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Emergency Medicine > Pulm > Flashcards

Pulm Flashcards

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Royal College: Emergency Medicine flashcards
1
Q 
dypsnea
hypoxia
hypercapnia
wheezing
cyanosis

these are all common problems found where?

A

ED

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2
Q

SUBJECTIVE FEELING OF DIFFICULT, LABORED OR UNCOMFORTABLE BREATHING?

A

dyspnea

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3
Q

6Ps of dyspnea?

A 
possible FB
Pulmonary bronchial constriction 
PE
Pneumo
pneumonia 
pump failure
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4
Q

MCC of dyspnea?

A 
asthma/copd
CHF
ischemic Heart disease
penumonia 
psychogenci
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5
Q

most immediately life threatening causes of dyspnea?

A

upper airway obstruction
tension penumo
PE, guillian barre, myastenia gravis

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6
Q

the goal for dyspnea is to what?

A

maintain PaO2 above 60mm Hg or O2 sat above 90% (goals may be lower in pts with COPD or chronic lung dx)

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7
Q

inadequate delivery of O2 to the tissues?

A

hypoxia

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8
Q

hypoxia is defined as PaO2 below what?

A

60 mm Hg `

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9
Q

dx of hypoxia:

clinical suspicion or what 2 other things?

A

ABG or pulse ox

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10
Q

PaCO2 above 45 mmHg and is exclusively due to alveolar hypoventiliation?

A

hypercapnia

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11
Q

chronic hypercapnia s/s?

A

tolerated large variations as seen in COPD

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12
Q

severe hypercapnia:above what PACO2? and s/s?

A

80mm Hg

coma, encephalopathy, seizures

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13
Q

dx of hypercapnia?

A

pulse ox

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14
Q

causes of hypercapnia?:

there is a shit ton

A

kyphoscolisis, morbid obesity

upper airway obstruction

depressed central respiratory drive: CNS dx (brainstem tumor), durgs (opioids, sedatives, anesthetics), tetnaus

MG/GB
botulism, organophosphate poisoning

intrinsic lung dx associated w/ increased dead space like COPD

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15
Q

tx of hypercapnia besides tx of underlying cause?

A

ABC!!!!!!!!!

O2 and ventiliation

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16
Q

musical, high pitches, adventitious lung sounds produced by the airflow through the central and lower airways?

A

wheezing

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17
Q

wheezing may result from what?

A

increased secretions

smooth muscle constrictions
muscular hypertrophy

peri bronchial inflammation

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18
Q

not all wheezing is what?

A

asthma

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19
Q

pts with severe airflow obstructions may actually have no wheezing but decreased what?

A

breath sounds

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20
Q

dx of wheezing?

A

PE (ausculation)

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21
Q

tx of wheezing?

A

UNDERLYING CAUSE

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22
Q

peripheral cyanosis:

A

poor perfusion in extremities

23
Q

central cyanosis:

A

low PaO2 or abnormal hemoglobins

24
Q

causes of peripheral cyanosis:

A

reduced CO

cold extremeites

misdistribution of blood flow

arterial/venous obstruction

25
Q

causes of central cyanosis?

A

hypoxemia (high altitude, hypoventiliation, ventiliation perfusion mismatch, right to left shunt, av fistulas, intrapulmonary shunts)

hemoglobin abnormalities: (metheglobinemia, sulfhemoglobinemia, carboxyhemoglinemia)

26
Q

tx of cyanosis:

A

TX UNDERLYING CAUSE

supplemental O2, get that sat above 90%

27
Q

infx of the conducting airways of the lungs?

A

acute bronchitis

28
Q

acute bronchitis is mainly causes by what?

A

viruses

29
Q

cough lasting more than 5 days, sputum/purulent, afebrile, wheezing

A

acute bronchitis

30
Q

work up for acute broncitis:

A

vitals and pulse ox

CXR to rule out pneumonia

NO FUCKING CULTURES

31
Q

TX of acute bronchitis:

A

symptomatics/supportive (SABA/cough suppressants)

its viral so let it go away on its own

32
Q

infection of the alveolar portion of the lung?

A

pneumonia

33
Q

1 pathogen of pneumonia?

A

s penumo (kids under 5 is viral)

34
Q

MC pathogen of atypical (walking) pneumonia?

A

mycoplasma

35
Q

who is at risk for apritation pneumonia?

A

alcholics, hx of seizures, CVA, neuromuscular dx, intubated pts

36
Q

big “chill” pneumonia is likely what?

A

strep pneumo

37
Q

fever, cough, dyspnea, pleuritic chest pain, sputum production are s/s of what?

A

pneumonia

38
Q

lobar pneumonia s/s:

A

consilidation, bronchial breath sounds, egophony, increased tactile/vocal fremitus, dullness to percussion

39
Q

bronchopenumonia s/s:

A

rales/rhonchi without consilidation, pleural effusion, empyema!!!

40
Q

interstitial pneumonia: s/s

A

rales, rhonchi, normal breath sounds

41
Q

tests for pneumonia:

A

cxr initial
ct is best

cbc, electrolytes/cmp, abg/vbg, blood cultures

42
Q

hospitalized over 48 hours within prior 90 days, those getting outpt dialysis, chemo, wound care or home IV AB therapy, residents in nursing/rehab

all criteria for what?

A

HAP

43
Q

lung abscess:

A

pus in the lung

44
Q

empyema:

A

pus in pleural space (seen in bronchopenumonia)

45
Q

main cause of TB?

A

mycobacterium tuberculosis

46
Q

slow growing aerobic rod with acid fast properties

A

myhcobacterium tuberculosis

47
Q

MC place for TB?

A

high O2 or blood flow like the apical/posterior segments of the upper lobes

48
Q

how is TB spread?

A

droplets

49
Q

latent and actibe TB will both have a positive skin test?

A

yes!!

50
Q

extrapulmonary TB: develops in 20% of cases, MC in who?

presentation?

A

children, immunocompromised

lymphadenitis with painless enlargement

51
Q

miliary TB:

multisystem dx causes by what?

A

massive hematogenous dissemination

52
Q

where is miliary tb mc?

A

young/immunocompromised

53
Q

gold standard TB work up?

A

sputum

54
Q

when would we admit a TB pt?

A

instability, hypoxia, dyspnea, unrelaibale pt, suspected or known MDR TB

ISOLATE PTS

Emergency Medicine (2 decks)

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