PPPs Flashcards
Define COPD and what is the MC RF
What is the only genetic dz linked to COPD
Irreversible airway obstruction d/t loss of elastic recoil and inc airway resistance
Smoking
Alpha-1 antitrypsin deficiency
Define Emphysema
What are the 3 types of emphysema
What is the hallmark of emphysema
Enlarged terminal airspace (distal to terminal bronchioles)
Centrilobar: smoking
Panacinar: a-1 antitrypsin
Paraseptal: Spot Pneumos
Dyspnea
How is emphysema Dz
Define Chronic Bronchitis
What is the MC etiology
PFT: irreversible restrictive pattern w/ FEV1/FVC <70%
Productive cough x 3mon x 2yrs
Smoking
What are the 3 cardinal Sxs of chronic bronchitis
How is Chronic Bronchitis Dx
? arrhythmia is seen in these Pts
Chronic cough, Sputum, Dyspnea
PFT: FEV1/FVC <70% w/ dec FVC
MAT: >100bpm w/ 3 different P-wave morphologies; Tx- Verapamil
What lab result differs Chronic Bronchitis from Emphysema
Most important step in Pt management along w/ ? vaccines
When is O2 supplementation needed
Inc H/H w/ resp acidosis
Cessation, Pneumococcal/Influenza
PaO2 >55,
SpO2 88% or less
Cor Pulmonale
Emphysema
Chronic bronchitis
Dyspnea- MC Sx Hyperinflated lunged/flat diaphragm Hyperresonance Matched V/Q defect Hypoxic
Productive cough- hallmark Rales, Rhonchi, Wheeze Resp acidosis w/ inc H/H V/Q mistmatch Hypercapnea
What ABX classes are used during COPD exacerbations
How are Pts Tx by GOLD Class
Macrolide: Azith/Clarith-romycin
Cephalosporin
Augmentin
Fluroquinolones
A: SABA (Albuterol) or SAMA (Ipratropium)
B: LAMA>BA (Tiotropium>Sal/For-meterol)
C: LAMA (Tiotropium)
D: LAMA+LABA or LABA+inhaled GCSS
COPD Gold Stages
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Why doe COPD Pts develop P-HTN and Cor Pulmonale
Define Bronchiectassis
What is the MCC and what infections are Pts vulnerable to
Hypoxic constriction inc R-sided atrial pressures
Permanent dilation of bronchials
CF w/ Pseudomonas infections;
Non-CF: HFlu
How is CF Dx and w/ ? two findings
What are the three components of Asthma
What is the strongest RF
CT: tram-track and signet ring sign
Airway hyperactivity
Bronchoconstriction
Inflammation
Atopy
Define Samter’s Triad
Define Atopic Triad
How is Asthma Dx
ASA, Rhinosinusitis, Polyps
Asthma Dermatitis Rhinitis
PFT: reversed obstruction w/ dec FEV1/FVC
How is Asthma Dx via bronchoprovocation test
How is an exacerbation best assessed
What criteria are needed for discharge after exacerbation
Methacholine challenge: 20% or more dec of FEV1 followed by bronchodilator challenge w/ FEV1 inc 12% or more
Peak expiratory flow rate
PEFR >70% or >15% improvement
What would ABG show during asthmatic exacerbation
Asthmatic categories w/ Txs
Resp alkalosis
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Define Sarcoidosis
What do Pts present w/
What lab results would be seen
Idiopathic, multi-system inflammatory granulomatous dz
Lupus pernia- most specific
Erythema Nadosum (classic)
Dry cough
Hyper ACE, Ca, Vit D
Define Lofgren Syndrome seen w/ Sarcoidosis
What is the best initial test and what would be seen
Polyarthralgias w/ fever
Erythema Nadosum
Bilateral hilar adenopathy
CXR:
1: BHL w/out pulm Sxs
2: BHL w/ ILDz
3: ILDz only
4: fibrosis w/ restrictive dz
