Pulm Flashcards
acute cough
< 3 weeks duration. Due to respiratory infection, aspiration, inhalation of something noxious
subacute cough
3-8 weeks in duration. residual from tracheobronchitis such as pertussis or post viral tussive syndrome
chronic cough
> 8 weeks. inflammation, infections, neoplasm, cardiovascular
asthma
airway obstruction and inflammation . airway mucosa infiltrated with eosinophils and t lymphocytes. Activated mucosal mast cells. can present at any age. Decreased FEV1 and decreased FEV1/FVC
What finding of spirometry indicated reversibility
> 12% ad 200ml increase in FEV1 15 minutes after SABA
what % increase is needed post bronchodilator to dx asthma with spirometry
10%
intermittent asthma sx
SX ≤2 days per week, nighttime awakenings ≤ 2 times per month, SABA use ≤2 times per week. No interference with ADL’s. Normal FEV1 between exacerbations
Mild persistant asthma sx
sx > 2 days per week not daily, 3 -4 nighttime awakenings per month, using SABA no more than 1x per day, FEV>80% predicted
moderate persistant asthma sx
daily symptoms, nighttime awakenings more than once per week, daily SABA use, FEV1 >60 and <80% predicted
Severe persistant asthma sx
sx throughout the day, nighttime awakenings daily, SABA several times per day, FEV1 <60% predicted
Beta Adrenergic Agonists effect on airway
relax smooth muscle of airway, increase mucociliary clearance, inhibit mast cell mediator release, decrease cough, NO effect on chronic inflammation
Anticholinergics
muscarinic receptor antagonists ( ipatroprium) prevent bronchoconstriction
hemoglobin level on emphysema vs chornic bronchitis
emphysema normal. chronic bronchitis elevated
CXR chronic bronchitis
dirty lungs, increased interstitial markings. diaphragms not flattened
total lung capacity emphysema vs bronchitis
emphysema increased, bronchitis normal
oxygen desaturation emphysema vs bronchitis
emphysema mild and bronchitis severe desaturation
MC bug in COPD exacerbation
H flu
MCC epiglottitis
group A strep if immunized. if nonimmunized h flu. strep in adults. h flu in kids
epiglotitis household contacts tx
rifampin for 4 days
pneumonia copd
h flu, pseudomonas,
pneumonia bat or bird droppings
histoplasma
pneumonia rabbits
francisella tularensis
IV drugs pneumonia
staph aureus, anaerobes
hotel/ cruise ship
legionella
aspiration pneumonia
anaerobes
nursing home pneumonia
strep pneumo, gram negative bacilli, h flu, TB
