Pulm Flashcards
What is the FEV1/FVC threshold for airflow obstruction
<0.7
An increase by what percentage in FEV1 or FVC indicates a reversible airway obstruction?
12% or >200mL from baseline
Equal reductions in FEV1 and FVC suggest what?
restrictive lung disease
What is the diagnosis?
decreased DLCO and reduced lung volumes
Pulmonary fibrosis
What is the diagnosis?
decreased DLCO and normal lung volumes
pulmonary vascular disease or anemia
What is the diagnosis?
decreased DLCO and airflow obstruction
COPD, bronchiectasis
What is the diagnosis?
increased or normal DLCO and airflow obstruction
asthma
What is the diagnosis?
increased DLCO
Pulmonary hemorrhage
L to R shunt
polycythemia
What does a normal DLCO in patients with low lung volumes suggest?
obesity!
What is CPET testing used for?
unexplained dyspnea
symptoms disporportionate to measured pulmonary function tests
exercise related lung symptoms
When use bronchoprovocation testing?
patients with a suggestive clinical history for asthma but normal spirometry, diagnose exercise-induced asthma in patients with dyspnea after exercise but normal spirometry
Peripheral eosinophilia, fever and weight loss in a long term smoker - dx?
chronic eosinophilic pneumonia
Dx with bronchoscopy and bx or BAL with high eo count
eosinophilia, high serum IgE level and intermittent pulmonary infiltrates - dx?
allergic bronchopulmonary aspergillosis
dx: with positive skin test for aspergillum and IgG and IgE Ab to aspergillus, radiographic opacities in upper lobes
Upper airway and sinus disease that precedes difficult to treat asthma, flares with leukotriene inhibitors and steroid tapers - dx?
Eosinophilic granulomatosis with polyangiitis (Churg Strauss)
- can have an elevated p-ANCA
- hallmark of diagnosis is eosinophilic tissue infiltrates
Do not administer theophylline with what drug class?
fluoroquinolone or macropodes because can result in theophylline toxicity
What drugs should not be used alone in patients with asthma?
LABAs - increased mortality
A normal PCO2 in a patient with severe symptomatic asthma indicates what?
impending respiratory failure
what diagnosis should be considered for patients with asthma who rapidly improve with intubation?
vocal chord dysfunction
How diagnose bronchiectasis?
High res CT
What patients are particularly at risk of bronchiolitis obliterates?
patients post lung or stem cell transplant
what antibiotics can you use for a mild COPD exacerbation?
tetracycline or bactrim
what is the most cost effective way to diagnose workplace asthma
spirometry before and after exposure
high value care
do you need a sputum culture in COPD flares?
no doesn’t normally affect mgmt
high value care
should you use steroids in sepsis without shock?
no
high value care
