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LUNG LUNG > important! > Flashcards

important! Flashcards

1
Q

Why will we hear crackles at the beginning of inspiration in patient with chronic bronchitis?

A

Due to opening of small collapsed airways

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2
Q

Hypoxia effect on vessels

A

vasoconstriction

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3
Q

Hypoxic vasoconstriction in lungs will lead to

A

Increase pulmonary vascular resistance and pulmonary HTN

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4
Q

Types of emphysema

A

Centriacinar- Smoking
Panacinar- a1-AT deficiency
Paraseptal

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5
Q

Chronic bronchitis definition

A

Productive cough on most days of the week for at least 3 months with total duration of 2 years

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6
Q

mMRC measures

A

Breathless scale 0-4

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7
Q

3 steps of combined COPD asessment

A

Spirometry to confirm diagnosis
Assessment of airflow limitation
Assessment of symp./risk of exacerbations

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8
Q

COPD non-pharmacological treatment

A 
Smokin cessation
Smoke prevention
Regular exercise
Rehabilitation
Oxygen therapy
NIV (CPAP)
Lung Volume Reduction Therapy
LuTx
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9
Q

Oxygent therapy- How long per day and what is the indication?

A

minimum 15h/d

PaO2 < 60 mmHg and <88% O2 saturation

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10
Q

COPD pharmacological treatment other than LABA LAMA ICS..

A

Influenza vaccine
Mucolytics
AB

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11
Q

Define COPD exacerbation

A

Acute worsening of respiratory symp. that result in need of additional therapy

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12
Q

How to assess the severity of an exacerbation?

A

Arterial blood gass
CXR (for alternative diagnosis)
ECG
WBC count

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13
Q

Systemic corticosteroids- What will we give, how much and for how long?

A

Prednisone
40 mg
5 days

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14
Q

Asthma severity classification

A

Mild intermittent
Mild persistent
Moderate persistent
Severe persistent

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15
Q

Special feature of PEF?

A

Daily variability > 20%

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16
Q

Anti IgE drug

A

Omalizumab

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17
Q

Clinical features of asthma exacerbation

A

Too breathless
Respiratory rate > 25/min
HR > 110 BPM
PEF < 50% of predicted normal or best

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18
Q

PEF value in life threatening situations

A

< 33%

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19
Q

Immediate management of asthma exacerbation

A

Oxygen
High dose Albuterol+Ipratropium
High dose systemic steroids

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20
Q

asthma exacerbation respiratory medicine lecture notes what to add

A

Nebulized ipratropium
IV MgSO4
IV bronchodilators

21
Q

Classification of pneumonia (pathology)

A

Bronchopneumonia
Lobar
Interstitial

22
Q

Stages of pneumonia (4)

A
  1. Congestion
  2. Red hepatization
  3. Grey hepatization
  4. Resolution
23
Q

Grey hepatization is due to

A

Break down of RBC

24
Q

Auscultation of pneumonia

A

Bronchial breathing sounds

25
Q

Tectile fermitus is pneumonia

A

Increased due to lungs being filled with fluids

26
Q

Bronchopneumonia on CXR

A

Patchy areas spread throughout the lung

27
Q

Interstitial pneumonia on CXR

A

Spread pattern throughout, especially concentrated in the perihilar regions

28
Q

Pneumonia specific pathogen - How can we recognise it?

A 
Sputum culture
Blood culture
Pleural fluid
Antigen detection
Serological test
29
Q

Which AB can we start if we suspect interstitial pneumonia?

A

Macrolides - Clarythromicine

30
Q

Hospital Aquired Pneumonia definition

A

Pneumonia that developes 48h post hospital admission

31
Q

Lung abscess are caused mainly by which bacterias?

A 
Fusobacterium
Prevotella
Strep
Staph
Klebsiella
32
Q

When can we say that a patient is free of TB infection?

A

3 sputum samples are negative

33
Q

Treatment for TB lasts

A

6-24 months

34
Q

ILD of known etiology caused by exposure is devided into 2

A

Organic- Hypersensitivity pneumonitis

Inorganic- Silicosis, Asbestosis

35
Q

Inorganic substances

A

Silicosis
Asbestosis
Berylliosis
Coal worker’s lung

36
Q

IIP is devided into

A

Idiopathic Pulmonary Fibrosis
Usual Interstitial Pneumonia
Acute Interstitial Pneumonia

37
Q

CXR in ILD

A

Reticular
Diffuse / Nodular bronchovascular
Reticulonodular or infiltrative pattern

38
Q

In IIP which is the most common?

A

IPF

39
Q

IPF drug

A

Nintedanib

40
Q

Sarcoidosis is most common in which populatons?

A

African american

Scandinevian

41
Q

Sarcoisosis symptoms

A

Hypoxemia
Heart blocks
Bells palsy
Erythema nodosum

42
Q

Sarcoidosis on HRCT

A

Ground glass appearance

43
Q

OSA definition

A

Total cessation of airflow > 10 sec

44
Q

Hypopnea=

A

shallow breathing or an abnormally low respiratory rate

45
Q

Apnea-Hypopnea Index is used to

A

Indicate the severity of sleep apnea

46
Q

AHI values

A

Normal: AHI<5
Mild sleep apnea: 5≤AHI<15
Moderate sleep apnea: 15≤AHI<30
Severe sleep apnea: AHI≥30

47
Q

Causes for OSA

A 
Obesity
Short neck
Alcohol
Diabetes
Tonsillitis
Macroglossia
Large uvula
Chronic URI
48
Q

Name of an intra-oral device that is given to OSA patients

A

Mandibular Advancement Device

49
Q

Why give CPAP/BPAP in OSA?

A

Airflow can prevent pharyngeal collapse

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