PULMO Flashcards
Flow loops:
Diff bet COPD & BA?
DLCO dec in COPD, (N) or inc in BA
Flow loops:
Diff bet intra & extrathoracic obstruction?
DLCO is dec in intrathoracic, (N) in extrathoracic
RV dec in intrathoracic, inc in extrathoracic
Flow loops:
What differentiates obstructive fr restrictive?
TLC
Inc in obstructive, dec in restrictive
When to use leukotriene modifiers?
Add on for mild/mod/severe asthma
Criteria for intermittent asthma?
daytime sx
Tx for mild persistent asthma
Low dose inhaled steroid
Or leukotriene modifier Or cromolyn
Mech of cromolyn
Mast cell stabilizer
Tx for moderate persistent asthma
Med dose steroids + LABA
Criteria for mod persistent asthma
Daytime sx daily, night sx weekly
Anti-IgE for asthma
Omalizumab
What can dec freq of exacerbation in asthma?
Tiotropium
Flow of meds in exercise-induced asthma?
B agonist - cromolyn - inhaled steroids/montelukast
Sx similar to asthma, PFT (n), methacholine challenge neg
Non-asthamatic eosinophilic bronchitis
Check sputum for eos
For ASA-sensitive asthma, what to use?
D/C asa, avoid nsaids
May use montelukast, codeine based analgesics
Byssinosis
Allergy to cotton dust
Pathology in alveolar proteinosis
Defective macrophages causing build up
Dxtic in alveolar proteinosis
BAL showing tan colored fluid
Tx in alveolar proteinosis
Whole lung lavage
Eosinophilic pneumonia presentation
Sob, fever, cough
BAL shows eosinophils
CXR in acute vs chronic eosinophilic pneumonia
Acute: ground glass
Chronic: very peripheral infiltrates
Tx of eosinophilic pneumonia
Steroids
Dx of ABPA
(Allergic)
Type 1 hypersensitivity rxn
Serum igE, IgM
(Bronchopulmonary)
Brown mucus plugs
Migratory infiltrates
(Aspergillosis)
skin testing pos for aspergillus
Tx of ABPA
Steroids
Asthma + vasculitis
Churg-strauss
Tx: steroids
Loeffler’s syndrome cause & tx
Strongyloides infxn
Tx: thiebendazole
Hypersensitivity pneumonitis findings?
Type 3-4 hypersensitivity
BAL NO EOSINOPHILS, lymphocytic, CD 8 > CD4
CXR groundglass
Lung reduction surgery for COPD
Fev1
Lung transplant in COPD
Fev1
COPD going for flight
Maintain paO2 > 70
Criteria for O2 in COPD
Pao2 55
Copd w/ fev1
Roflumilast
What has shown to dec exacerbations in copd?
Abx for 5 days every 8 weeks (azithro, moxi)
GOLD criteria for COPD
Fev1 > 80 – mild
Fev1 55 – very severe
Tx per stage of copd
Mild - b agonist prn
Mod - tiotropium +/- salmeterol
Severe - steroids
Very severe- O2
Treatment for high altitude sickness/pulmonary edema
Descent
Dexamethasone
Prophy: acetazolamide
What vaccine has been shown to dec mortality in copd
Influenza