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Pulm Flashcards

1
Q

normal FEV1

A

> 80%

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2
Q

normal FVC

A

> 80%

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3
Q

normal FEV1/FVC

A

> 70-75

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4
Q

obstructive disease levels

A 
hi volume
hi residual volume
low vital capacity
low FEV1
low FEV1/FVC
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5
Q

restrictive disease levels

A 
low volume
low residual vol
low VC
low FEV1
normal or hi FEV1/FVC
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6
Q

most accurate way to measure TLC

A

plethysmography

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7
Q

normal PO2

A

75-100

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8
Q

normal PCO2

A

38-42

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9
Q

normal HCO3

A

22-28

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10
Q

normal pH

A

7.38-7.42

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11
Q

upper limit compensation (pH)

A

0.25 x (PCO2actual - PCO2norm)

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12
Q

lower limit compensation (pH)

A

0.75 x (PCO2actual - PCO2norm)

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13
Q

diff alkalosis

A

resp: pH up cuz CO2 down (27)(hypovent)

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14
Q

diff acidosis

A

resp: pH down cuz CO2 up (>50)
met: pH down cuz HCO3 down (

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15
Q

mixed acidosis

A

pH down cuz PCO2 up and HCO3 down

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16
Q

alveolar disease (area affected)

A

peripheral only

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17
Q

alveolar disease CXR (characteristics)

A

homogenous opacity
obscured BVs
poor marginations
air bronchograms

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18
Q

pneumonia CXR sign

A

silhouette sign

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19
Q

CHF/pulm edema CXR sign

A

bat wing

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20
Q

pulm infacrtion sign

A

wedge shaped density

hampton’s hump

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21
Q

interstitial disease (area affected)

A

bronchoarterial
parenchymal
peripheral

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22
Q

interstitial disease CXR (characteristics)

A 
Kerley B lines
reticular
ground glass
nodular
reticulonodular
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23
Q

atelectasis CXR (characteristics)

A

tracheal, mediastinal, fissure deviation (twd side of atelectasis)
elevated hemidiaphragm
overinflation of other lung

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24
Q

linear atelectesis sign

A

plate like?

post abdominal surgery

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25
flat line on CXR -->
air-fluid level | hemopneumothorax
26
HIV PEP for HCWs
raltegravir (or dolutegravir) + emitricitabine/tenofovir start w/in hours treat 4 weeks
27
transudative vs exudative effusions
light's criteria (any = exudative) pleural prt/serum prt > 0.5 pl LDH/serum LDH > 0.6 pl LDH > 2/3 upper limit normal lab serum LDH
28
d/o w/ transudative effusions
``` CHF cirrhosis nephrotic syndrome PE peritoneal dialysis ```
29
d/o w/ exudative effusions
``` infections malignancy GI collagen vasc disease drugs hemo/chylothorax PE asbestos ```
30
PPD: 5 mm + population
``` HIV close contact TB CXR show old unTx TB organ trans immunocomp ```
31
PPD: 10mm+ pop
``` recent immigrants IVDU high risk med conditions high risk job myco lab ppl kids exposed to adult @ hi risk ```
32
PPD: 15mm+ pop
no known TB RFs
33
tx latent TB
INH 9 months (+kids) | RIF 4 months
34
latent TB vs disease
both + PPD, QFT latent: normal CXR, smears, cultures, no Sx, not infectious disease: abnormal CXR, +smears/cultures, cough, fever, weight loss, infectious
35
EKG in PE
MC: sinus tachy rare: S1Q3T3
36
BOOP path
fibroproliferative plug lipid laden macs minimal architectural distortion
37
histiocytosis aka
eosinophil granuloma | pulm langerhans cell granulomatosis
38
histiocytosis mech/progression
interstitial w/ obstructive granulomatous lesions langerhans cell proliferation in small airways/parenchyma later, more fibrosis restrictive or obstructive
39
histiocytosis CXR
bilat, upper lobe cysts/nodules pneumothorax
40
sarcoidosis stages
I: lymphocytic alveolitis II: non-casseating granulomas III: fibrosis
41
sarcoid periphery
lymphocytes (T) | fibrocytes
42
sarcoid core
non necrotic | mac + epitheliod cells = multinucleated giant cells
43
MNGC inclusion bodies
asteroid schumann hamazaki-wesenberg
44
phys causes of hypoxemia
asphyxia low V/Q shunt (not better with O2) hypoventilation
45
phys causes of hypercapnea
``` alveolar hypoventilation high V/Q haldane VD/VT up CO2 production ```
46
ways to impair tissue oxygenation
fail to vent fail to oxygenate arteries fail to transport o2 failt to use O2
47
drug OD tx
``` intubate/ventilate treat OD (narcan, romazicon) resp stim? ```
48
CHF tx
O2, ASA diuresis nitrates heparin
49
pulm HTN from lung issues - causes
``` COPD interstitial sleep apnea high altitude (chronic) bronchopulm dysplagia developmental ```
50
mPAP for pulm HTN
mild 25-34 mod 35-44 severe >45
51
lung changes that cause pulm HTN
increased PVR increased CO increased wedge pressure
52
how obesity -> hypoventilation syndrome
low resp musc strength low chest wall compliance defect in central resp control system (down responsiveness to CO2 or hypoxia)
53
kyphoscoliosis lung changes
down VC down TV RV about the same
54
COPD and hypoventilation
decreased chemical responsiveness to CO2 and hypoxia | abnormal diaphragm fxn from fatigue and mechanical disadvantage
55
sniff test for...
unilateral diaphragmatic paralysis
56
+ sniff test is
paradoxical elevation of diaphragm with sniff
57
hemoptysis description
``` no n/v bright red blood frothy alkaline blood-tinged sputum hemosederin macs hx lung disease blood loss uncommon ```
58
causes of hemoptysis (infection)
``` bronchitis, bronchiectasis pneumonia TB abscess aspergilloma ```
59
causes of hemoptysis (neoplasm)
bronchogenic carcinoma bronchial adenoma carcinoid met carcinoma
60
causes of hemoptysis (CV)
CHF mitral stenosis pulm HTN
61
causes of hemoptysis (broad)
``` infection neoplasm CV vascular trauma ```
62
causes of hemoptysis (vascular)
``` PE aneurysms AV malformations collagen vascular pulmonary renal wegners churg-strauss ```
63
telangiectasias
dilation of small vessels --> flat red marks on skin
64
hemoptysis vasculitic workup
anti GBM ab: goodpatsures anti DS DNA: SLE ANCA to proteinase-3: wegners ANCA to myloperoxidase: microscopic polyangiitis
65
when bronchoscopy
``` suspect tumor localize bleeding site collect samples biopsy laser ```
66
pulm HTN Tx
endothelin rec blockers nitric oxide PDE inhibitors prostacyclins
67
vasoreactivity test (pulm HTN)
give short acting vasodilator (adenosine, NO) | (+) mPAP down by 10 with up in CO
68
(+) vasoreactivity test tx
CCBs
69
(-)vasoreactivity test tx
endothelin rec blockers nitric oxide prostacyclins
70
T1
tumor
71
T2
``` tumor btwn 3-7 or tumor which invades visceral pleura or atelectasis ( ```
72
T3
``` prox extent w/in 2 cm of carina or involve diaphragm, mediastinal pleura or pericardium or atelectasis of whole lung or separate tumor nodules in same lobe or chest wall invasion ```
73
T4
invasion of mediastinum, heart, great vessels, trachea, esophagus, vert body, carina or separate nodules w/in diff ipsi lobe
74
N0
N0: no regional node involved
75
N1
met to ipsi hilar +/or peribronchial nodes
76
N2
met to ipsi mediastinal +/or subcarinal
77
N3
met to contra mediastinal or hilar, ipsilateral or contralateral scalene or supraclavicular nodes
78
M1
distant mets include nodules in contra lobe malignant pleural/pericardial effusions
79
stage IA
T1N0M0 (nothing but T)
80
stage IB
T2N0M0 (nothing but T)
81
stage IIA
T1N1M0 (N only 1)
82
stage IIB
T2N1M0 T3N0M0 (N only 1)
83
stage IIIA
T3N1M0 | T1-3N2M0
84
stage IIIB
TanyN3M0 | T4NanyM0
85
stage IV
TanyNanyM1 (Mets)
86
stage IA management
surgical resection
87
stage IB management
surgical resection | paclitaxel+carboplatin before and after surg
88
stage II management
surgical resection w/ or w/o therapy
89
stage IIIA management
chemo then surgery + post op chemo/rad
90
stage IIIB management
vhemo+rad
91
stage IV
chemo or palliative
92
sarcoidosis imaging
panda sign
93
asbestosis CXR
pleural plaque | pleaurl thickening
94
small airway definition
95
bronchiolitis
SA destruction from inflammation and fibrosis
96
obliterative bronchiolitis
begin in and destroy SA
97
proliferative bronchiolitis
debris collection w/in alveolus extends back to airways but doesn't destroy them
98
bronchiolitis obliterans
CT: mosaic | obliterative, obstructive
99
BOOP
CXR: bilat peripheral infiltrates proliferative restrictive no CRP
100
resp bronchiolitis interstitial lung disease
smokers only ground glass pigmented macs

Clinical Medicine (9 decks)

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