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PNCE > JB Pulm > Flashcards

JB Pulm Flashcards

1
Q

Acute bronchitis MCC

A

Adenovirus

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2
Q

Acute epiglottitis MCC, dx

A

Hib

laryngoscopy definitive

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3
Q

ARDS sx

A

Critically ill pts
severe refractory hypoxemia hallmark
CXR: bilateral pulmonary infiltrates (white out pattern), spares costophrenic angles

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4
Q

ARDS tx

A

intubation

BiPAP

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5
Q

Alpha 1 antitrypsin deficiency

A

linked to COPD in young adults

associated with pan lobular emphysema

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6
Q

Aspergillosis complication

A

Produces aflatoxin B1- increased risk of hepatocellular carcinoma

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7
Q

Aspergillosis dx

A

Increased IgE and eosinophilia if allergic

Bx: dusky necrotic tissue, septate hyphae

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8
Q

Aspergillosis tx

A

Allergic: CS, chest physiotherapy, itraconazole
Severe: voriconazole DOC, itraconazole, amphotericin B, caspofungin
Aspergilloma: surgical resection
Asx: observation

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9
Q

Asthma dx

A

PFT gold standard

12% improvement in FEV1 after SABA administration or 20% worse with methacholine challenge test

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10
Q

Asthma Tx

A

Acute: SABA anticholinergics, PO steroids
Chronic: ICS, LABA, ICS/LABA (Symbicort. Advair diskus)

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11
Q

Bacterial tracheitis sx

A

inspiratory stridor, deep/barking croup cough, post URI

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12
Q

Bronchiectasis dx

A

High resolution CT: TOC. tram tracking

signet ring sign

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13
Q

Chronic bronchitis PE

A

Chronic cough 6mo/2yrs. Obese w/ leg edema (blue bloaters)

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14
Q

Chronic bronchitis/COPD health maintenance

A

Vaccines: pneumococcal and flu

Acute exacerbation: azithromycin

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15
Q

Chronic bronchitis tx

A

Combo therapy: anticholinergics + B2 agonists
LABA + ICS
O2- decrease mortality

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16
Q

COPD tx

A

Oxygen- decrease mortality
Bronchodilators (anticholinergics/B2 agonists)
CS (ICS + LABA)
Abx w/ exacerbations

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17
Q

Cystic fibrosis sx

A

Young pt with bronchiectasis and recurrent respiratory infections.
Pancreatic insufficiency, steatorrhea, infertility. Meconium ileus at birth

17
Q

Cystic fibrosis sx

A

Young pt with bronchiectasis and recurrent respiratory infections.
Pancreatic insufficiency, steatorrhea, infertility. Meconium ileus at birth

18
Q

Cystic fibrosis labs

A 
Sweat chloride >60 on 2 occasions with pilocarpine
CXR: bronchiectasis
PFT: obstructive
DNS analysis: definitive 
Sputum cultures: pseudomonas
19
Q

Cystic fibrosis tx

A

airway clearance (bronchodilators, mucolytics, abx, decongestants)
pancreatic enzyme replacement (ADEK)
lung/pancreatic transplant
vaccines (flu and pneumococcal)

20
Q

emphysema tx

A

bronchodilators (anticholinergics + B2 agonist)
ICS+ LABA
O2

21
Q

Emphysema dx

A

Hyperinflation of lungs
Barrel chest
Respiratory alkalosis
pink puffer

22
Q

empyema dx

A

xray/CT confirm

thoracentesis TOC

23
Q

Flu vaccines

A

Given annually
Trivalent vaccine: CI if allergy to eggs, gelatin, or thimerosal
Intranasal (live): CI if preg or >50yo

24
Q

Legionella pneumonia sx

A

GI sx
increased LFT
hyponatremia

25
Q

Legionella pneumonia tx

A

Levoquin or azithromycin

26
Q

MC type of lung cancer

A

Adenocarcinoma

27
Q

Pertussis due to

A

Bordetella pertussis

28
Q

Pertussis sx

A

Catarrhal phase: URI sx 1-2 wks (contagious)
Paroxysmal phase: cough, inspiratory whoop
Convalescent phase

29
Q

Pertussis tx

A

supportive

Abx within 7d of sx onset. Macrolide (erythromycin/azithromycin), bactrim if allergic

30
Q

Pertussis dx

A

nasopharyngeal swab PCR gold standard

31
Q

Pleural effusion dx/tx

A

thoracentesis: TOC and gold standard

32
Q

MCC CAP

A

Pneumococcal pneumonia (Gram positive cocci in pairs)

33
Q

pneumococcal pneumonia tx

A

B lactam (ceftriaxone/amoxicillin/augmentin) + macrolide (azithromycin)

34
Q

Pneumocystis jiroveci pneumonia (PCP) tx

A

bactrim DOC, add prednisone if hypoxic
Sulfa allergy: dapsone-trimethoprim
PCP prophylaxis in HIV pts: bactrim when CD4 <200

35
Q

Pneumothorax PE

A

chest pain, hyper resonance

Tension: increased JVP, pulses paradoxus, hypotension

36
Q

Pneumothorax tx

A

tube thoracostomy

if shock: needle thoracostomy

37
Q

Pulmonary embolism PE

A

Homans sign

38
Q

Pulmonary embolism dx

A

Helical CT BIT

Angiogram gold standard

39
Q

Pulmonary embolism tx

A

Stable: anticoags or IVC filter
Unstable: thrombolytics or embolectomy

40
Q

Silicosis tx

A

supportive

41
Q

Smoke inhalation tx

A

100% O2 nonrebreather

PNCE (33 decks)

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