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Urgent Care Guide > Pulmonary 1 > Flashcards

Pulmonary 1 Flashcards

1
Q

bronchitis

A

inflammation of large airways characterized by cough w/ or w/o sputum

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2
Q

inflammation of large airways characterized by cough w/ or w/o sputum

A

bronchitis

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3
Q

acute bronchitis - duration of a/sx, follows
2

A

symptoms 5 days - 3 weeks; typically preceded by URIs

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4
Q

chronic bronchitis - duration, predecessor to

A

sx present most days 3 months or more in a year, and it has been 2 or more consecutive years
predecessor to COPD

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5
Q

bronchitis clinical pres
3

A
  1. cough
  2. URI sx
  3. fever
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6
Q

bronchitis - cough may present for how long

A

weeks, mean duration 18 days

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7
Q

bronchitis - cough may have what

A

+/- sputum production

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8
Q

bronchitis - fever can accompany what
2

A

wheezing
dyspnea

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9
Q

bronchitis - PE findings
2

A

may be present
1. wheezing
2. rhonchi

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10
Q

rales vs rhonchi mnemonic

A

rales/crackles in the tails (aveoli)
rhonchi/wheezing in the bronchi (bronchial tree)

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11
Q

bronchitis - img/testing

A

consider cxr t r/o pneumonia

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12
Q

bronchitis - DD
5

A
  1. PNA
  2. pertussis
  3. COPD exacerbation
  4. asthma exacerbation
  5. irritants - smoke, inhalation, chemicals, allergic irritants
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13
Q

bronchitis - what tx’s not indicated
3

A
  1. abx not indicated for acute bronchitis
  2. steroids not indicated for acute bronchitis
  3. bronchodilators not indicated for acute bronchitis
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14
Q

bronchitis - when to give abx, steroids, bronchodilators

A

abx - COPD or chronic bronchitis exacerbations
steroids - suspected asthma or COPD or chronic bronchitis exacerbation
bronchodilators - consider for reactive airway disease

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15
Q

bronchitis - non pharm antitussives
4

A
  1. smoking cessation
  2. how water/tea
  3. honey
  4. avoiding irritants
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16
Q

bronchitis - pharm antitussives have limited efficacy data but options include
3

A
  1. benzonatate/Tessalon pearls (100-200mg TID x 1 week; max 600 mg/day)
  2. guaifenesin/Mucinex
  3. dextromethorphan/Robitussin
17
Q

bronchitis - when to refer to PCP

A

PCP f/u in 3-5 days if worsening symptoms

18
Q

bronchitis - when to send to ER
2

A
  1. respiratory distress
  2. hypoxia
19
Q

COPD

A

chronic inflammatory disease that caues obstruction of airflow

20
Q

chronic inflammatory disease that caues obstruction of airflow

A

COPD

21
Q

COPD two types

A

emphysema
chronic bronchitis

22
Q

COPD clinical pres
6

A
  1. dyspnea
  2. chest tightness
  3. wheezing
  4. cough productive of sputum
  5. hypoxia
  6. +/- fever
23
Q

COPD - usually has hx of
2

A

smoking
home oxygen use

24
Q

acute exacerbations of COPD often associated w/

A

URI

25
Q

COPD - PE findings
9

A
  1. inspiratory/expiratory wheezing
  2. rhonchi
  3. decreased breath sounds
  4. tachypnea
  5. accessory muscle use
  6. pursed lips
  7. increase AP chest diameter
  8. cyanosis
  9. cachexia
26
Q

COPD - img/testing
2

A
  1. consider cxr if concerned for PNA or HF
  2. consider EKG
27
Q

COPD - DD
7

A
  1. asthma
  2. PNA
  3. PE
  4. pneumothorax
  5. CHF
  6. ACS
  7. arrhythmia
28
Q

COPD - most can be managed where

A

OP

29
Q

COPD - tx
3

A
  1. short acting bronchodilators
  2. possible abx
  3. possible prednisone PO 5-7 days
30
Q

COPD - bronchodilator rx options (adults)

A

i.e. albuterol inhaler 2-4 puffs (q4-6 hours, max 12 puffs/day)
albuterol NEB 2.5 mg (max 10mg/day)

other SABA is levalbuterol

31
Q

COPD - pediatrics bronchodilator info
2

A

2-4 years old
NEB 0.63-2.5 mg NED q4-6h prn

5 years +
NED 1.25-5 mg q4-8h prn

32
Q

COPD - steroid PO

A

consider prednisone 40-60 mg PO for 5-7 days

33
Q

COPD - abx if 3 cardinal sx present

A
  1. increased dyspnea
  2. increased sputum volume
  3. increased purulence
    OR
    increase sputum purulence + 1 other cardinal sx
34
Q

COPD abx choices
3

A
  1. azithromycin 500 mg PO once daily x 3 days
  2. doxy 100 mg PO BID 5-7 days
  3. cefuroxime 500 mg PO BID 5-7 days
35
Q

COPD - when to refer to ER
3

A
  1. hypoxia <92% on RA or home oxygen
  2. little to no improvement after tx
  3. impaired mental status or somnolence

Urgent Care Guide (38 decks)

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