Pulm Flashcards
What constitutes intermittent asthma (#daytime ssx, #nocturnal ssx, FEV1)
- daytime ssx: up to 2x/wk
- nocturnal ssx: up to 2x/mo
- FEV1: >80%
What constitutes mild persistent asthma (#daytime ssx, #nocturnal ssx, FEV1)
- daytime ssx: <1/day
- nocturnal ssx: <1/wk
- FEV1: >80%
What constitutes mod persistent asthma (#daytime ssx, #nocturnal ssx, FEV1)
- daytime ssx: 1x or more/day
- nocturnal ssx: 1x or more/wk
- FEV1: 60-80%
What constitutes severe persistent asthma (#daytime ssx, #nocturnal ssx, FEV1)
- daytime ssx: 1x or more/day
- nocturnal ssx: frequent
- FEV1: <60%
What is tx for intermittent asthma?
SABA
What is tx for moderate persistent asthma?
SABA + ICS + LABA
What is tx for refractory asthma?
SABA + high ICS + LABA + PO steroids
What is tx for mild persistent asthma?
SABA + ICS
What is tx for severe persistent asthma?
SABA + high ICS + LABA
ED –> acute asthma exacerbation –> labwork?
- peak expiratory flow rate
- ABG
ED –> acute asthma exacerbation –> tx?
- O2
- albuterol/ipratropium nebulizer
- corticosteroid
ED –> acute asthma exacerbation –> refractory –> rescue therapy? why is this used?
- racemic epi nebulizer
- SQ epi
- IV magnesium
To avoid intubation
ED –> acute asthma exacerbation –> continuous nebulizer tx –> how long before dispo decision?
3hr
which lung cancer is most common in non-smokers?
adenocarcinoma
lung adenocarcinoma –> histology
glandular formation -> mucin production
sarcoidosis –> lab finding
non-caseating granuloma secrete:
- angiotensin-converting enzyme (ACE) increased
- vitD –> Ca increased
sarcoidosis –> tx
steroids
68F in ICU –> ventilated on positive pressure –> acutely becomes agitated –> oxy sat drop from 96% to 85%
what condition?
barotrauma from positive pressure ventilation
or
pneumothorax
what is Cheyne-Stokes respiration
cycles of apnea followed by hyperpnea
very deep breaths at fast rate
type of respiration pattern? seen in what condition?
Kussmaul
metabolic acidosis –> DKA
patient initiate breath –> ventilator deliver breath –> backup rate in place if patient fail to initiate breath
what type of ventilation?
assist-control ventilation
patient makes no respiratory effort –> what type of ventilation is appropriate for this patient?
controlled mechanical ventilation –> total ventilator dependent setting –> not allow or support spontaneous breaths
diffuse parenchymal lung disease –> tx
steroids
what are the idiopathic DPLDs? (2)
- acute interstitial pneumonitis (acute <6wk)
- idiopathic pulmonary fibrosis (chronic >6mo)
what rheumatologic disorders can lead to pulmonary fibrosis? (3)
- SLE
- RA
- SS
sarcoidosis –> extra-pulmonary manifestations (3)
- heart block
- bell’s palsy
- erythema nodosum
shipyard –> what occupational exposure?
asbestos
bird fancier –> what type of DPLD?
hypersensitivity pneumonitis
silicosis –> CXR findings can look like what other condition?
nodules in upper lung –> TB
ssx of DPLD at work –> feel better on weekend/vacation –> ssx come back when return to work
what condition?
hypersensitivity pneumonitis
sarcoidosis –> diagnosed and treated –> what followup management?
cardiac MRI
sarcoidosis –> how dx?
lung bx
PE –> tx
- first line: factor Xa inh (rivaroxaban), if no renal dz
- LMWH –> bridge to warfarin
PE –> when trt w tPA?
R heart strain + hypotension
small cell lung CA –> tx
chemo + rad
squamous cell lung cancer –> paraneoplastic synd
PTH-rp –> hyperCa
PFT: differentiate emphysema vs chronic bronchitis
diffusion capacity of lung for carbon monoxide (DLCO):
- emphysema: decreased
- chronic bronchitis: increased
Lights criteria for exudate
- LDHf >2/3 ULN
- LDHf/LDHs >0.6
- TPf/TPs >0.5
pleural effusion –> ADA positive
dx?
TB
- erythema nodosum
- hilar adenopathy
- migratory polyarthralgia
- fever
what condition?
Lofgren’s synd (sarcoidosis)
