pulm 2 Flashcards
Labs with ARDS?
Resp alkalosis b/c hyperventilating
just blowing off a lot of CO2
Low O2
PCWP in ARDS?
Less than 18 mmHg (distinguishes from Left heart failure)
PaO2:FiO2 in ARDS?
Less than 200. KNOW THAT
Transfusion in ARDS?
Dont do it unless below 7, can hurt the patient
Asthma attack can cause pulsus
Oh yeah, b/c hyperventilated
Mild intermittent asthma definition? Tx?
less than 2 episodes per week or less than two nighttime episodes per months
Tx albuterol PRN
Mild persistent asthma df?Tx?
3-6 daytime per week
3-4 inghttime per month
FEV>80
Albuterol
Scheduled low dose steroid
Moderate persistent asthma df and tx?
Daily episodes
More than 1 nighttime per week
LABA with glucocorticoid
PRN albuterol
Severe persistent asthma?
EVERYTHING bad and FEV les than 60
High dose steroid, LABA, PO steroid, Albuterol
What is cromolyn?
Stabilizes mast cells
Must do 3-4 times a day
Theophylline od tx?
Hypotension, seizure, tachy
Benzo for seizure
B blocker for tachy
may need dialysis
Anticholinergic inhaled drugs used when?
_tropium
for adjunctive for moderate or severe
also helps for acute asthma
helps for COPD
Status asthmaticus tx?
keep o2 above 94.. Bronchodilators, steroids, intubation maybe…
Can be deadly
Bronchiectasis?
read up on it
COPD Staging
GOLD 1
GOLD 2
GOLD 3
GOLD 4
FEV1 80
50-80
30-50
Tx of category COPD A
B?
C?
D?
A (GOLD1 or 2 mild symptoms) is short beta agonist
B GOLD1 or 2 moderate symptoms) is short and long acting beta or anticholinergic
C GOLD 3 or 4 with mild symptoms short with LABA and steroids
D GOLD 3 or 4 with moderate to severe short beta LABA, steroids, may need theophylline
Note anticholinergics fairly common in COPD, but not asthma
Yeah in chategory 2
INdications for home O2
Pulse ox below 88
Pulm HTN
Peripheral edema
Polycythemia
Give pneuma revaccination at age 65 in smoker
O OK
Smoking affect on histo?
centriacinar
PAnacinar is alpha1 antitrypsin
ABG in emphysema?
Low O2 high CO2 at baseline
DLCO in emphysema?
Decreased diffusion (think alveoli lose surface area)
Chronic bronchitis is what?
cough 3 months in two years in a row and NOT bronchiectasis
Difficult for antibiotic management, azithro or levy or amok with clavulonate
Bronchiectasis is What? from what?
Dilation of small and medium bronchi from chronic smoking, tobacco, fungal, pneuma….
Dyskinetic cilia (kartagener), ADPKD
Obstruction can cause it
Bronchiectasis H&P?
CT?
Persistent cough
COPIOUS SPUTUM
Hemoptysis
frequent URI
Bronchial dilation
Tx bornchiectasis?
Tx pulmonary hygene
Antibiotics, beta agonists steroids
Resection of very diseased areas
THINK OF CYSTIC FIBROSIS and chest shaking
