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Lungs > Online Meded Pulm > Flashcards

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
Q

Squamous Cell Lung Cancer PT

A

Sentral (Central) Mass
Paraneoplastic Syndrome
PTH-rp = HyperCA

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26
Q

Squamous Cell Lung Cancer DX

A

Bronch/EUS

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27
Q

Squamous Cell Lung Cancer TX

A

Resection

Chemo, Radiation

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28
Q

Adenocarcinoma Path

A

Asbestosis (Cancer that NON smokers get)

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29
Q

Adenocarcinoma PT

A

Peripheral mass

Pleural Plaques

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30
Q

Adenocarcinoma DX

A

Percutaneous BX

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31
Q

Adenocarcinoma TX

A

Chemo/Rads

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32
Q

Carcinoid Tumor Path

A

Serotonin

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33
Q

Carcinoid Tumor PT

A

Wheezing, Flushing, Diarrhea

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34
Q

Carcinoid Tumor DX

A

5-HIAA in the urine

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35
Q

Carcinoid Tumor TX

A

Resection

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36
Q

Pleural Effusion Path

A

Transudate: “fluid”
Increased Hydrostatic = CHF
Decreased Oncotic = Cirrhosis, Nephrosios
Exudate: “stuff”
Increased permeability = TB, Cancer, Pna

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37
Q

Pleural Effusion PT

A

Exertional Dyspnea, Orthopnea, (Incidentally found on X-ray)

38
Q

Pleural Effusion DX

A 
In order
1st: CXR
Decubitus CXR (or ultrasound)
Thoracentesis (not loculated) OR Thoracostomy (loculated) OR Thoracotomy (empyema)
BEST: BX, Gram Strain, Cytology
39
Q

Pleural Effusion TX

A

If CHF, do NOT tap just diuresis

If no CHF, tap then treat accordingly to the underlying diagnosis

40
Q

Thoraprocedures: Thoracentesis

A

Needle in Chest

41
Q

Thoraprocedures: Thoracostomy

A

Chest tube in the chest

42
Q

Thoraprocedures: Thoracotomy

A

Hole cut in the chest

43
Q

Light’s criteria to determine exudate

A

LDH > 200
LDH fluid : LDH serum > 0.6
TP fluid : TP serum > 0.5
Any one signifies an exudate

44
Q

Effusion WU cell count w/ diff

A

Infection

45
Q

Effusion WU Gram Stain

A

Infection

46
Q

Effusion WU culture

A

Infection

47
Q

Effusion WU AFB Smear

A

TB

48
Q

Effusion WU Adenosine Deaminase

A

TB

49
Q

Effusion WU Cytology

A

Cancer

50
Q

Effusion WU TP

A

Light’s

51
Q

Effusion WU LDH

A

Light’s

52
Q

Effusion WU RBC

A

Hemothorax

53
Q

Effusion WU Amylase

A

Chylothorax

54
Q

DVT/PE Path

A

Virchow’s triad
Endothelial injury
Venous Stasis
Hypercoagulability

55
Q

DVT/PE PT

A

Unilateral leg swollen than the other >2cm

Pain, Erythema, swelling

56
Q

DVT/PE DX

A

Ultrasound

57
Q

DVT/PE TX

A

Anticoagulation (LMWH to Coumadin)

58
Q

DVT/PE FU

A

INR 2-3

59
Q

PE Path

A

DVT embolizes to lung

60
Q

PE PT

A

wedge infarct = hemoptysis, dyspnea
Pulmonary HTN = heart strain
Ischemia = Pleuritic chest pain
V/Q mismatch = Hypoxemia and dyspnea, tachycardia, tachypnea, hypoxia, hypocapnia

61
Q

PE DX

A

1st: D-dimer to rule out (clinic)
Best: Spiral CT (CT chest IV contrast)
Alt: V/Q scan in creatinine compromised

62
Q

PE TX

A

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
Q

PE FU

A

ABG: low O2, Low CO2, high pH
ECG: S1, Q3, T3
CXR: Negative
Well’s criteria

64
Q

Well’s Criteria Scoring

A 
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
Q

V/Q and D Dimer Interpretation

A

6 (High prob)….V/Q OPK

66
Q

Wells Criteria determining score

A

equal or less than 4, DONT DO IT

Great than 4, Scan that bad boy

67
Q

COPD Path

A

Emphysema and Bronchitis

Genetics and Smoking

68
Q

COPD Pink Puffer PT

A 
Pink Puffer = emphysema = trapped air
hyperresonant
increased AP diameter, flatten diaphragm 
Pursed Lips, prolonged expiration 
CO2 retainer
69
Q

COPD Blue Bloater PT

A 
Blue Bloater = Bronchitis = hypoxia
cyanotic
Pulmonary HTN
Right heart failure
Hepatosplenomegaly
Peripheral Edema
70
Q

COPD DX

A

PFT: decreased FEV1/FVC, Irreversible

CXR : Flattened Diaphragm

71
Q

COPD TX

A 
Corticosteriods = ICS then Oral Prednisone 
Oxygen = PaO2
72
Q

COPD Escalation of therapy

A 
In Order
Saba
Saba + Tiotropium
SABA + Tiptropium + ICS
SABA + Tiptropium + ICS + LABA
Saba + Tiptropium + ICS + DPE-4-inhibitor
add steriods
73
Q

COPD Exacerbation Path

A

Infectious (viral or bacterial)

74
Q

COPD Exacerbation PT

A

Cough, SOB, Productive sputum, Wheezing, CO2 retention

75
Q

COPD Exacerbation DX

A

1st: CXR (rule out pneumonia)

ABG = CO2 retention

76
Q

COPD Exacerbation TX

A

CO2 = Bipap
Albuterol and Ipatropium
Oral or IV Steriods
ABX = Doxycyline or Azithromycin

77
Q

COPD Exacerbation FU

A

Intubate if CO2 rises

78
Q

ARDS Path

A

Non-cardiogenic pulmonary edema

79
Q

ARDS PT

A

TRALI, Gram neg rods, near-drowning
Bilateral fluffy infiltrates on CXR
Pulmonary Edema

80
Q

ARDS DX

A

ARDS Criteria

P/F ratio

81
Q

ARDS TX

A 
Intubation 
PEEP
Low Tv
Oxygenation 
Paralysis
82
Q

ARDS FU

A

Fix the underlying disease

83
Q

Sarcoid Path

A

Autoimmune, infiltrating disease

84
Q

Sarcoid PT

A

Young, African American woman
Bilateral Hilar Lymphadenopathy
E-Nodosum

85
Q

Sarcoid DX

A

1st: CXR = B hilar Lymph
then : PFT = restrictive disease
BEST: BX = Noncaseating Granuloma

86
Q

Sarcoid TX

A

Predinsone

87
Q

Asbestosis Path

A

Inhaled , non-degradable material

88
Q

Asbestosis PT

A

Construction worker, Shipyard industry, Lung cancer or Interstitial lung disease

89
Q

Asbestosis DX

A

1st: CXR = Pleural Plaques
BEST: BX Barbell Bodies

90
Q

Asbestosis TX

A

Smoking Cessation

91
Q

Asbestosis FU

A

High risk for adenocarcinoma

Lungs (2 decks)

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