Obstructive Lung Disease CIS III Flashcards
42yo M asthma since childhood, smokes marijuana, exercise induced dyspnea, elevated temp, thick brown cords of phlegm, Dx of pneumonia with azithromycin - no benefit, WBC 35% eosinos, X-ray diffuse pulmonary infiltrates
most likely diagnosis
-acute bronchopulmonary aspergillosis
pneumococcal pneumonia
rust colored sputum
high fever, chills
tuberculosis
night sweats
weight loss
fever chills
positive PPD
chronic cough
wegners granulomatosis
sinusitis, kidney and lung sx
35yo women, urticaria, SOB, wheezing, asthma, stabilized with epi and antihistamine, no known food allergies
small bilateral nasal polyps
urticaria = hives
most likely cause of her reaction
-sensitivity to ASA or NSAIDs
-other clues - nasal polyps
aspirin triad
samters
asthma
nasal polyps
ASA/NSAID sensitive
scombroid poisoning
rxn to eating decayed fish
histadine - causes histamine rxn
32yo white F ranch hand, COPD sx, hypoxia, prolonged expiratory phase of respiration, poor FEV1, never smoked, fam hx of early emphysema
evaluate for - alpha 1 antitrypsin deficiency
23yo F hx asthma, wakes up 1 week with sx, inhaler 4x/week
asthma classification
mild persistant
42yo F, coughing, wheezing, SOB, past 2 months, sins spill glacial acetic acid, frequent cough, chest tightness, awakening with SOB, decreased FEF25-75 at 45%, improves with albuterol
most likely diagnosis
- reactive airway dysfunction syndrome
- RADS
44yo F progressive dyspnea, since oophorectomy, thyroid supps, hormone therapy, eye drops glaucoma, no smoking, fam hx hay fever, slender nervous women with wheezing, FEF25-75 45% predicted
most likely cause - beta blocker induced asthma
-eye drops for glaucoma
psychological dyspnea - diagnosis of exclusion
22yo M, asthma hx, cannot control, 2 episodes of pneumonia, brownish mucous plugs
inspiratory crackles, gloved finger shadow
IgE serum elevated
most appropriate therapy
-prednisone
aspergillosis - dx
antifungals
amphotericin B
casopfungin
fluconazole
allergic bronchopulmonary aspergillosis
asthmatics in CF patients from hypersensitivity to aspergillus colonization
fever and pulmonary ilfiltrates
-unresponsive to antibacterial therapy
cough, produce mucous plugs, possible hemoptysis
poorly controlled asthmatics with difficulty tapering off oral corticosteroids
65yo F, quit smoking 10 years ago, 24 hour O2, increasing SOB, bedridden, no fever/chills/shakes/SOB/chest pain
O2 sat 69%, heart RRR, EKG normal, FEV1 18% predicted
next appropriate step
-refer for lung transplant**
