Pulm Flashcards

1
Q

Primary spontaneous pneumothorax

A

Tall, thin males who smoke.

Patients will present with sudden unprovoked chest pain and shortness of breath.

Lack of pleural movement with respirations on ultrasound

M mode on ultrasound will show barcode/ stratosphere sign indicating pneumothorax

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2
Q

Sickle-cell trait

A

Diagnosed by electrophoresis which displays an increased (but not predominant) HbS.

Have normal peripheral smears.

Benign carrier trait, with no decrease in life expectancy.

Patients are at an increased risk of hematuria, which is thought to be from renal papillary necrosis.

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3
Q

Mild intermittent Asthma

A

Symptoms <2days/week

Nighttime awakenings <2x/month

FEV1 >80%

No Limitations

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4
Q

Mild Persistent Asthma

A

Symptoms >2 days/ week BUT not daily

Nighttime awakenings 3-4x/ month

FEV1> 80%

Limitations Minor

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5
Q

Moderate persistent Asthma

A

Symptoms Daily

Nighttime awakenings >1 episode / Week but Not daily

FEV1 60-80%

Limitations Some

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6
Q

Severe Persistent Asthma

A

Symptoms throughout the day

Nighttime awakenings- Almost nightly

FEV1- <60%

Limitations- Extremely limited

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7
Q

Preferred test to confirm the diagnosis of pulmonary embolism

A
  • CT pulmonary angiography

- Ventilation/perfusion scan can be obtained in patients unable to tolerate iodinated IV contrast.

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8
Q

Lung adenocarcinoma

A

Most common lung cancer to occur in never smokers

Peripheral spiculated lung mass

Arises from bronchial mucosal glands that secrete mucin.

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9
Q

Treatment of Lung adenocarcinoma

A

Mutations of the epidermal growth factor receptor (EGFR) that can be targeted by EGFR tyrosine kinase inhibitors such as erlotinib or gefitinib.

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10
Q

Wells criteria

A

1) Clinical signs/symptoms of deep venous thrombosis (3 points)
2) PE #1 diagnosis or equally likely (3 points)
3) Heart rate > 100/min (1.5 points)
4) Immobilization or recent surgery (1.5 points)
5) Previously diagnosed PE or deep venous thrombosis (1.5 points)
6) Hemoptysis (1.5 points)
7) Malignancy (1.5 points)

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11
Q

Wells criteria for PE likelihood

A

Low (< 2 points)

Moderate (2-6 points)

High (> 6 points)

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12
Q

MOST ACCURATE (gold standard) imaging modality to diagnosis pulmonary embolism

A

Pulmonary angiogram is MOST accurate

However, because it is invasive, slow, and expensive, CT angiogram with contrast is the preferred imaging modality

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13
Q

alpha-1 antitrypsin deficiency

A

Alpha-1-antitrypsin deficiency is inherited in an autosomal codominant pattern. Alpha-1 antitrypsin is a serine protease that normally functions to break down elastase. When levels of alpha-1-antitrypsin are abnormally low, the elevated levels of elastase cause breakdown of the pulmonary parenchyma, resulting in emphysema

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14
Q

Acute angle closure glaucoma

A

Acute angle closure glaucoma may present with abdominal pain, nausea, vomiting, a painful eye, and a fixed mid-dilated pupil that is nonreactive to light.

Tx: Decrease intraocular pressure with acetazolamide

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15
Q

Obstructive Lung disease:

Asthma

A

Decreased FEV1/FVC ratio

Value less than 0.80 is diagnostic for airflow obstruction

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16
Q

Diffusing capacity of the lungs for carbon monoxide (DLCO)

A

Measures the ability of the lungs to transfer gas from inhaled air to the red blood cells in pulmonary capillaries

DLCO decreases in patients with emphysema because of damage at the alveolar level

17
Q

Wells criteria low risk (<4pts)

A

Get D dimer

18
Q

Wells criteria High risk (>4pts)

A

CT angiography of pulmonary vasculature

19
Q

Most common ECG finding of PE

A

sinus tachycardia

20
Q

Diffuse ST elevation or PR segment depression

A

acute pericarditis

21
Q

Low voltage on ECG

A
Obesity
hypothyroidism
Pericardial or pleural effusions
COPD
Amyloidosis
22
Q

Massive PE

A

S1Q3T3 pattern (large S-wave in lead I, large Q-wave in lead III, inverted T-wave in lead III)

Right bundle branch block (RBBB)

23
Q

Patients diagnosed with HIT

A

Discontinue heparin immediately and begin therapy with direct thrombin inhibitors.