Inpatient EOR - Pulm Flashcards
asthma dx
FEV1/FEV <0.7, imrpove w/ bronchodilator
asthma stepwise tx
- saba prn
- low-med ICS
- med-high ICS+LABA
- high ICS+LABA+oral steroid
daily chronic cough with smelly discharge/hemoptysis - dx and tx
brochectasis (dx on CT)
tx
FQ, zosyn for psuedomonas
CCS+itraconazole for aspergillus
clarith+ethambutol for MAC
flu and prevnar vax
beta agonist, fluctiasone
signet ring sign
for brocnhectasis, a pulm artery with dilaeted bronchus
localized wheeze and a hormone being secreted (resulting in cushings, SIAD)
carcinoid tumor- neuroendocrine, made of enterochromaffin cells
carcinoid tumor tx
excision, octreotide reduces hormones screted
copd tx
ipratoprim and albuterol
MC acute cause of cor pulmonale
PE
EKG finding cor pulmonale
peaked P waves
hilar LAD, dry cough, erythema nodosum dx
sarcoid
MC Ca death in both sexes
lung ca
lambert-eaton syn
weakness like MG that imrpoves with use, a/w small cell carcnoma
pancoast syndrome
shoulder pain, horner syn, atrophy of hands/arm, a/w suamous cell cacrinoma
what type of lung ca is best a/w hemoptysis
small/oat cell
what type of lung ca is peripheral as opposed to central (in terms of loc)
adenocarcinoma (MC type in smokers and overall in non-smokes)
what type of lung Ca is a/w gyncomastia
adenocarcinom
who should be screened for lung Ca
55+ with 30 pack yr hx, quit <15 y ago
a small lesion in lung <3cm is called a ___ ; what are it’s possibly etiologies
nodule.
infxn: TB, histo, coccidio
tumor: thymoma, benign, malig
inflam: RA, sarcoid
XR finding and PFT finding for pulm fibrosis
honeycombing, ground glass opacity
normal or increased FEV1/FVC
3 abcess forming PNA organiams
kleb, anarobes, S.aureus
rusty sputum
strep pnuemo PNA
tx: typical PNA
MC: S. pneumo
inpt: FQ + macrolide
outpt: macrolide or doxy
tx: atypical PNA
could be viral - no tx
M. pnuemo: erthromycin or doxy
(erythro for the ear)
Chylamydia: tetracycline
tx: aspiration PNA
clinda or Zosyn
tx: hospital PNA
pseudomonas or MRSA
FQ + betalactam
+ vanc if suspect MRSA
+ levoflox/azithro if sus legionella
+bactrim & CCS is sus PJP
what kind of PNA is a/w elevated LFT
Legionella
where in lung would you expect to see a consolidation for anarobic PNA
RLL
pulmonary arterial pressure qualification for dx of pulm HTN
> 25 at rest, 30 with exercise
CBC lab with pulm HTN
polycythemia
pulm HTN tx - if vasoreactive
CCB
pulm HTN tx - not vasoreactive
prostacyclin (epoprostenol, iloprost), PDE51, O2
define primary and secondary pulm htn
primary-idiopathic (BMPR2)
2ndary- LHF, COPD/PE (arterioles shunt away and ^HTN)
