcards
What are the 3 types of lung sounds?
Wheeze
Crackle
Ronchi
What are causes of Interstitial Infiltrates?
SHITFACED
Sarcoid
Hypersensitive pneumonitis
Interstitial lung disease
Tumor/TB
Fungal
Asbestos
Collagen Vascular Disease/CA
Eosinophilic granuloma
Drugs (Nitrofurantoin most commonly)
Why do Transbronchial biopsy vs. Open Lung Biopsy?
What is seen in either for Sarcoidosis?
1 in 500 pts. with chest tube versus 1 in 1
Transbronchial biopsy: Well circumscribed, non-necrotizing epithelioid cell granuloma w/ multinucleate giant cells
Open lung biopsy: Granulomas w/ “lymphatic” distribution pattern- discrete, well circumscribed and following bronchovascular bundles and interstitial septa
What are the different stages of Sarcoid and what is seen?
Stage I: Potato nodes, hilar adenopathy, bilaterally. On Lateral CXR: Jumbo Shrimp (JUST NODES)
Stage II: Paratracheal adenopathy, scratchy lungs (NODES AND LUNGS)
Stage III: No nodes, Scratchy lungs (JUST LUNGS)
Stage IV: Total fibrosis of the lungs
What do you check for in patients with sarcoid?
Eyes
Heart
Kidney stones
What is seen on CXR for ARDS?
Fluffy lungs
What do fluffy lungs mean?
What cause Alveolar infiltrates?
Consolidation: any pathologic process that fills the alveoli.
PeCanPIE
Pus
Cells (RBC, Eosinophils, tumors)
Protein
Inflammatory (know BOOP/COP)
Edema
What is the Berlin Criteria for ARDS?
ARDS: Mild-moderate-severe by ABG while on Peep>or= 5 cm H2O
Timing: acuteness, <7 days
Fluid overload assessed by clinical judgement: Echo if no risk factor
CXR or CT findings-bilateral infiltrates
What to do for ARDS?
6 ml/kg PBW for Tidal volume, not 12
Peep, increase b/w 15-20, settled on 16
Conservative fluid: 2 less days on ventilation
Prone position for people with severe ARDS
Paralysis (cisatracurium)
Choose PEEP
Beta agonist in OLD
Surfactant in Neonates
No Statins or omega 3 FA in the water
