PULM Flashcards
For what conditions would you consider measuring ABGs?
- COPD
- HF
- DM
- drug OD
What are the normal pH, CO2 and HCO3 levels for blood in ABG testing?
- pH: 7.35-7.45
- CO2: 35-45
- HCO3: 22-26
What pH, CO2 and HCO3 levels for blood in ABG testing indicate acidosis?
- pH: less than 7.35
- CO2: >45
- HCO3: less than 22
What pH, CO2 and HCO3 levels for blood in ABG testing indicate alkalosis?
- pH: >7.45
- CO2: less than 35
- HCO3: >26
Signs & Sxs:
- Productive cough
- Pleuritic chest pain
- Hemoptysis
- Fever/chills/night sweats
- Malaise, weight loss
- Painless adenopathy
TB
Signs & Sxs:
- Cough, sputum production
- Dyspnea, wheezing
- Hemoptysis
- Frequent infxs
- AM headache
- Pedal edema, weight loss
COPD
Signs & Sxs:
- Normal vitals
- Decreased breath sounds
- Decreased tactile fremitus
- Localized pleural friction rub
- Mediastinal shift if massive
Pleural effusion
Signs & Sxs:
- Dyspnea, pleuritic chest pain
- HoTN, tachyardia, S3 gallop
- Cough, hemoptysis
- Anxiety and apprehension
- Acute cor pulmonale
- Distended neck veins
Pulmonary embolism
Signs & Sxs:
- Dyspnea, orthopnea, PND, DOE, tachypnea
- Cough, pink/frothy sputum
- Diaphoresis, fatigability
- Bibasilar rales, wehezing
- Hypoxemia
- Signs of fluid overload
- Elevated JVP, S3
Pulmonary edema
Signs & Sxs:
- Productive cough, may last several weeks
- Sputum
- Smokers have prolonged cough
- Rales, rhonchi, wheezing
- Injected pharynx
- Fever, tachypnea
Acute bronchitis
Signs & Sxs:
- Cough
- Wheezing, prolonged expiration
- Chest tightness, tachycardia
- Rhonchi lung sounds
- Use of accessory muscles (SCM, scalenes of neck)
Asthma
Signs & Sxs:
- Cough, dyspnea, thick sputum, tachypnea
- Fever, chills
- Chest pain
- Cyanosis
- Consolidation
Community acquired pneumonia
What type of pneumonia:
- walking
- non-productive cough
- fever
- slow course
- young
Mycoplasma pneumo
What type of pneumonia:
- rust colored sputum
- rapid fever onset
- CXR shows lobar consolidation
Strep pneumo
What type of pneumonia:
- pleuritic chest pain
- hemoptysis
- hyponatremia
Legionella pneumo
How is acute bronchitis diagnosed?
- diagnosis of exclusion
- rule out pneumonia, asthma, exacerbation of COPD, common cold
Labs/Testing/Imaging for Pneumonia
- CXR
- sputum gram stain/culture
- CBC with dif
- lytes
- BUN/Cr
- glucose
What causes pleural effusion?
- fluid leaks in (trauma)
- secretion of extra fluid (TB, lung abscess)
- CHF, pneumonia, malignancy, pulmonary embolism
Diagnostic Imaging for Pleural Effusion
- CXR
- US
Tx for Pleural Effusion
-diagnostic thoracentesis (US guided, cell count, gram stain/culture)
How is asthma severity determined?
- sxs: # of days per week or month
- night time awakening per week
- SABA use
- lung function (spirometry, LFTs)
How is COPD diagnosed?
spirometry/LFTs
-FEV1/FVC ratio is less than 70% in COPD
FEV1 in Mild/Stage 1 COPD
FEV1 > 80%
FEV1 in Moderate/Stage 2 COPD
FEV1 50-80%
