Pulmo, Harrison Flashcards
Condition in which venous thrombi dislodge from their site of formation and emboli to pulmonary arterial circulation
PE
PE in the setting of normal right heart function and normal systemic arterial pressure
Small to moderate PE
PE in the setting of RV hypokinesis but normal systemic arterial pressure
Moderate to large PE
PE in the setting of arterial hypotension and anatomically widespread TE
Massive PE
PE: Gender predominance
F
PE: Acquired risk factor that has a greater risk of fatal PE
Cancer
PE: Non-DVT specific risk factor that has a greater risk of fatal PE
Cerebrovascular disease
50% of DVT is due to (2)
1) Pelvic vein thrombosis
2) Proximal leg DVT
Vein thrombi that poses a lower risk of PE
Isolated calf vein thrombi
PE: First step in outpatient or ER setting with non-high clinical likelihood
D-dimer
PE: Elevated D-dimer, next step is
Imaging
PE: First step for inpatients or with high likelihood
1) Chest CT with contrast
2) Lung scan if with renal insufficiency or renal contrast allergy
COPD: Major risk factor
Cigarette smoking
COPD, normal vs slightly reduced, vs markedly reduced levels of α1 antitrypsin: M allele
Normal
COPD, normal vs slightly reduced, vs markedly reduced levels of α1 antitrypsin: S allele
Slightly reduced
COPD, normal vs slightly reduced, vs markedly reduced levels of α1 antitrypsin: Z allele
Markedly reduced
COPD, normal vs slightly reduced, vs markedly reduced levels of α1 antitrypsin: Null allele
Absence
COPD: Most common cause of exacerbation
Viral infections
3 most common symptoms of COPD
1) Cough
2) Sputum production
3) Exertional dyspnea, frequently of long duration
COPD: Pursed lip breathing
Emphysema
Tripod position is in order to
Facilitate actions of SCM, scalene, and intercostal muscles
Sign associated with paradoxical breathing
Hoover sign (inward movement of rib cage)
Signs of cor pulmonale (6)
1) Peripheral edema
2) Ascites
3) Hepatic congestion
4) Elevated JVP
5) RV heave
6) 3rd heart sound
T/F Chronic bronchitis without chronic airflow obstruction is not COPD
T
T/F Asthma patients can also develop chronic (not fully reversible) airflow obstruction
T
T/F Clubbing of fingers is not a sign of COPD
T
In patients with COPD, newly developed clubbing is most likely explained by
Lung CA
Hospitalization in COPD is recommended for (4)
1) Respiratory acidosis and hypercarbia
2) Significant hypoxemia
3) Severe underlying disease
4) Living situation not conducive to careful observation and delivery of prescribed treatment
2 interventions demonstrated to influence the natural history of COPD
1) Smoking cessation
2) O2 therapy
The only therapy demonstrated to decrease mortality in COPD
Supplemental O2
COPD: Arterial pH allows classification of ventilatory failure, which is defined as
pCO2 >45mmHg
Principal determinant of morbidity in COPD
Degree of airway obstruction
COPD: Patients who continue to smoke cigarettes experience an annual decline in FEV1 of
80-100mL
COPD: Patients who quit smoking experience an annual decrease inFEC1 of
30mL
COPD: Median survival for severe disease
4 years
COPD: Severe disease is defined as
FEV1 less than 1L
