Pulm l Flashcards
FEV1 / FVC
if high, think
if low, think
high, restrictive (hard to get air in)
low, obstructive (hard to get air out)
% PPV
if higher think
if lower think
normal is obstructive
lower, restrictive
silhouette sign - see with
pneumonia
TB primary infx XRAY
secondary infx XRAY
primary - upper lobes, pleural effusion, hilar nodes
secondary - small calcifications in LU & nodes, or NORMAL
Non-sedating antihist vs sedating
does not cross BBB vs does
non-sedating - allegra (fexofenadine), claritin (loratadine, desloratadine) - H-1 antag
sedating - diphenhydramine (benadryl), chlorpheniramine - H-1 R antag; CI CNS depression, MAO-I
Emergency Bronchodilator
Atropine, then EPI
alpha-1 agonists for nasal congestion 1. oxymetazoline 2. phenylephrine hydrochloride 3. pseudoephedrine CI?
CI - severe HTN, MAO-I
ADR’s: anaphalyxis, asthma, HA,
Glucocorticoids end in ?
ADR’s
fxn for asthma?
-sone, -zone, -onide
ADRS: water retention, CV probs, osteoprosis, peptic ulcers
used in conjunction w bronchodilators for LU
BLOCKS PHOSPHOLIPASE A2 in membrane blocking production of arachondic acid
if atropine is used as an emergency bronchodilator, what Rx use atropine as an anticholinergic bronchodilator?
IPRATROPIUM BROMIDE
TIOTROPIUM BROMIDE
(parasympatholytic)
does not tx acute asthma
types of rescue inhalers
epi, ALBUT
what is mometasone?
inhaled corticosteroid powder for asthma
what is salmeterol?
serevent dikus
B2 agonist
BB warning!!! increase risk of asthma related death
long acting
montelukast pharm
leukotriene R antag
dextromethorphan fxn
robitussin
central acting
antitussive
how long after chronic cough should you xray?
> 8 weeks
viral resp infx
sharp pain worse w deep breath or cough
friction rub “leathery sound
pleurisy
pneumonia vs effusion
hear increased or decreased sounds?
pneumo decreased
effusion increased
bronchiolitis
xray?
eti?
what to know
viral
hyperinflation, peri-bronchial infiltrate
deadly in children and elderly
Pneumonia in alcoholics get which kind?
klebsiella consildated
pneumonia in diabetics get which kind?
e coli consolidated
atypical pneumonia is seen as what on xray? caused by what?
BL DIFFUSE INFILTRATE
mycoplasma, chlamydia, viral
Hospital Acq Pneumonia appears how long after admission?
what kind of bug?
about 3 days
gram neg is about half of em
strep is MC community acq
smelly rusty sputum
LU abscess
tx like lobar pneumonia
Aspergillosis on xray
solitary lesion 3-5mm in diameter
found in dirt
Cryptococcla Pneumonia Rx Dx Xray complications
yeast pigeon poo MENINGITIS so much R/O XRAY - solitary nodule DX biopsy and culture Rx amphotericin
Histoplasmosis
xray
dx
atypical presentation - patchy infiltrates, hilar adenopathy; cavitations, fibrosis
flu-like sxs
sputum culture or biopsy
flu-like sxs
hemoptysis
dry cough
mississippi, SE US, africa
Blastomycosis pneumonia
Valley Fever
xray
coccidioidomycosis can be bad! * no hemoptysis RASH, fever, erythema nodosum XRAY - non specific infiltrate hilar adenopathy
flu-like, rash, erythema nodosum, no hemoptysis
coccidiodomycosis “valley fever”
MC secondary to EMPHYSEMA
genetic cause of emphysema
reactive polycythemia
alpha 1 anti trypsin xu
normal pCO2
if acute exacerbation of chronic bronchitis, think
bacterial so tx w antibiotics
Bronchiectasis ETI
WHAT IS IT
xray
many things like tumors, foreign body, mucus (CF), external compression
IRREVERS DILATATION OF BRONCHIOLES
SEE HONEYCOMBING, loss of LU vol
Cryptogenic organic pneumonia
sxs
what happens
xray
rapid
dry cough
inflam, scarring, alveoli
xray - see widespread white patchees
Sarcoidosis xray
BL hilar adenopathy reticulonodular infiltrate
Goodpasture syndrome ssx
hemoptysis & hematuria
bc basement membrane of both LU and Kidneys affected
Wegeners
ssx
what is it
vascular dz
increased ANCA
ssx: freq URI and sinusitis
alveoli filled w eosinophilic debris
Silicosis
ARDS
medical emergency very sick
eti many things, chemical inhal
Cheyne Stokes
CHF and neuro
altered tachypnea and apnea
Cough w progressively worsening sputum production, SOB, F, Chills
TB
Smoker - what kind of LU cancer?
small cell lung cancer
F, cough, chest pain, hemoptysis, rash
SW United States
Coccidiomycosis
usu only in immunocomp ppl
otitis externa, runny nose, fever
aspergillosis
alpha 1 anti trypsin xu
when to check for this?
suspected COPD if no smoking hx
