Pulm Flashcards
Initial management of pulmonary htn due to lv dysfunction
Loops and aceis
Management of idiopathic pulm htn
Endothelin receptor antagonists (bosentan), phosphodiesterase inhibitors eg sildenafil, and or prostanoids (epoprostenol)
In osa you have ___ hematocrit and epo levels
Increased
How do you screen for lung cancer
Chest ct (not X-ray!)
When and how do you screen for lung cancer in smokers?
Annual low dose chest ct in pts 55-80 with a >30 pack year smoking history who are currently smoking or quit within the last 15 years
Three common causes of secondary clubbing
Lung malignancies
Cystic fibrosis
Right to left cardiac shunts
Does copd present with digital clubbing
No
Can you have a pleural effusion with a pe
Yes
Etiology of infectious/inflammatory pleural exudative effusion
Increase in capillary permeability
What is lights criteria
Is pleural effusion transudative or exudative
Exudate if any of these are true
- PF ldh/serum ldh > 0.6
- PF protein/serum protein > 0.5
- PF ldh > 2/3 The upper limit of normal
Cause of biphasic stridor/wheezing/dysphagia, more prominent during expiration, improves with neck extension in a baby under one
Vascular ring
Laryngomalacia is __ when supine
Worse
Laryngomalacia is ___ with inspiration because ___
Worse
Collapse of supraglottic structures
Sudden loss of vision, onset of floaters, fundus hard to visualize in a diabetic
Vitreous hemorrhage
Asthma, chronic sinusitis, nasal polyps, congestion following ingestion of aspirin or NSAIDs
What am I
Aspirin exacerbated resp disease
Vulvar pain, malaise, dysuria, painful labial ulcers, inguinal lymphadenopathy, what am I
Genital herpes
Symptom management in copd
Ipratropium (anti muscarinic, anti cholinergic) plus short acting beta agonist
Transudative effusions are marked by ___ protein
Low (<3g/dL)
In pulmonary fibrosis, total lung capacity is ___, functional residual capacity is ___, and residual volume is ___
Tlc is low
Frc is low
Residual capacity is low
In pulmonary fibrosis, dlco is ___ and alveolar-arterial gradient is ___
Dlco is reduced
Alveolar-arterial gradient is high
Progressive dyspnea and productive cough are more associated with copd or angina?
Copd
Dead space ventilation refers to
Ventilation of areas of lung that are not perfused with blood (eg pe)
Normal pleural fluid ph
7.6
Normal pleural fluid ph in transudative pf
7.4-7.55
Normal pleural fluid ph in exudative pleural fluid
7.3-7.45
Pleural fluid ph <7.3 is usually due to
Empyema, pleuritis, pleural fibrosis
Pulmonary arterial hypertension causes what heart exam findings?
Rv heave
Dlco is asthma and chronic bronchitis
Normal
Dlco in emphysema
Low
