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PANCE > Pulm > Flashcards

Pulm Flashcards

1
Q

Spontaneous Pneumothorax

- treatment

A
  • stable and >3 cm or symptomatic : needle aspiration

- persistent leak: tube thoracostomy

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2
Q

Foreign body aspiration

- Classic triad of sx

A
  1. coughing
  2. diminished breath sounds
  3. wheezing
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3
Q

Foreign body aspiration

- mgmt

A

removal with rigid bronchoscopy

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4
Q

Acute asthma exacerbation

- mgmt

A
  • O2 and inhaled bronchodilators/anticholinergics (beta agonist, ipratroprium)
  • systemic glucocorticoids
  • if still sx: 2 grams IV mg
  • then consider intubation
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5
Q

RSV

- RF for developing lower respiratory tract infection

A
  • down syndrome
  • significant asthma
  • chronic pulm disease
  • immunocompromised
  • institutionalized
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6
Q

RSV

- RF for increased risk of bronchiolitis

A
  • born <36 weeks gestation
  • cardiopulmonary dz
  • older siblings
  • second hand smoke exposure
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7
Q

RSV

- treatment

A
  • Nonsevere: nasal suctioning, hydration

- Severe: ? bronchodilator, heated humidified high-flow nasal cannula, CPAP, intubation

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8
Q

Pneumonia

- PE

A
  • increased tactile fremitus
  • diminished lung sounds
  • bronchial lung sounds
  • crackles
  • egophany
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9
Q

Pneumonia

- XR findings

A
  • patchy lung infiltrate

- lung consolidation

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10
Q

Pneumonia

- CAP treatment

A
  • doxycycline or macrolide

- abx in 3 months or comorbidities: augmentin + macrolide or doxy

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11
Q

Aspiration pneumonia

- prevention for those at risk (stroke, etc.)

A
  • thickened fluids
  • feeding upright
  • proper oral hygiene to reduce oral bacteria present
  • don’t rush feeding time
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12
Q

Pulmonary nodule

  • dx first line
  • dx next steps
A
  • CXR

- CT without contrast

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13
Q

Solitary pulmonary nodule

- size

A
  • <3 cm

> 3 cm is considered pulmonary mass

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14
Q

Most common cause of hemoptysis

A

bronchitis

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15
Q

TB

- dx

A
  • screening with PPD

- definitive with positive acid-fast bacillus sputum stain

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16
Q

TB

- mgmt

A
  • 2 months 4 drugs

- 4 months 2 drug (isoniazid and rifampin)

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17
Q

What vitamin is co-administered with isoniazid to reduce risk of peripheral neuropathy?

A

Pyridoxine (B6)

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18
Q

Legionella pneumonia

- mgmt

A

Abx: azithromycin, levofloxacin, doxy

19
Q

Bordetella pertusus

- what kind of bacteria

A

gram-negative coccobacillus

20
Q

Blastomycosis

- describe

A
  • Widespread, systemic pyogranulomatous infection due to the inhalation of fungal Blastomyces dermatitidis and Blastomyces gilchristii.
  • midwest and souther US
21
Q

Blastomycosis

- three most common clinical presentations

A
  • Pneumonia (MC)
  • Skin - verrucous lesions, irregular border, gray/violet color (looks like squamous cell)
  • Osteomyelitis
22
Q

Blastomycosis

- dx

A
  • culture
  • histopathology
  • serologic testing
  • PCR
23
Q

Blastomycosis

- tx

A
  • amphotericin B

- Itraconazole

24
Q

Who should be tested for lung cancer

A
  • Adults 55-80
  • 30 year hx smoking who currently smoke or quit within last 15 years
  • dc screening once has not smoked in 15 years or health problem that diminishes their life expectancy
25
Q

Pneumocystis jirovecii pneumonia

- mgmt

A

Bactrim

26
Q

PCV13

- recommended for whom?

A
  • children <2
  • adults >=65
  • 2-64 with issues
27
Q

PPSV23

- recommended for whom

A
  • Adults >=65 (one year after PCV13)
  • Children >2 with RF for pneumonia
  • 19-64 who smoke, chronic disease
28
Q

Coin in trachea

- appearance on XR

A

AP: sliver

29
Q

Coin in esophagus

- appearance on XR

A

AP: circle

30
Q

Histoplasmosis

- location

A
  • Ohio and Mississippi river valleys

- spelunkers, caves, bat and bird droppings

31
Q

Histoplasmosis

- clinical

A
  • usu asx
  • disseminated infection in immunocompromised
  • primary infection: flu like
  • chronic infection: TB like
32
Q

Histoplasmosis

  • Dx
  • Tx
A
  • culture

- itraconazole, amphotericin B

33
Q

Nosocomial PNA

  • org to consider
  • abx
A
  • pseudomonas

- imipenem, gentamicin, vancomycin

34
Q

Outpatient CAP

- pharm

A

Macrolide or doxy

35
Q

CAP with chronic dz, immunocompromised, abx in last 3 months

- pharm

A
  • Resp FQ

- Beta-lactam + macrolide/doxy

36
Q

HAP Pharm

  • no multi drug resistance RF
  • yes multi drug resistance RF
  • MRSA RF
A
  • beta-lactam, ertapenem, resp FQ
  • antipseudomonal beta-lactam or carbapenem + resp FQ
  • add vanc
37
Q

Coccidioidomycosis

- location

A

SW USA (arizona, New Mexico, central/souther CA, western TX)

38
Q

Coccidioidomycosis

- clinical

A
  • acute pulm infection
  • CP, cough, dyspnea, hemoptysis, fever, fatigue
  • hilar and mediastinal lymphadenopathy
  • HA, pharyngitis, arthralgia, erythema nodosum
39
Q

Coccidioidomycosis

- mgmt

A
  • azoles
40
Q

Lung abscess

- RF

A
  • aspiration
  • reduced level of consciousness (etoh, drugs, general anesthesia, head trauma)
  • dysphagia
41
Q

Lung Abscess

- sx

A
  • indolent that develop over weeks/months
  • fever, cough, SOB, foul smelling sputum
  • systemic sx (night sweats, weight loss)
42
Q

Lung abscess

- imaging

A
  • XR: pulm infiltrates with cavity and air fluid level

- CT for more detail

43
Q

Lung abscess

- dx

A
  • imaging

- sputum gram stain/culture

44
Q

lung abscess

- mgmt

A
  • ampicillin-sulbactam
  • carbapenem
  • betalactam allergy: clindamycin

PANCE (14 decks)

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