MKSAP Pulm IV Flashcards
Patients recommended for lung cancer screening are those aged ____ years with a greater than ____-pack-year history of tobacco use within the previous ___ years.
50 to 80; 20; 15
Patients with nonexertional (which consists of ____ ) heat stroke should be treated with evaporative cooling to lower their core temperature to a safe level.
Sprayed water and cooling fans
Cardiopulmonary resuscitation should be continued in patients with accidental hypothermia accompanied by cardiac arrest until the patient can be rewarded. Conventional treatment of ventricular arrhythmias and asystole is often ineffective until the temperature is raised to greater than 30.0 °C (86.0 °F). What are ways to rewarm (passive external rewarming, active external rewarming, internal rewarming)?
A critical first step entails removing wet clothing and covering the patient with insulating material, especially the head and neck. For mildly hypothermic, healthy individuals capable of shivering, this strategy of passive external rewarming alone suffices.
Active external rewarming using warm blankets or a forced heated air blanket is commonly used in hemodynamically stable patients with moderate hypothermia.
Body cavity lavage with warm fluids is an option for patients with hypothermia that is severe or does not respond to external rewarming.
Although the most important treatment of high-altitude cerebral edema is descent to lower elevation, ____ should be administered immediately upon recognition of high-altitude cerebral edema.
dexamethasone (acetazolamide can be used for ppx or adjunct but not monotherapy once symptoms occur)
Treatment of pulmonary sarcoidosis should be based on symptoms rather than radiographic findings.
Pulmonary sarcoidosis is classified based on the radiographic pattern: stage I, _____; stage II, hilar lymphadenopathy with abnormal lung parenchyma; stage III, no lymphadenopathy with abnormal lung parenchyma; and, stage IV, parenchymal changes with fibrosis and architectural distortion.
hilar lymphadenopathy with normal lung parenchyma (things can just be observed)
Patients can, however, have extrapulmonary disease, and screening electrocardiography, assessment of serum calcium, and eye examination are appropriate initial tests in this population.
Normal pCO2 on ABG
35-45 mmHg
pH cut off for low TV parameters
fine as long as pH does not go below 7.3
These strategies generally include limiting the tidal volume given in mechanical ventilation to 6 mL/kg of ideal body weight, limiting the plateau pressure in the respiratory cycle to no more than 30 cm H2O.
What is actigraphy and what is it used for?
An accelerometer that is worn like a wrist watch that helps measure sleep parameters and average motor activity
An empyema is defined as a bacterial infection of the pleural space that results in ____ or _____.
frank pus on visual inspection of the pleural fluid or a positive Gram stain.
What is the cut off for pleural fluid acidosis and what is it seen with?
pH less than 7.3; complicated parapneumonic effusions, tuberculous pleuritis, rheumatoid and lupus pleuritis, esophageal rupture, and malignancy
What is the cutoff for low pleural fluid glucose level?
Less than 60; A low pleural fluid glucose level results from either increased utilization within the pleural space (bacteria, malignant cells) or decreased transport into the pleural space (rheumatoid pleurisy)
A complicated parapneumonic effusion is defined as an effusion associated with a pneumonia that has a pH less than ___ and glucose less than ___.
7.2; 60
Complicated parapneumonic effusions occur when bacteria invade the pleural space. However, because bacteria may be cleared rapidly from the pleural space, the Gram stain is typically negative and cultures are usually sterile. So this is DIFFERENT than an empyema.
How long after do you wait to get PPSV23 after getting first dose of PCV13 it receiving it for a immunocompromised/cochlear implant/etc patient?
How long do you wait for a immunocompetent patient age 65?
8 weeks; 1 year
If patient has already received PPSV23, how long do they have to wait before getting PCV13?
1 year
There are two diagnostic criteria for CTEPH:
(1) mean pulmonary artery pressure of 25 mm Hg or higher by right heart catheterization in the absence of left heart pressure overload and (2) compatible imaging evidence of chronic thromboembolism. CT pulmonary angiography (CT-PA) may demonstrate proximally located abnormalities such as vascular webs, intimal irregularities, and luminal narrowing but has limited sensitivity in more distal lesions. Ventilation-perfusion scanning is a more sensitive indicator of CTEPH and is generally the preferred first imaging modality.
