Pulm/crit Flashcards
Asthma with eosinophilia, high serum IgE, intermittent pulmonary infiltrates In the upper lobes. Dx?
Allergic bronchopulmonary aspergillosis (ABPA)
Chest x-ray with photographic negative pulmonary edema (peripheral Pulmonary edema), Striking peripheral blood eosinophilia, fever, weight loss in a long-term smoker. Dx?
Chronic eosinophilic pneumonia
Upper airway and sinus disease precedes difficult to treat asthma, flares associated with use of leukotriene inhibitors and glucocorticoid tapers. Dx?
Eosinophilic granulomatosis with polyangiitis
Allergic bronchopulmonary aspergillosis diagnostic tests?
Positive skin test for aspergillus and IgG and IgE antibodies for aspergillus
Chronic eosinophilic pneumonia Dx test? 2
Diagnose by bronchoscopy with biopsy or bronchoalveolar lavage W/High eosinophils
Eosinophilic granulomatosis with polyangiitis Dx test?
Elevated P anca, diagnostic finding is eosinophilic tissue infiltrates
What are the three components of lights criteria?
1) Pleural LDH greater than 2/3 upper limit of normal serum LDH 2) Pleural LDH/serum LDH greater than 0.6 3) Pleural protein /serum protein greater than 0.5
What are the two most common causes of an exudate?
Infection and malignancy
What kind of pleural effusion is Caused by a pulmonary embolism?
Transudative or exudative
What are the three indications for a chest tube placement for pleural effusion?
1) Pus in pleural space 2) Positive culture on pleural space fluid 3) complicated parapneumonic effusion
How do residual lung volumes and DLCO change with kyphosis compared to normal lungs?
DLCO remains normal while residual lung volumes are increased compared to normal
Parapneumonic effusions typically arise As a result of which three conditions?
Lung Abscess, Bronchiectasis, pneumonia.
Oxygen should be given if the patient has PA O2 less than what, or O2 saturation less than what during rest, Exercise or sleep?
PA O2 <55, 02 sat <88%.
Bilateral hilar adenopathy, uveitis Dx?
Sarcoidosis (noncaseating granulomas)
With allergic bronchopulmonary aspergillosis (ABPA), what two labs will be increased?
IgE and peripheral eosinophils greater than 10 percent
Cystic Fibrosis Dx test?
sweat Chloride > 60 mmol. If sweat chloride neg but suspicion still high, tx as CF. Tx w/mucolytics, hydrating agents, inhaled abx,macrolides
Rapid fire assoc: Desquamated epithelium casts in sputum
Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)
What is the main pulmonary function test that helps differentiate obstructive from restrictive lung disease?
Total lung capacity (TLC)
Rapid fire assoc: “Honeycomb lung” on x-ray or CT
Interstitial pulmonary fibrosis
Rapid fire assoc: Iron-containing nodules in alveolar sputum
Ferruginous bodies (asbestosis: ↑ chance of mesothelioma)
Rapid fire assoc: Colonies of mucoid Pseudomonas in lungs
Cystic fibrosis (autosomal recessive mutation in CFTR gene > fat-soluble vitamin deficiency and mucous plugs)
Rapid fire assoc: Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
Rapid fire assoc: Hilar lymphadenopathy peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Ghon complex (1º TB: Mycobacterium bacilli)
Transient airway hyper responsiveness that occurs during or after strenuous activity is known as what?
Exercise induced Bronchoconstriction
What are treatments for exercise induced Bronchoconstriction?
SABAs, Inhaled corticosteroids, leukotriene receptor antagonists
What are the components of curb 65?
Confusion, urea>20, respirations >30,SBP (hypotension), age>65
