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Clin Med Pulm > Others > Flashcards

Others Flashcards

1
Q

Cor Pulmonale Etiology

A
  • Enlarged RV resulting from pulm HTN (due to lung disease)
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2
Q

Cor Pulmonale Pathophys

A
  • RV dilation and hypertrophy

- R heart failure

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3
Q

Cor Pulmonale Sx

A
  • Chronic, slow progressing
  • Peripheral edema
  • SOB
  • JVD
  • Hepatomegaly
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4
Q

Cor Pulmonale Dx

A
  • CXR: widening of pulm arteries

- EKG: flat or inverted T waves

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5
Q

Cor Pulmonale Tx

A
  • Treat hypoxemia/acidosis: O2, diuretics, vasodilators

- Surgery: VAD, transplant

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6
Q

Pulmonary HTN Etiology

A
  • Hypoxia
  • Acidosis
  • Emphysema
  • PE
  • Sickle cell
  • Mitral stenosis
  • LV Failure
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7
Q

Pulmonary HTN Pathophys

A
  • Vasoconstriction in pulm arteries
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8
Q

Pulmonary HTN Sx

A
  • SOB
  • Cough
  • CP
  • Hemoptysis
  • Fatigue
  • Syncope
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9
Q

Pulmonary HTN Dx

A
  • R heart cath

- ECHO

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10
Q

Pulmonary HTN Tx

A
  • O2, diuretics, anticoagulant, exercise
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11
Q

Pleural Effusion RF

A
  • Transudative: CHF**, cirrhosis, nephrotic syndrome

- Exudative: TB, PE

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12
Q

Pleural Effusion Etiology

A
  • Transudate

- Exudate (pus, blood, lymph fluid)

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13
Q

Pleural Effusion Pathophys

A
  • Accumulation of fluid in pleural cavity
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14
Q

Pleural Effusion Sx

A
  • SOB, pleuritic CP, cough +/- fever/chills
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15
Q

Pleural Effusion Dx

A
  • Diminished breath sounds
  • Dullness to percussion
  • Decreased tactile fremitus
  • Labs
  • CXR
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16
Q

Pleural Effusion Tx

A
  • Treat underlying cause

- Thoracentesis

17
Q

Pulmonary Embolism RF

A
  • Male, AA, preg, obesity, age, oral contraceptive, recent travel
18
Q

Pulmonary Embolism Etiology

A
  • Thrombus breaks off
19
Q

Pulmonary Embolism Sx

A
  • Key sx: dyspnea (at rest or w/ exertion), pleuritic CP, cough
  • Other sx: orthopnea (laying down), calf/thigh pain or edema, wheezing
20
Q

Pulmonary Embolism Tests

A
  • CBC, CMP, PT/PTT/INR
  • D-dimer (sensitive, not specific)
  • ECG
  • Chest radiograph (Hampton’s hump)
  • CT angio
  • VQ scan
  • Contrast enhanced pulm angio (gold standard)
21
Q

Pulmonary Embolism Dx

A
  • Well’s Criteria: low/medium/high suspicion of PE, not diagnostic, used to guide workup
  • PERC r/o criteria: must meet all 8 criteria
22
Q

Pulmonary Embolism Tx

A
  • Stable: supportive +/- anticoagulant

- Unstable: resp support, anticoag, IV fluids, +/- TPA or embolectomy

23
Q

Pneumothorax Types

A
  • Primary Spontaneous (smokers, younger people)
  • Secondary Spontaneous (COPD, CF)
  • Traumatic
  • Tension (mechanical ventilation or resuscitation, EMERGENCY)
24
Q

Pneumothorax Tx

A
  • CXR first then chest tube

- Except tension pneumo–chest tube first then CXR

25
Q

ARDS Stages

A
  1. Exudative: acute inflam
  2. Proliferative: 7-10 days later, chronic inflam w/ myofibroblasts
  3. Fibrotic: diffuse fibrosis
26
Q

ARDS Etiology

A
  • Injury or infection

- Acute diffuse inflam leads to syndrome

27
Q

ARDS Pathophys

A
  • Impaired gas exchange
  • Increased lung weight (from edema)
  • Loss of aerated tissue (filled w/ fluid)
  • Reduced lung compliance
  • Pulm HTN
28
Q

ARDS Sx

A
  • Rapid development of resp failure
  • Bilateral (often diffuse) crackles
  • Hypoxia
29
Q

ARDS Dx

A
  • Within 1 wk of injury/illness: bilateral opacities on imaging (CXR, CT)
  • Edema cannot be explained by HF or excess fluid (BNP, ECG)
  • Severe hypoxia (P/F <300)
  • Sick contacts?
30
Q

ARDS Tx

A
  • Treat underlying cause

- Supportive tx

31
Q

ARDS Prognosis

A
  • Mortality has been improving w/ use of low tidal volume ventilation (less stretching of lungs=less inflam)
  • Obesity is protective
32
Q

ARDS PaO2/FiO2 ratio

A

<300 = ARDS

- Lower ratio = more severe

33
Q

Bronchiolitis Obliterans Epi

A
  • Non-reversible

- Rare

34
Q

Bronchiolitis Obliterans Etiology

A
  • Occurs after acute injury due to exposure (inhaled toxins, drug rxn, chemo, RA)
35
Q

Bronchiolitis Obliterans Pathophys

A
  • Inflam of small airways

- Constriction of smooth muscle

36
Q

Bronchiolitis Obliterans Sx

A
  • Dyspnea and cough (slowly progressive)
37
Q

Bronchiolitis Obliterans Dx

A
  • H/o RA or toxin exposure (work/hobby hx)
  • Bronchoscopy (helpful for culture and biopsy)
  • Surgical lung biopsy is only definitive dx
38
Q

Bronchiolitis Obliterans Tx

A
  • Remove causative agent
  • STOP SMOKING
  • Symptomatic tx w/ bronchodilator and O2
  • Lung transplant (otherwise terminal dx)

Clin Med Pulm (7 decks)

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