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STEP 2 Pulmonary > Pulmo. Hypox/ch.cough/acu+ch bronch/UACS 10-28 (1) > Flashcards

Pulmo. Hypox/ch.cough/acu+ch bronch/UACS 10-28 (1) Flashcards

1
Q

Hypoxemia.
Reduced PiO2 examples?

A

High altitude

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2
Q

Hypoxemia.
PiO2 A-a gradient?

A

normal

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3
Q

Hypoxemia.
Reduced PiO2 corrects with supplemental O2?

A

yes

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4
Q

Hypoxemia.
Hypoventilation examples?

A

CNS depression, morbid obesity, neuromuscular weakness

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5
Q

Hypoxemia.
Hypoventilation A-a gradient?

A

normal

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6
Q

Hypoxemia.
Hypoventilation corrects with supplemental O2?

A

yes

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7
Q

Hypoxemia.
Diffusion limitation examples?

A

Emphysema, ILD

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8
Q

Hypoxemia.
Diffusion limitation A-a gradient?

A

Increased

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9
Q

Hypoxemia.
Diffusion limitation corrects with supplemental O2?

A

yes

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10
Q

Hypoxemia.
V/Q mismatch*
examples?

*caused by localized dead-space ventilation and/or intrapulmonary shunting.

A

Small PE, lobar pneumonia

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11
Q

Hypoxemia.
V/Q mismatch A-a gradient?

A

Increased

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12
Q

Hypoxemia.
V/Q mismatch corrects with supplemental O2?

A

Yes

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13
Q

Hypoxemia.
Large intrapulmonary shunt examples?

A

Diffuse pulmonary edema
+ atelectasis, pneumonia

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14
Q

Hypoxemia.
Large intrapulmonary shunt A-a gradient?

A

Increased

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15
Q

Hypoxemia.
Large intrapulmonary shunt corrects with supplemental O2?

A

No

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16
Q

Hypoxemia.
Large dead space ventilation examples?

A

Massive PE, right-to-left intracardiac shunt

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17
Q

Hypoxemia.
Large dead space ventilation A-a gradient?

A

Increased

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18
Q

Hypoxemia.
Large dead space ventilation corrects with supplemental O2?

A

No

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19
Q

Hypoxemia. Intracardiac shunt (right to left), examples?

A

Tetralogy of Fallot, Eisenmenger syndrome

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20
Q

Hypoxemia. Intracardiac shunt (right to left), A-a gradient?

A

Increased

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21
Q

Hypoxemia. Intracardiac shunt (right to left), corrects with supplemental O2?

A

No

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22
Q

Chronic cough. Duration in adults and children?

A

> 8 weeks in adults and >4 weeks in children

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23
Q

Chronic cough.
Most common causes. Upper airway disorders? 2

A

Upper airways cough syndrome (UACS) (postnasal drip) - Allergic rhinitis, Nonallergic rhinitis (vasomotor), Acute nasopharyngitis, Sinusitis.

Chronic sinusitis

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24
Q

Chronic cough.
Most common causes. Lower airway and parenchymal disorders?

A

Asthma
Post respiratory tract infection
Chronic bronchitis
Bronchiectasis
Lung cancer
Nonasthmatic eosinophilic bronchitis

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25
Chronic cough. Most common causes. Other causes?
GERL ACEI
26
Chronic cough. scheme. 1st step - suspected etiology on history and physical --> evaluate and treat as indicated. ACEI?
Stop ACEI
27
Chronic cough. scheme. 1st step - suspected etiology on history and physical --> evaluate and treat as indicated. UACS?
First generation H1 blockers
28
Chronic cough. scheme. 1st step - suspected etiology on history and physical --> evaluate and treat as indicated. Asthma?
PFTs (pulmonary function tests)
29
Chronic cough. scheme. 1st step - suspected etiology on history and physical --> evaluate and treat as indicated. GERD?
PPI
30
Chronic cough. scheme. 1st step - suspected etiology on history and physical --> evaluate and treat as indicated. ACEI, UACS, Asthma, GERD --> no improvement -->?
Chest X ray
31
Chronic cough. scheme. 1st step - suspected etiology on history and physical --> kitas langelis su simptomais (ne vaistu langelis) ? 3
Parenchymal disease Purulent sputum/immunocompromised No specific etiology After this evaluation next step is chest xray
32
Chronic cough. asthma evaluation?
PFTs or 2-4 weeks of inhaled glucocorticoids (if the cough improves --> diagnosis is made).
33
Chronic cough. ACEI: due to impaired metabolism of kinins and substance P. Increased production of prostaglandins by kinins. Increased thromboxane levels as well.
.
34
Acute bronchitis. Etiology?
Preceding respiratory illness (90 proc viral)
35
Acute bronchitis. clinical? 3
Cough Absent systemic fundings (fever, chills) Wheezing or rhonchi, chest wall tenderness
36
Acute bronchitis. clinical. cough characteristic?
>5 days to 3 weeks Can be productive (yellow, green, or purulent sputum)
37
Acute bronchitis. Diagnosis?
Diagnosis is clinical
38
Acute bronchitis. Diagnosis. when do xray?
only when suspected pneumonia
39
Acute bronchitis. Symptomatic treatment? Abs?
Nsaids/acetaminophen and or bronchodilators abs ARE NOT recommended
40
Acute bronchitis. what viruses?
Influenza A or B, parainfluenza, adenovirus
41
Acute bronchitis. what may be sputum?
bloddy sputum
42
Upper airway cough syndrome. called ,,postnasal drip syndrome"
.
43
Upper airway cough syndrome. presentation?
It presents as chronic cough caused by: a. Rhinosinus conditions: Allergic rhinitis, perennial nonallergic rhinitis, Vasomotor rhinitis b. Acute nasopharyngitis c. Sinusitis
44
Upper airway cough syndrome. what clinical may be reported?
Some patients report liquid dripping into the back of the throat or frequent throat clearing episodes
45
Upper airway cough syndrome. treatment?
1st generation H1 blocker (eg, diphenhydramine) OR Combined antihistamine-decongestant (eg, brompheniramine and pseudoephedrine)
46
Upper airway cough syndrome. if do not respond to treatment after 2-3 weeks?
i. Further investigation (eg, sinus imaging, PFTs, high-resolution CT scan of chest) ii. Empiric sequential therapy for GERD, cough-variant asthma, chronic sinusitis, and non-asthmatic eosinophilic bronchitis
47
Acute bronchitis. symptomatic treatment?
nonprescription pain relievers
48
Acute bronchitis. treatment for cough?
Throat lozenges and OTC cough suppressants (eg, dextromethorphan/guaifenesin)
49
Acute bronchitis. treatment. bronchodilators?
Inhaled bronchodilators (eg, albuterol) are recommended in patients with wheezing in the setting of underlying pulmonary disease (eg, asthma)
50
Acute bronchitis. treatment. abs??
Antibiotics should NOT be given
51
Acute bronchitis. xray for what? 3
i. Suspicion of pneumonia ii. Elderly patients (because signs of pneumonia may be subtle in these patients) iii. Patients with advanced lung disease (eg, COPD)
52
Chronic bronchitis. definition?
3 consecutive months of productive cough in 2 successive years.
53
Chronic bronchitis. leading cause?
smoking
54
Chronic bronchitis. symptoms?
a. Chronic smoking (>=1 pack a day for at least 20 years) b. Productive cough c. Dyspnea on exertion
55
Chronic bronchitis. diagnosis, test?
PFTs
56
Chronic bronchitis. PFTs pattern? DLCO?
i. Obstructive pattern on spirometry ii. Normal DLCO
57
Chronic bronchitis. Differentials?
iCompared to chronic bronchitis, bronchiectasis is associated with a history of recurrent respiratory tract infections and chronic cough with daily production of copious mucopurulent sputum.
58
Chronic bronchitis vs emphysema. bronchitis DLCO?
normal
59
Chronic bronchitis vs emphysema. emphysema DLCO?
decr. DLCO
60
Chronic bronchitis vs emphysema. bronchitis xray?
prominent bronchovascular markings and a mildly flattened diaphragm
61
Chronic bronchitis vs emphysema. emphysema xray?
decreased vascular markings and hyperinflated lung
62
Chronic bronchitis vs emphysema. bronchitis hypoxemia?
more pronounced hypoxemia
63
Chronic bronchitis vs emphysema. emphysema hypoxemia?
less pronounced hypoxemia

STEP 2 Pulmonary (30 decks)

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