Internal med pulmonology Flashcards
etiology of acute bronchitis
viral or bacterial
s/s of acute bronchitis
- cough
- substernal pain
- wheezing
- rhonchi
- fever
- SOB
diagnosis of acute bronchitis
clinical
treatment of a cute bronchitis
symptomatic
chronic bronchitis
chronic productive cough for 3 months in each of two successive years in a patient whom other causes of chronic cough have been excluded
asthma
reversible obstructive lung disease caused by increased reaction of the airways to various stimuli or triggers
etiology of asthma
eosinophilic
s/s of asthma
- SOB
- chest tightness
- cough
- wheezing
diagnosis of asthma
- children: ratio below 85% and fev or fvc >12% improved post bronchodilator
- adults: ratio below 70% and fev or fvc >12% and 200mL
treatment of asthma
start with SABA, then ICS, then LABA
mild intermittent asthma
- symptoms <2 days per week
- use of SABA <2 times per week
- ratio is normal
- no interference with normal activities
mild persistent asthma
- symptoms more than 2 weekly
- use of SABA >2 times a week
- minor interference with normal activities
moderate persistent asthma
- daily symptoms
- daily use of SABA
- some limitation of normal activities
severe persistent asthma
- symptoms throughout the day
- need for SABA several times per day
- extreme limitation of normal activities
bronchiectasis
dilation of the bronchi
s/s of bronchiectasis
- chronic cough
- purulent sputum in copious amounts
- repeated respiratory infections
treatment of bronchiectasis
- Antibiotics
- Bronchodilators
- Chest physiotherapy
- Treatment of primary condition
s/s of bronchial carcinoid tumor
- rarely metastasizes
- hemoptysis
- cough
- wheezing
carcinoid syndrome
- flushing
- diarrhea
- wheezing
- hypotension
diagnosis of bronchial carcinoid tumor
pink/purple tumor on bronchoscopy
management of bronchial carcinoid tumor
surgical excision
Cor pulmonale
right heart failure due to increased pressure in lungs leading to peripheral edema caused by COPD
(so COPD causes increased lung pressure causes peripheral edema and right sided heart failure)
s/s of idiopathic pulmonary fibrosis
- gradual onset of exertional dyspnea
- nonproductive cough
- fine inspiratory rales/crackles
- restrictive on PFT
diagnosis of idiopathic pulmonary fibrosis
alternating areas of healthy lung, interstitial inflammation, fibrosis, and honeycomb change
management of idiopathic pulmonary fibrosis
- tyrosine kinase inhibitor
- anti-inflammatory
etiologies of pneumoconiosis
- coal workers
- silicosis
- asbestosis
s/s of coal workers pneumoconiosis
- diminished lung function
- small rounded opacities on upper half of lungs
s/s of silicosis
- cough
- SOB
- pleuritis CP
- weight loss
- fatigue
diagnosis of silicosis
small nodules scattered diffusely
s/s of asbestosis
- DOE
- bibasilar inspiratory crackles
diagnosis of asbestosis
- pleural plaques
- asbestos on lavage
treatment for pneumoconiosis
supportive
MC etiology of pneumonia
strep pneumo
s/s of pneumonia
- fever
- shaking chills
- SOB
- purulent cough
- CP
- crackles
diagnosis of pneumonia
CXR
treatment of pneumonia
- outpatient low risk: amoxicillin, doxy, or azithromycin
- outpatient high risk: rocephin + azithromycin or levaquin
- inpatient non-ICU: rocephin + azithromycin or levaquin
- inpatient ICU: rocephin + levaquin
goal mPAP
10-18mmHg
definition of pulmonary HTN
mPAP >20
WHO classifications of pulmonary HTN
- 1: idiopathic
- 2: due to left heart disease
- 3: due to lung disease
- 4: thromboembolism
- 5: miscellaneous
s/s of pulmonary HTN
- malaise
- fatigue
- dyspnea
- JVD
- 3rd heart sound
- nonproductive cough
diagnosis of pulmonary HTN
swan ganz
classifications of pulmonary HTN
- NYHA 1: no sx
- NYHA 2: slight limitation of activity
- NYHA 3: marked limitation of activity
- NYHA 4: unable to perform activity without symptoms
treatment of pulmonary HTN
- NYHA 1: monotherapy
- NYHA 2/3: endothelin + PDE5, add on guanylate cyclase and prostaglandin
- NYHA 4: add on parenteral prostanoid
s/s of solitary pulmonary nodule
- <3cm
- isolated and round
diagnosis of solitary pulmonary nodule
CT
malignant vs benign characteristics of solitary pulmonary nodule
- malignant: subsolid, ill-defined, spiculated, halo, fast growth, stippled, eccentric
- benign: solid, smooth and well defined, dense calcification,
treatment of solitary pulmonary nodule
- > 30mm: resection
- <30mm: risk calculator
characteristics of small cell lung cancer
- smokers
- central
characteristics of adenocarcinoma
- slow growing
- periphery
- nonsmokers
characteristics of squamous cell carcinoma
- central
- smokers
characteristics of large cell carcinoma
- rapidly growing
- peripheral
etiology of hypoventilation syndrome
- COPD
- neuromuscular disorders
- drugs
