Pulm 1 Flashcards

1
Q

most effective drug for controller therapy asthma

A

ICS (twice a day)

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2
Q

early COPD’ers will have what on exam?

A

nothing, can be normal in early stages

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3
Q

hemoglobin is normal, o2 reduce, sat02 normal at rest. cxr hyperinflated lungs with flattened diaphragm. Am I emphysema or chronic bronchitis.

A

emphysema

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4
Q

hemoglobin is eleavted, o2 reduced, c02 elevated, CXR increased interstitial markings “dirty lungs”. normal diaphragm. Am i emphysema or chronic bronchitis?

A

Chronic bronchitis

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5
Q

in emphysema is total lung capacity increased or decreased?

A

increased

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6
Q

thin, elongated chests, with increased AP diameter and BIG BAGGY LUNGS, what am I?

A

Emphysema

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7
Q

Criteria for chronic bronchitis

A

Productive cough more than 3 months in a year for two consecutive years.

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8
Q

best copd treatment

A

stop smoking, o2 therapy, and Atrovent (anticholinergic, ipratropium)
SABA for exacerbation

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9
Q

best test for copd status?

A

ABG (and 6 minute walk test)

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10
Q

common bugs if COPD’ers get PNA?

A

HiB (Most common), and strep pneumo

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11
Q

the 3 criteria for an acute COPD exacerbation

A

cough increases, sputum increases, dyspnea increases

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12
Q

best choice to diagnose bronchiectasis?

A

CT

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13
Q

what you see on chest xray in bronchiectasis?

A

tram tracks

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14
Q

if HR >100, RR > 24, Temp > 100.4 (38), and age > 64, what can we think if were diagnosing bronchitis?

A

its PNA, not bronchitis

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15
Q

hemoptysis is….

A

> 200ml in 24 hours of coughed blood

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16
Q

in a workup for hemoptysis, we get sputum cultures, and CT. what wont CT show?

A

endobronchial lesions

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17
Q

MCC of epiglottitis

A

Hib, and recently in peds is GABHS

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18
Q

tx for epiglottitis

A

IV ampicilin/sulbactam, and a cephalosporin

19
Q

what is a patient gets it, and a 4 year old in the house isnt Hib vaccinated?

A

give Rifampin to everyone in the house to kill any carrier

20
Q

Whats the most common cause of severe chronic lung disease in young adults?

A

Cystic fibrosis

21
Q

what does cystic fibrosis xcr show?

A

hyperinflation

22
Q

What do CF patients need to be vaccinated against?

A

flu and pneumococcal

23
Q

MCC of bronchiolitis in peds?

A

RSV or Adenovirus

24
Q

MCC of bronchiolitis in adults?

A

inhalation injury, drug exposure, post infection

25
Q

tx for bronchiolitis

A

prednisone taper

26
Q

whats normal/abnormal on xray with the two types of bronchiolitis?

A

constrictive is normal (post inhalation)

proliferative is abnormal

27
Q

MCC of croup

A

parainfluenza

28
Q

croup on xray of the neck shows

A

steeple sign

29
Q

tx for croup

A

mild: one time PO ICS (Budesonide or dexamethasone)
severe: racemic epi

30
Q

mucopurulente unilobar infiltrates are typical PNA, while what is atypical?

A

bilateral, or watery sputum production, and in wierd areas of the chest.

31
Q

gold standard to dx PNA

A

infiltrate on cxr

32
Q

traditional therapy for CAP PNA

A

beta-lactams, macrolides, and tetracyclines

33
Q

inpatient tx for PNA

A

ceftriaxone and a macrolide (to cover atypicals)

34
Q

blood on sputum in PNA

A

rust colored

35
Q

sign of legionella PNA

A

GI symptoms

36
Q

Mycoplasma PNA sign

A

bullous myringitis (no rigors)

37
Q

Klebsiella PNA sign

A

currant jelly (ETOH or nursing homes)

38
Q

kelbsiella on cxr

A

like regular PNA but usually in right upper lobe.

39
Q

abx for anaerobes in aspiration PNA

A

clinda

40
Q

what is the most predisposing factor to lung abcess in PNA?

A

aspiration

41
Q

what type of PNA shows air/fluid levels?

A

pneumococcal PNA

42
Q

MCC bug of RSV?

A

paramyxovirus (MCC of lower resp. tract infection in peds)

43
Q

prophylactiv tx for RSV, since its viral?

A

Palivizumab (synagis)

44
Q

tx for whooping cough

A

macrolide for 1 week, and vaccinate/booster pt. and others