pulm Flashcards
tram track
bronchiectasis
honeycombing
IPF (but really also any dz that has interstitial lung fibrosis)
mining, quarry rocks, sandblasting –> what lung dz
silicosis
coal –> what lung dz
coal miners lung/black lung
aerospace engineering –> what lung dz
berylliosis
work exposure + nodules in upper lung fields
silicosis
berylliosis
also coal workers
work exposure + nodules in lower lung fields
asbestosis
just in case… cotton/textile worker can develop what lung dz
byssinosis
4 characteristic of malignant lung nodules: shape growth calcium deposition cavitary
shape: irregular, spiculated
growth: rapid, may double in 4mo
ca: no calcifications
cavitary: seen in both, but has thickened walls here
what is 1st line tx for non small cell carcinoma
surgery
4 types of non small cell carcinoma
adeno
squamous cell
large cell (anaplastic)
bronchoalveolar — rare
what is the 1st line tx for small cell carcinoma (oat cell)
chemo +/- radiation
which lung CA are central
squamous cell
small cell
which lung CA are peripheral
adeno large cell (anaplastic)
which lung CA is assoc with cavitary lesions, hypercalcemia and pancoast syndrome
squamous cell
lung neuroendocrine tumors that secrete serotonin, acth, etc.
bronchial carcinoid tumor
“pink to purple well vascularized central tumor”
bronchial carcinoid tumor
light’s criteria for pleural effusions:
exudative if: a) pleural protein:serum protein > 0.5 b) pleural LDH:serum LDH > 0.6 OR b) pleural LDH > 2/3 upper limit of normal
what is the max you can remove during 1 thoracentesis
1.5L
what % is considered a “small” ptx that only needs observation and O2
<20%
in a PE you see avascular markings distal o the area of the embolus. what is this sign
westermarks sign
if a PE you see a wedge shaped infarction in the lung. what is this sign
hamptons hump
other than nothing, what are the ekg findings of a PE
R heart strain - s1q3t3
wide deep S in lead 1
q wave in lead 3
TWI in lead 3
mgmt of heme stable PE
iv or subq heparin + po warfarin for 5-7 days then switch to po warfarin alone
mgmt of heme unstable PE
thrombolysis; embolectomy if C/I
proceed once heme stable
which heparin do you need to do PTT monitoring
unfractioned
do not need to for LMWH
what is a normal PTT when someone is on UFH
1.5-2.5x above normal
what is the heparin toxicity antidote
protamine sulfate
s/e of rifampin
orange secretions
thrombocytopenia
s/e of isoniazid
hepatitis
neuropathy
s/e of pyrazinamide
hepatitis
gout
s/e of ethambutol
optic neuritis
at what weeks does an infant produce surfactant
24-28 weeks
at what weeks does the fetus have enough surfactant to survive on its own
35+
how can you prevent infant respiratory distress syndrome/hyaline membrane disease
give mom steroids between 24-36 weeks pregnancy
ARDS doesn’t ever respond to 100% O2. What should you give them?
mechanical ventilation (cpap, peep)
how do you make a definitive dx of pulm htn
right sided heart cath
what is the mgmt for pulm htn
vasodilators (1st line ccb***, also PDE-5 inhibitors)
O2 and anticoag
