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Online Meded Pulm Flashcards

1
Q

Asthma Path

A

Reversible inflammation and bronchoconstriction

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2
Q

Asthma PT

A

SOB, wheezing, hyper resonant, prolonged expiration, Exposure to trigger, CBC eosinophilia, nasal polyps

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3
Q

Asthma DX

A 
PFT's 
FEV1/FVC decreased
Reversible with bronchodilators
Inducible with methacholine
Skin test = ID triggers
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4
Q

Asthma TX

A 
Beta-Agonist:
Short acting
Long acting (never alone)
Steroids:
Inhaled corticosteroid
Oral prednisone
Stabilizers:
Cromolyn
Leukotriene antagonist
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5
Q

Asthma FU

A

Avoid triggers

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6
Q

Chronic Asthma I TX

A

SABA (Albuterol)

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7
Q

Chronic Asthma II TX

A

SABA+ICS (Albuterol + Fluticasone)

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8
Q

Chronic Asthma III TX

A

SABA+ICS+LABA (Albuterol + Fluticasone + Formoterol/Salmeterol)

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9
Q

Chronic Asthma IV TX

A

SABA+ HD ICS+LABA (Albuterol + HD Fluticasone + Formoterol/Salmeterol)

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10
Q

Asthma Exacerbation Path

A

Exposure to trigger

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11
Q

Asthma Exacerbation PT

A

HX of asthma, SOB, wheezing

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12
Q

Asthma Exacerbation DX

A

Clinical, Peak flow (X-ray to RO maybe, PFT’s usually not done)

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13
Q

Asthma Exacerbation TX

A

IV Methylprednisolone, Albuterol + Ipatropium, Steroid taper

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14
Q

Asthma Exacerbation FU

A

‘stops wheezing” or”CO2 rising” then intubate

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15
Q

Lung Cancer Path

A

Smoking, Toxic Exposure

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16
Q

Lung Cancer PT

A

Weight loss, Hemoptysis, Dyspnea, Pleural Effusion (tap that shit)

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17
Q

Lung Cancer DX

A 
1st: CXR then CT scan
Best BX: 
percutaneous if peripheral
Endoscopic Ultra Sound if proximal
VATS if in the middle
Lobectomy
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18
Q

Lung Cancer TX

A

Diagnose, Stage
PFT’s (can they tolerate surgery?)
Surgery vs. Chemo

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19
Q

Lung Cancer FU

A 
Annual low-dose CT scan 
Cancer Screen if:
Smoker within 15 yrs.
55-80 yr.
greater than 30 pack year history
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20
Q

Small Cell Cancer Path

A

Smoking

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21
Q

Small Cell Cancer PT

A

Sentral (Central) Mass
Paraneoplastic Syndrome
SIADH = HypoNA
ACTH = Cushing’s

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22
Q

Small Cell Cancer DX

A

Bronch/EUS

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23
Q

Small Cell Cancer TX

A

Chemo

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24
Q

Squamous Cell Lung Cancer Path

A

Smoking

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25
Squamous Cell Lung Cancer PT
Sentral (Central) Mass Paraneoplastic Syndrome PTH-rp = HyperCA
26
Squamous Cell Lung Cancer DX
Bronch/EUS
27
Squamous Cell Lung Cancer TX
Resection | Chemo, Radiation
28
Adenocarcinoma Path
Asbestosis (Cancer that NON smokers get)
29
Adenocarcinoma PT
Peripheral mass | Pleural Plaques
30
Adenocarcinoma DX
Percutaneous BX
31
Adenocarcinoma TX
Chemo/Rads
32
Carcinoid Tumor Path
Serotonin
33
Carcinoid Tumor PT
Wheezing, Flushing, Diarrhea
34
Carcinoid Tumor DX
5-HIAA in the urine
35
Carcinoid Tumor TX
Resection
36
Pleural Effusion Path
Transudate: "fluid" Increased Hydrostatic = CHF Decreased Oncotic = Cirrhosis, Nephrosios Exudate: "stuff" Increased permeability = TB, Cancer, Pna
37
Pleural Effusion PT
Exertional Dyspnea, Orthopnea, (Incidentally found on X-ray)
38
Pleural Effusion DX
``` In order 1st: CXR Decubitus CXR (or ultrasound) Thoracentesis (not loculated) OR Thoracostomy (loculated) OR Thoracotomy (empyema) BEST: BX, Gram Strain, Cytology ```
39
Pleural Effusion TX
If CHF, do NOT tap just diuresis | If no CHF, tap then treat accordingly to the underlying diagnosis
40
Thoraprocedures: Thoracentesis
Needle in Chest
41
Thoraprocedures: Thoracostomy
Chest tube in the chest
42
Thoraprocedures: Thoracotomy
Hole cut in the chest
43
Light's criteria to determine exudate
LDH > 200 LDH fluid : LDH serum > 0.6 TP fluid : TP serum > 0.5 Any one signifies an exudate
44
Effusion WU cell count w/ diff
Infection
45
Effusion WU Gram Stain
Infection
46
Effusion WU culture
Infection
47
Effusion WU AFB Smear
TB
48
Effusion WU Adenosine Deaminase
TB
49
Effusion WU Cytology
Cancer
50
Effusion WU TP
Light's
51
Effusion WU LDH
Light's
52
Effusion WU RBC
Hemothorax
53
Effusion WU Amylase
Chylothorax
54
DVT/PE Path
Virchow's triad Endothelial injury Venous Stasis Hypercoagulability
55
DVT/PE PT
Unilateral leg swollen than the other >2cm | Pain, Erythema, swelling
56
DVT/PE DX
Ultrasound
57
DVT/PE TX
Anticoagulation (LMWH to Coumadin)
58
DVT/PE FU
INR 2-3
59
PE Path
DVT embolizes to lung
60
PE PT
wedge infarct = hemoptysis, dyspnea Pulmonary HTN = heart strain Ischemia = Pleuritic chest pain V/Q mismatch = Hypoxemia and dyspnea, tachycardia, tachypnea, hypoxia, hypocapnia
61
PE DX
1st: D-dimer to rule out (clinic) Best: Spiral CT (CT chest IV contrast) Alt: V/Q scan in creatinine compromised
62
PE TX
IVF, O2, anticoagulation heparin to Coumadin bridge (5 days LMWH or therapeutic INR 2-3) tPA if massive IVC filter only if anticoagulation is contraindicated
63
PE FU
ABG: low O2, Low CO2, high pH ECG: S1, Q3, T3 CXR: Negative Well's criteria
64
Well's Criteria Scoring
``` ZOMFG I DONT KNOW = 3 DVT = 3 HR > 100 = 1.5 Immobilization = 1.5 Surgery w/1 4 weeks= 1.5 h/o DVT or PE = 1.5 Hemoptysis = 1 Malignancy = 1 ```
65
V/Q and D Dimer Interpretation
6 (High prob)....V/Q OPK
66
Wells Criteria determining score
equal or less than 4, DONT DO IT | Great than 4, Scan that bad boy
67
COPD Path
Emphysema and Bronchitis | Genetics and Smoking
68
COPD Pink Puffer PT
``` Pink Puffer = emphysema = trapped air hyperresonant increased AP diameter, flatten diaphragm Pursed Lips, prolonged expiration CO2 retainer ```
69
COPD Blue Bloater PT
``` Blue Bloater = Bronchitis = hypoxia cyanotic Pulmonary HTN Right heart failure Hepatosplenomegaly Peripheral Edema ```
70
COPD DX
PFT: decreased FEV1/FVC, Irreversible | CXR : Flattened Diaphragm
71
COPD TX
``` Corticosteriods = ICS then Oral Prednisone Oxygen = PaO2 ```
72
COPD Escalation of therapy
``` In Order Saba Saba + Tiotropium SABA + Tiptropium + ICS SABA + Tiptropium + ICS + LABA Saba + Tiptropium + ICS + DPE-4-inhibitor add steriods ```
73
COPD Exacerbation Path
Infectious (viral or bacterial)
74
COPD Exacerbation PT
Cough, SOB, Productive sputum, Wheezing, CO2 retention
75
COPD Exacerbation DX
1st: CXR (rule out pneumonia) | ABG = CO2 retention
76
COPD Exacerbation TX
CO2 = Bipap Albuterol and Ipatropium Oral or IV Steriods ABX = Doxycyline or Azithromycin
77
COPD Exacerbation FU
Intubate if CO2 rises
78
ARDS Path
Non-cardiogenic pulmonary edema
79
ARDS PT
TRALI, Gram neg rods, near-drowning Bilateral fluffy infiltrates on CXR Pulmonary Edema
80
ARDS DX
ARDS Criteria | P/F ratio
81
ARDS TX
``` Intubation PEEP Low Tv Oxygenation Paralysis ```
82
ARDS FU
Fix the underlying disease
83
Sarcoid Path
Autoimmune, infiltrating disease
84
Sarcoid PT
Young, African American woman Bilateral Hilar Lymphadenopathy E-Nodosum
85
Sarcoid DX
1st: CXR = B hilar Lymph then : PFT = restrictive disease BEST: BX = Noncaseating Granuloma
86
Sarcoid TX
Predinsone
87
Asbestosis Path
Inhaled , non-degradable material
88
Asbestosis PT
Construction worker, Shipyard industry, Lung cancer or Interstitial lung disease
89
Asbestosis DX
1st: CXR = Pleural Plaques BEST: BX Barbell Bodies
90
Asbestosis TX
Smoking Cessation
91
Asbestosis FU
High risk for adenocarcinoma

Lungs (2 decks)

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