Pulm Flashcards
Sarcoidosis
Systemic disease, presents classically in the lungs.
CXR hilar adenopathy. Noncaseating granulomatous inflammation.
Cough, fever, fatigue, dyspnea, weight loss.
Can affect skin, muscles, joints, eyes, lungs, heart, nervous system.
Management of parapneumonic Pleural Effusions
Small effusion with no resp distress or hypoxia: oral meds and close monitoring
Large effusion +/- resp distress +/- hypoxia: Ultrasound, IV Abx, drainage
Light’s Criteria (Determines an exudate)
Pleural protein/serum protein >0.5
Pleural LDH/serum LDH >0.6
Pleural LDH >2/3 the upper limit of normal for serum
Pleural fluid with glucose lower than 60
Either empyema or rheumatoid effussion, glucose low due to high metabolic activity of WBCs.
Pulmonary Embolism
PAO2
PaO2
PaCO2
PAO2-PaO2 (Alveolar O2 - Arterial O2) will be increased because of decreased gas exchange. PaCO2 is usually decreased due to hyperventilaiton.
Bronchopulmonary Dysplasia
Chronic lung disease of the infant
Found in premature infants following ARDS
From repeated insults from ventilator, continuous oxygen and inflammation
xray: hazy with decreased lung size
Most improve over 2-4 months, some may develop pulmonary HTN
Features of Restrictive Lung Disease
Decreased lung volume, high to normal FEV1/FVC, Decreased diffusion capacity, Decreased compliance.
Pulmonary Capillary Wedge Pressure
Equivalent to left atrial pressure, increased value in the setting of dyspnea indicates a cardiac cause.
Aspirin Exacerbated Respiratory Disease
10-20% of patients with Asthma may develop a pseudo allergic reaction to NSAIDS.
Leukotriene inhibitors can improve symptoms.
Pancoast Tumor
Superior pulmonary sulcus tumor. Arm/shoulder pain, horner’s syndrome, may have weakness of arm and hand, weight loss, may have superior vena cava syndrome.
Lung Sounds of Lobar Pneumonia
Increased.
High to normal CO2 after appropriate Asthma treatment
Impending respiratory failure
Laryngomalacia
Collapse of supraglottic tissue on inspiration. Inspiratory stridor that is worse when supine peaks at 4 to 8mo.
Dx: Laryngoscope shows omega-shaped epiglottis.
Tx: Close following with possible tx of GERD, may need surgery if severe.
COPD exacerbation not responding to O2
Noninvasive if pH is about 7.1 and the patient is alert
Invasive if otherwise
Granulomatosis with polyangiitis
sinusitis, otitis, lung nodules with cavitations, rapidly progressive glomerulonephritis, nonhealing ulcers.
ANCA + 70%
steroids and immunomodulators