Part 3 of MDTs

Question 1

Hallmarks of TB?

Answer 1

• Gen 7
• Productive cough >2-3 wks
• Lymphadenopathy
• Crackles on inspiration or with cough
• Dullness with decreased fremitus
• Travel to endemic area
• Clubbing

Question 2

What is the primary bacterial cause of TB?

Answer 2

Mycobaterium

Question 3

Other than recent travel to endemic area, what other risk factors could cause TB?

Answer 3

Household exposure
Drug use
Incarceration

Question 4

What can TB lead to?

Answer 4

Hemoptysis
Pneumothorax
Extensive pulmonary destruction

Question 5

What lobes and what percentage of patients does reactivation TB involve?

Answer 5

Apical Upper Posterior Lobes (Upper most portion of the lobe and posteriorly)

80-90% of all patients

Question 6

How much sputum do you analyze and from where do you get that sputum regarding TB?

Answer 6

Lower respiratory tract and 5-10ml

Question 7

Treatment for TB?

Answer 7

• Isoniazid 5mg/kg/daily
• Rifampin (causes red tears)
• Corticosteroids for tb meningitis as well

Question 8

How is TB transmitted mainly?

Answer 8

Air or sputum

Question 9

What symptoms can rib fractures cause?

Answer 9

Pain with inspiration
Crepitus
Shallow fast breathing (hurts to get a full inhale)

Question 10

Complications of rib fracture?

Answer 10

Hemo/Pneumothorax
Hypoventilation
Atelectasis
Pneumonia

Question 11

Rads for rib fracture?

Answer 11

Xray will identify any complications

Question 12

Treatment for young healthy patients that experience a rib fracture?

Answer 12

• Pain meds
• Deep breathing exercises
• Incentive spirometry (reduce CO2 retention)

Question 13

What can assist with possible respiratory failure due to rib fracture?

Answer 13

Mechanical ventilation

Incentive spirometry

Question 14

What is a flail chest?

Answer 14

Segment of chest is basically just floating

Question 15

What happens during inspiration with a flail chest?

Answer 15

It moves inward which reduces tidal volume

Question 16

Hallmarks of Flail chest?

Answer 16

Trauma

Severe Chest pain and respiratory distress

Question 17

Rads for flail chest?

Answer 17

No, dx based on physical exam and history

Question 18

Treatment for flail chest?

Answer 18

O2
Pain control with IV morphine

Intubate if needed

Question 19

Disposition for Flail chest?

Answer 19

MEDEVAC

Question 20

How long do symptoms last for URI?

Answer 20

3 - 10 days

Possible 2 weeks for smokers

Question 21

Are URI’s bacterial or viral in nature?

Answer 21

Viral

Question 22

MOST common symptoms of URI?

Answer 22

Runny nose
Sinus Congestion
Scratchy throat
Cough

Question 23

What is the incubation period for URIs?

Answer 23

24 to 72 hours

Question 24

Treatment for URI?

Answer 24

Yup, all of the meds

Question 25

What is a pulmonary contusion?

Answer 25

Damage to lung tissue with hemorrhage and edema NO LACERATIONS

Question 26

What is the most frequent intrathoracic injury in nonpenetrating chest trauma?

Answer 26

Pulmonary contusions

Question 27

What percentage of patients experience pulmonary contusions from significant blunt chest trauma?

Answer 27

30-75%

Question 28

Where do pulmonary contusions occur?

Answer 28

Impact site

Question 29

What is the most common complication of pulmonary contusions>

Answer 29

Pneumonia

Question 30

What can pulmonary contusions become a risk factor for

Answer 30

acute respiratory disorder

Question 31

What are the hallmarks for pulmonary contusions?

Answer 31

Hx of blunt chest trauma HYPOXIA Hemoptysis Evidence of chest injury Crackles Decreased Breath sounds

Question 32

What will CXR show for pulmonary contusion?

Answer 32

Patchy or full lobar opacity Present within 6 hours of injury

Question 33

What is the mainstay treament for pulmonary contusions?

Answer 33

Supportive Care * IV * O2 * Mechanical ventilation

Question 34

Disposition for pulmonary contusion?

Answer 34

MEDEVAC

Question 35

It's in the name but what is a tracheobronchial injury?

Answer 35

Injury to trachea or bronchus via blunt trauma

Question 36

How many patients die from TBronchial Injuries prior to reaching a hospital?

Answer 36

80%

Question 37

Which side of the bronchial are more common for TBIs?

Answer 37

right sided with 80% within 2 cm of carina

Question 38

Hallmarks of TBI?

Answer 38

3 H's * Hoarseness * Hemoptysis * Hypoxia Subq Emphysema Persistent pneumo

Question 39

Treatment for TBI?

Answer 39

O2 ET tube Bronchoscopy for stable patients Cric as last resort

Question 40

Disposition for Pulmonary contusion?

Answer 40

MEDEVAC

Question 41

What is an acute respiratory disease?

Answer 41

Severe airway obstruction

Question 42

What are the most common causes of ARS for children?

Answer 42

Aspiration if foreign bodies

Question 43

What are the most common causes of ARS for us?

Answer 43

Allergic Response Tissue swelling caused by infection or angioedema (swelling due to allergic reaction)

Question 44

Hallmarks of ARS?

Answer 44

Stridor Retractions Signs of Choking

Question 45

What will rads find for ARD?

Answer 45

Laryngoscopy * foreign body * tumor * obstruction in the larynx or trachea CXR

Question 46

Treatment for ARD?

Answer 46

Suction with a blunt tip (yankauer) Heimlich for foreign bodies Treat the tissue swelling and angioedema ( Cooling or Epi) Cric or trach if needed

Question 47

Disposition for ARS?

Answer 47

Examine in medical if needed MEDEVAC if aspiration of toxic or harmful materials that will cause damage to the airways

Question 48

Rads for TBI?

Answer 48

CXR * subq * pneumo