Pulm

Question 1

Serum osm <275
Euvolemica
U osm >100 & U Na >40

Answer 1

SIADH

Question 2

How to calculate serum osm

Answer 2

2Na + glc/18 + BUN/2.8

Question 3

Normal serum osm

Answer 3

275-295

Call it 285

Question 4

What happens when someone has SIADH and they get saline?

Answer 4

Worsens hyponatremia

Question 5

Theophylline toxicity

Answer 5

CNS stimulation, GI disturbances, cardiac toxicity

Question 6

Pathophys of massive PE

Answer 6

RV outflow obstruction and increased RV pressure

RV hypokinesis => dec RV output => dec LV preload and CO => dec RV O2 supply =>

Also RV dilation => inc RV wall tension => inc RV O2 demand =>

RV ischemia & infarction => RV failure and chock

Question 7

Asthma symptoms for Intermittent

Tx?

Answer 7

SABA use <2 days a week
Nighttime <2 times a month
SABA PRN

Question 8

Asthma symptoms for Mild Persistent?

Tx?

Answer 8

SABA use >2 days/week, not daily
Nighttime 3-4 time a month, ~1/week
Tx: SABA + low dose ICS

Question 9

Symptoms for Moderate Persistent Asthma

Tx

Answer 9

SABA use Daily
Nighttime >1/week
Tx: SABA + (Low dose ICS + LABA) or (Medium-dose ICS)

Question 10

Symptoms of Severe Persistent Asthma

Answer 10

SABA use multiple times daily
Nightttime pretty much nightly
Tx: SABA +Medium dose ICS + LABA

If need more next is increase to high dose ICS, consider omalizumab if allergies

If more, oral steriods

Question 11

Cough >5 days to 3 weeks
Absent systemic findings
Wheezing, rhonchi, chest wall tenderness
Preceding respiratory Illness

Dx? Tx?

Answer 11

Acute bronchitis

Symptomatic tx

Question 12

In ARDS, PaO2/FiO2 (increases/decreases)

Answer 12

Decreases

Lower ratio = increased severity

Question 13

Anticoagulation in CKD

Answer 13

Unfractionated heparin

Question 14

How much is low tidal volume ventilation?

Why use it?

Answer 14

4-6 mL/kg

Prevent alveolar overdistension

Question 15

MC lung cancer in young adults

Answer 15

Bronchial carcinoid tumor

Question 16

> 3 months of fever, wt loss, fatigue, cough, hemoptysis, and/or dyspnea
Cavitary lesions
Previous lung damage/debris

Answer 16

Chronic pulmonary aspergillosis

Question 17

CURB-65

What is it and what it do?

Answer 17

Confusion
Urea >20
Respirations >30
BP <90/60
Age >65

Hospitalization for pneumonia/sepsis

Question 18

What score on cuRB-65 gets you hospitalized? ICU?

Answer 18

3;4

Question 19

What is the recommended FiO2 to prevent O2 toxicity?

Answer 19

> 60%