Pulm 1 Flashcards
indication for corticosteroid use
PaO2 less than 70
A-a gradient greater than 35
see solitary pulmonary nodule, but have no previous CXR for comparison. next step?
CT scan
diagnosis of fat embolism
fat droplets in urine
intra arterial fat globules on fundoscopy
hear louder expiratory sounds
consolidation of lung
physical exam with consolidation
dullness to percussion (b/c only air makes hyper resonant)
bronchial breath sounds
egophony
MCCs of hemothorax
traumatic laceration of lung parenchyma
damage to intercostal or internal mammary artery
pneumonia with multiple thin walled cavities / abscesses
staph
max tidal volume
6 ml/kg
max PEEP
about 15 in ARDS
indications for long term oxygen therapy
PaO2 less than or equal to 55 mmHg or SaO2 less than or equal to 88% RA
or 59 and 89 in people with cor pulmonale, right heart failure, or Hct greater than 55
workup of recurrent pneumonias in same location
chest CT
management of new solitary pulmonary nodule
get CT first
cough and mucopurulent sputum
- dx
- next step
bronchiectasis
CT
what prolongs survival in COPD patients
smoking cessation
supplemental oxygen
lung reduction surgery
high likelihood of PE and no CI to anticoag
start heparin
risk assessment for pneumonia
CURB-65 Confusion Uremia BUN greater than 20 Respirations greater than 30 BP less than 90/60 Age greater than 65
2 = inpatient 4+ = ICU
hospital ATBs for pneumonia
fluoroquinolone
OR beta lactam plus macrolide
outpaitnet tx for pneumonia
doxycycline or macrolide
FiO2 in vent setting should be below
60%
ARDS PaO2/FiO2 is
less than 300
complication of bronchiectasis
hemoptysis
management of empyema
prolonged ATBs 2-4 weeks
drainage with chest tube
cavity with air fluid levels
lung abscess
