Pulm Flashcards

1
Q

Sarcoidosis

A

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.

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2
Q

Management of parapneumonic Pleural Effusions

A

Small effusion with no resp distress or hypoxia: oral meds and close monitoring

Large effusion +/- resp distress +/- hypoxia: Ultrasound, IV Abx, drainage

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3
Q

Light’s Criteria (Determines an exudate)

A

Pleural protein/serum protein >0.5
Pleural LDH/serum LDH >0.6
Pleural LDH >2/3 the upper limit of normal for serum

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4
Q

Pleural fluid with glucose lower than 60

A

Either empyema or rheumatoid effussion, glucose low due to high metabolic activity of WBCs.

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5
Q

Pulmonary Embolism
PAO2
PaO2
PaCO2

A

PAO2-PaO2 (Alveolar O2 - Arterial O2) will be increased because of decreased gas exchange. PaCO2 is usually decreased due to hyperventilaiton.

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6
Q

Bronchopulmonary Dysplasia

A

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

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7
Q

Features of Restrictive Lung Disease

A

Decreased lung volume, high to normal FEV1/FVC, Decreased diffusion capacity, Decreased compliance.

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8
Q

Pulmonary Capillary Wedge Pressure

A

Equivalent to left atrial pressure, increased value in the setting of dyspnea indicates a cardiac cause.

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9
Q

Aspirin Exacerbated Respiratory Disease

A

10-20% of patients with Asthma may develop a pseudo allergic reaction to NSAIDS.
Leukotriene inhibitors can improve symptoms.

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10
Q

Pancoast Tumor

A

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.

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11
Q

Lung Sounds of Lobar Pneumonia

A

Increased.

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12
Q

High to normal CO2 after appropriate Asthma treatment

A

Impending respiratory failure

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13
Q

Laryngomalacia

A

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.

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14
Q

COPD exacerbation not responding to O2

A

Noninvasive if pH is about 7.1 and the patient is alert

Invasive if otherwise

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15
Q

Granulomatosis with polyangiitis

A

sinusitis, otitis, lung nodules with cavitations, rapidly progressive glomerulonephritis, nonhealing ulcers.

ANCA + 70%
steroids and immunomodulators

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16
Q

Pulmonary Contusion

A

CXR with patchy infiltrates within 24 hours of blunt trauma

17
Q

Bronchiectasis

A

Recurrent bacterial respiratory infections, caused by any prolonged injury to the lung. Dx high res CT

18
Q

Croup treatment

A

Dexamethasone 1 dose
Racemic epi
Intubation

19
Q

Bronchiolitis treatment

A

Emergency room: not much

20
Q

High probability PE based on vitals and presentation

A

Anticoagulation before confirmatory testing

21
Q

Indications for extubation

A

pH >7.25, FiO2 <40%, and PEEP <5mm, sufficient alertness to protect airway

22
Q

Solitary pulmonary nodules

A

<0.6 cm generally do not require follow up
>0.8 cm do require follow up
These should be either biopsied or removed surgically especially if there are other risks for lung cancer (age, smoking, etc.)

23
Q

Septic Pulmonary Emboli

A

Caused by IE with S. aureus commonly in IV drug users. Multiple abscesses/cavitations. Acute onset. Look for other signs of IE.

24
Q

Most common cause of persistent nasal blockage in a kid.

A

Adenoid hypertrophy