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cardio and pulm > LA pulm 3 > Flashcards

LA pulm 3 Flashcards

FB aspiration, pleural effusion, pneumothorax, pulm HTN, ARDS, sleep apnea

1
Q

what differentiates costochondritis from Tietze syndrome

A

Tietze syndrome has the presence of palpable edema

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2
Q

most common foreign body aspirated in children

A

peanuts

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3
Q

what is mean age for FB aspiration and why

A

2 years, no molars

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4
Q

complications include bronchiectasis, pneumonia, lung abscess, atelectasis

A

FB aspiration

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5
Q

definitive dx test for FB aspiration

A

rigid bronchoscopy, therapeutic as well sometimes

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6
Q

what is the parapneumonic type of pleural effusion

A

non infected pleural effusion, secondary to bacterial pneumonia

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7
Q

what is the empyema type of pleural effusion

A

direct infection of pleural space, purulent

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8
Q

what is the hemothorax type of pleural effusion

A

gross blood; trauma or malignancy

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9
Q

what is the chylothorax type of pleural effusion

A

increased lymph, persistent turbidity after centrifuge

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10
Q

most common type of pleural effusion

A

transudative; CHF most common

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11
Q

nephrotic syndrom, cirrohosis, atelectasis, hypoalbuminemia

A

think transudative pleural effusion due to increased hydrostatic pressure or decreased oncotic pressure

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12
Q

Pulmonary emboli and malignancy in pleural effusion

A

usually exudative

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13
Q

percussion, fremitus, breath sounds in a pleural effusion

A

all decreased, dullness

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14
Q

blunting of costophrenic angles/meniscus sign

A

CXR in pleural effusion

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15
Q

best film for pleural effusion

A

lateral decubitus

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16
Q

gold standard for pleural effusion from thoracentesis

A

lights criteria
1. pleural fluid protein : serum protein > 0.5 or
2. pleural fluid LDH : serum LDH >0.6 or
3. pleural fluid LDH >2/3 the upper limit of normal LDH

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17
Q

primary vs secondary pneumothorax

A

primary is idiopathic

secondary is underlying lung disease

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18
Q

percussion, fremitus, breath sounds in a pneumothorax

A

hyperresonance, decreased fremitus/breath sounds

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19
Q

what type of CXR(position)

A

expiratory upright view

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20
Q

companion lines

A

visceral pleural line running parallel with ribs; pneumothorax

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21
Q

pulm HTN is what pressure

A

elevated mean pulmonary arterial pressure >20

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22
Q

BMPR2 gene defect

A

primary pulm htn

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23
Q

pulm HTN auscultation

A

accenuated S2.

24
Q

definitive dx in pulm HTN

A

right heart cath is gold standard

25
Q

labs: polycythemia with increased hematocrit

A

pulm HTN

26
Q

what percentage of PE arise from deep vein in legs

A

70%

27
Q

most common sign of a PE

A

tachypnea

28
Q

most common abnormal finding in PE

A

atelectasis

29
Q

westermark sign

A

avascular markings distal to the PE

30
Q

hamptons hump

A

wedge shaped infiltrate due to PE infarction

31
Q

EKG: nonspecific ST/T changes and sinus tachycardia

A

PE

32
Q

S1Q3T3

A

most specific for PE

wide deep S wave in lead 1
isolated q and t wave inversion in lead 3

33
Q

abg in PE

A

initally respiratory alkalosis and hypoxemia.

respiratory acidosis occurs with more time

34
Q

d dimer and PE

A

only helpful if negative and low suspicion for PE

35
Q

best initial test for PE

gold standard

A

helical(spiral) CT angiography

pulm angiography gold standard

36
Q

PE tx if hemodynamically unstable

A

thromobolytic tx: LMWH

37
Q

PE tx if hemodynamically stable

A

IV unfractionated heparin 3 months or LMWH

38
Q

antidote for LMWH

A

protamine sulfate

39
Q

PTT for what

A

monitor unfractionated heparin

40
Q

avoid LMWH in who

A

renal failure,thombocytopenia

41
Q

major complication with unfractionated heparin

A

heparin induced thombocytopenia

42
Q

ARDs and high mortality rate why

A

acute hypoxemic respiratory and organ failure

43
Q

hypoxemia without hypercarbia

A

ARDs

44
Q

what kinds of pts at risk for ARDs

A

gram neg sepsis most common. critically ill pts

45
Q

CXR: bilateral diffuse pulm infiltrates, spares costophrenic angles

similar to what?

A

ARDs

CHF does not spare the angles

46
Q

PCWP < 18 and > 18

A

< 18 is ARDs
>18 is cardio pulm edema

47
Q

tx of ARDs

A

CPAP, PEEP, and low tidal volume

48
Q

sleep apnea sleep study positive with what

lab

A

15 or more events/hour

polycythemia(due to chronic hypoxemia)

49
Q

cheyne stokes

A

cyclic breathing in response to hypercapnia leading to decreased brain blood flow/ increase then decrease in respirations

50
Q

biots breathing

A

irregular respirations with irregular periods of apnea: due to damage of medulla oblongata or opioid use

51
Q

kussmaul respiration

A

hyperpnea; deep, rapid, continuous respirations due to metabolic acidosis.

52
Q

CXR: bilateral diffuse reticular(ground glass) opacities and air bronchogram

A

neonatal respiratory distress syndrome

53
Q

neonatal respiratory distress syndrome tx

A

exogenous surfactant via endotracheal tube to open alveoli, continuous CPAP

54
Q

CXR: coarse, irregular infiltrates with lung hyperinflation

A

meconium aspiration

55
Q

signs of respiratory distress after birth(post term), cyanosis, tachypnea

A

meconium aspiration

cardio and pulm (22 decks)

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