Pulm need to know Flashcards
New born with respiratory distress, cyanosis, and scaphoid abd has?
Diaphragmatic hernia
Does Pnx have a scaphoid abdomen?
No, its has a mediastinal shift
How does CO kill you?
Stronger affinity to Hemoglobin - irreversible, very left shift
How do barbitures affect ABGs?
Respiratory depression (Increase C02+ Resp Acid). and Hypoxemia
What Pna has absent fevers or rigors, and a nonprod cough with bilat insterstitial inflitrates?
Mycoplasma, Mac/FQ/Dox
What helps to reinflate alveoli?
CPAPs - after drowning.
Inhalant abuse teenage patients present with ?
Encephalopathy
How are PEs diagnosed?
Angiogram or VQ scan (less invasive)
What is pulses paradoxus?
decreased BP with inspiration- asthma
What is the best Beta blocker for asthma?
Metoprolol
How do you diag Pna?
Infiltrates on Xray
How can GERD cause night time cough attacks?
Laying down, acid seeps into the trachea = bronchospasm
What med can lead to exercise induced asthma?
Mast cell stabilizer
Severe asthma attacks get…
Inhaled Saba + IV steroids
Severe Emphysema will have what pH, pC02 and P02?
pH = low pC02 = high p02 = low
COPD has Resp acid or Resp alk?
Resp Acid
Asthmatics has Resp acid or Resp alk?
Resp Alk
If someone has asbestos exposure what cancers will they get?
MCC = Bronco carcinoma,
Then -> Mesothelioma a pleural cancer.
Chronic use of a ventilator at 100% 02 can lead to?
Pulm fibrosis
PEEP increases the risk of …
Hypotension due to Rside HF
Large bacteria like pneumococcal pna lead to dyspnea bc?
fill alveola with pus. This decreases 02 diffusion.
Beclomethasone is a low or high ICS?
low - used in Mild persistant asthma
What vaccinations does a COPD pt need?
Flu and Pna
What type of breathing is cycles of increased tidal vol and apnea?
Cheyne-Stokes
What type of breathing occurs after head trauma and is long seconds of no breathing?
Apneustic
meningities patients have what kind of breathing?
Biots
Diabetics have what kind of breathing?
Kussmaul = meta acid compensation.
What kind of PFT is seen in severe COPD?
Emphysema will have decrease diffusion for Carbon Monox.
Patho of Emphysema?
Destroyed elastic = air is trapped in lungs = increased residual capacity and increased total capacity.
Patho of hyperventilating?
uncomp respiratory alk = needs a brown bag.
MCC lung tumor in non smokers is?
Adenocarcinoma
Tx for a tension Pnx is?
Chest tube thoracostomy
What disease has Vit A deficiency, foul stools, Hx of URI, and chronic cough?
Cystic Fibrosis
Another name for Croup is?
Acute Laryngotracheobronchitis. Same as Croup
How can you diagnose a restrictive lung disease?
High Ct and Biopsy with a pulmonologist
Solitary Pulm nodules are safe is you are…
<35, the nodule is <3
How often do you FU with a pulm nodule?
3 months with a CT for 2 years. After 2 years, dont do anything
What do you do with a patient with 88% 02 sat?
Supplement 02
Bronchospams has what triad?
SOB, nonprod cough, and wheezing.
What disease has Honey-combing and calcified pleural plaques?
Asbestosis
Cruises, Trips, diahhrea and lung issues is caused by what bacteria and treated with what?
Legionnaires.
Azythromycin or FQ
Post splenectomy the MCC of pneumonia is?
S. pneumonia
02 dissociation curve to the left is caused by?
CO
02 dissociation curve to the right is caused by?
Acid pH, Increase PCO2, Increased Temp
Cold agglutinin assay is treated with?
Azythromycin = Mycoplamsa TB
How do you treat RSV?
What age gets RSV?
02 and palivizumab.
<2 years
Onset of tachy with HoTN on a vent with positive pressure can lead to?
Pnx
Fine inspiratory crackles at base is associated with?
Restrictive lung disease
Why do you do a VQ scan on a PE patient?
bc they are pregnant or have CKD
Worsening patient with Asthma, resp akl, cyanotic needs?
Intubation
Anti-glomerular + nephrotic + hemoptosis/ lung issues is?
Goodpastures
Asthma exacerbations get?
Albuterol Nebulizer
what has a lung calcification with fluid?
Lung abscess
Multi air filled cavities in pleural space could be a
diaphragmatic rupture. Single air filled would be a hemopnx.
Exudative effusions need?
Chest tube + Antibox
A Pa02<55 =
02 sat<88
Side effect of Fluconazole are?
Hepatotoxicity
Why is low diffusion of CO expected in Emphesyma?
destroyed cartilage and alveoli = increase CO in alveoli spaces
What is ARDS?
Hypoxic lungs - Sepsis, Trauma, Overdose
What does a FB need for Tx?
Rigid Broncoscope and remove
What will FB look like?
Sudden onset Unilateral rhinorrhea, Foul smell.
FB diagnoses?
History + CXR (R-lung doesn’t collapse) = obstruction.
What cough med does not cause addiction or constipation
Dextromethorphan (Robitussin)
Positive Charcoal yeast is treated with what?
Azithro - Legionella
Horner’s comes from?
Right side Apex cancer compression of sympathetic nerves
What does Acute Asthma look like on CXR?
Normal
Tx for a carcinoid Small Cell?
Rad + Chemo
Multi rib fractures and pardadoxical breathing leads to?
Flail Chest
How do you support a choking kid that is coughing?
Allow him to cough out the obstruction, then Heimlich
AMS in COPD pt is due to?
Hypoventilation
What genetic dx has lung and elevated ALTs?
Alpha 1 antitrypsan
Cromyln Na’s MAO?
Mast cell stabilizer
Most common COPD associated PNA?
Strep> Heamp>Morax
Obstruction in the lungs can lead to what CO/02 distal?
low pH, increased C02
Lancet shaped diploccoci are?
S. pneumo AKA pneumococcus
Why does TB like the apex?
Increased 02 pressure
Exercise induced asthma is due to?
Mast cell rupturing
