pulm 2

Question 1

Labs with ARDS?

Answer 1

Resp alkalosis b/c hyperventilating

just blowing off a lot of CO2

Low O2

Question 2

PCWP in ARDS?

Answer 2

Less than 18 mmHg (distinguishes from Left heart failure)

Question 3

PaO2:FiO2 in ARDS?

Answer 3

Less than 200. KNOW THAT

Question 4

Transfusion in ARDS?

Answer 4

Dont do it unless below 7, can hurt the patient

Question 5

Asthma attack can cause pulsus

Answer 5

Oh yeah, b/c hyperventilated

Question 6

Mild intermittent asthma definition? Tx?

Answer 6

less than 2 episodes per week or less than two nighttime episodes per months

Tx albuterol PRN

Question 7

Mild persistent asthma df?Tx?

Answer 7

3-6 daytime per week
3-4 inghttime per month

FEV>80

Albuterol
Scheduled low dose steroid

Question 8

Moderate persistent asthma df and tx?

Answer 8

Daily episodes
More than 1 nighttime per week

LABA with glucocorticoid
PRN albuterol

Question 9

Severe persistent asthma?

Answer 9

EVERYTHING bad and FEV les than 60

High dose steroid, LABA, PO steroid, Albuterol

Question 10

What is cromolyn?

Answer 10

Stabilizes mast cells

Must do 3-4 times a day

Question 11

Theophylline od tx?

Answer 11

Hypotension, seizure, tachy

Benzo for seizure
B blocker for tachy
may need dialysis

Question 12

Anticholinergic inhaled drugs used when?

Answer 12

_tropium

for adjunctive for moderate or severe

also helps for acute asthma

helps for COPD

Question 13

Status asthmaticus tx?

Answer 13

keep o2 above 94.. Bronchodilators, steroids, intubation maybe…

Can be deadly

Question 14

Bronchiectasis?

Answer 14

read up on it

Question 15

COPD Staging

GOLD 1
GOLD 2
GOLD 3
GOLD 4

Answer 15

FEV1 80
50-80
30-50

Question 16

Tx of category COPD A
B?
C?
D?

Answer 16

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

Question 17

Note anticholinergics fairly common in COPD, but not asthma

Answer 17

Yeah in chategory 2

Question 18

INdications for home O2

Answer 18

Pulse ox below 88
Pulm HTN
Peripheral edema
Polycythemia

Question 19

Give pneuma revaccination at age 65 in smoker

Answer 19

O OK

Question 20

Smoking affect on histo?

Answer 20

centriacinar

PAnacinar is alpha1 antitrypsin

Question 21

ABG in emphysema?

Answer 21

Low O2 high CO2 at baseline

Question 22

DLCO in emphysema?

Answer 22

Decreased diffusion (think alveoli lose surface area)

Question 23

Chronic bronchitis is what?

Answer 23

cough 3 months in two years in a row and NOT bronchiectasis

Difficult for antibiotic management, azithro or levy or amok with clavulonate

Question 24

Bronchiectasis is What? from what?

Answer 24

Dilation of small and medium bronchi from chronic smoking, tobacco, fungal, pneuma….

Dyskinetic cilia (kartagener), ADPKD

Obstruction can cause it

Question 25

Bronchiectasis H&P?

CT?

Answer 25

Persistent cough
COPIOUS SPUTUM
Hemoptysis
frequent URI

Bronchial dilation

Question 26

Tx bornchiectasis?

Answer 26

Tx pulmonary hygene
Antibiotics, beta agonists steroids

Resection of very diseased areas

THINK OF CYSTIC FIBROSIS and chest shaking