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AGACNP Exam > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

Pulsus paradoxus of greater than 12 mmHg is seen in asthma or COPD?

A

Asthma

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2
Q

What do you hear when you percuss over the gastric air bubble?

A

Tympany

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3
Q

Hospitalization is recommended if FEV1 is below what in asthma?

A

Below 30% predicted value

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4
Q

Hospitalization is recommended if peak flow is below what in asthma?

A

Below 60 liters/min

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5
Q

What will you see on the CXR of a pt with acute asthma?

A

Hyperinflation

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6
Q

What is the preferred step 1 agent in asthma, and what is an example of one?

A

SABA - ex. is albuterol

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7
Q

How do SABAs work?

A

Stimulate enzymes that convert adenosine triphosphate to cAMP

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8
Q

What is the preferred step 2 agent in asthma?

A

Low-dose inhaled corticosteroids

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9
Q

What is the step 3 in asthma management?

A

Low dose inhaled corticosteroid + LABA

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10
Q

What are two combined inhaled corticosteroid + LABA combos used in asthma?

A

Advair and Symbicort

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11
Q

What is Advair a combo of?

A

Fluticasone and salmeterol

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12
Q

What is Symbicort a combo of?

A

Formoterol and budesonide

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13
Q

What is the indication for IM epi?

A

Stridor or resp distress 2/2 anaphylaxis

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14
Q

What is chronic bronchitis defined as?

A

Productive cough for 3 or more months in at least 2 consecutive years

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15
Q

What is emphysema defined as?

A

Abnormal, permanent enlargement of the alveoli

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16
Q

COPD/emphysema will show what on CXR?

A

Low, flat diaphragm 2/2 air trapping

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17
Q

What two drugs are the mainstay of COPD tx?

A

Inhaled ipratropium bromide or sympathomimemetics

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18
Q

What is a major pulmonary disease that causes night sweats?

A

TB

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19
Q

How is the definitive diagnosis of TB made?

A

Culture of M. tuberculosis x 3

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20
Q

What is seen on CXR in TB?

A

Small homogenous infiltrates in upper lobes of CXR

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21
Q

What does a PPD for a pt with TB?

A

Just that they were exposed to TB

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22
Q

What should you do if pt has a positive PPD and neg CXR?

A

Offer 6 months INH

23
Q

What 4 drugs are given for TB?

A

Isoniazid, rifampin, pyrazinamide, ethambutol

24
Q

How long should someone be on TB treatment, at minimum?

A

6 months

25
Q

How long should someone with HIV be treated for TB?

A

9 months

26
Q

What is a major complication of INH (isoniazid)?

A

Hepatotoxicity

27
Q

Pts taking ethambutol should be tested for what?

A

Visual acuity and red-green color perception

28
Q

The general population is considered PPD positive at what size reaction?

A

15 mm

29
Q

Immigrants from high risk areas or health care workers are considered PPD positive at what size reaction?

A

10 mm

30
Q

HIV infected persons are considered PPD positive at what size reaction?

A

5 mm

31
Q

What is the most common agent that causes CAP?

A

S. pneumoniae

32
Q

What are three treatment choices for low severity, outpatient CAP?

A

Amoxicillin, doxycycline, or macrolide

33
Q

What is the tx for inpatient CAP caused by psuedomonas?

A

Zosyn or meropenem or cefepime + aminogylcoside/azithromycin

34
Q

What is HAP defined as?

A

PNA that occurs at greater than 48 hours of admission

35
Q

What is VAP defined as?

A

PNA that occurs more than 48–72 hours after intubation

36
Q

What is the most common causative organism for VAP?

A

Pseudomonas

37
Q

Is fremitus increased or decreased in PTX?

A

Decreased

38
Q

Is fremitus increased or decreased in PNA?

A

Increased

39
Q

At what landmark is needle decompression for a PTX done?

A

2nd intercostal space, mid clavicular line

40
Q

At what landmark is a chest tube placed for PTX?

A

4th or 5th ICS, mid axillary line

41
Q

What is the mainstay therapy for sarcoidosis?

A

Corticosteroids

42
Q

What study should be performed in all clinically stable pts with suspected PE?

A

VQ scan

43
Q

If VQ scan is indeterminate for PE but you suspect pt has a PE, what is the next step?

A

Pulmonary angiography

44
Q

Hypoxemia is defined as what on an ABG?

A

PaO2 <80 mm Hg

45
Q

What will you see on an ABG in PE?

A

Hypoxemia and hypocapnia

46
Q

What is the hallmark feature of ARDS?

A

Refractory hypoxemia

47
Q

How much TV should a pt with ARDS have?

A

6-8kg of ideal body weight

48
Q

How much PEEP should a pt with ARDS have?

A

At least 10 cm H2O

49
Q

If you put a pt on a vent and ABG shows resp acidosis, what should you do?

A

Increase ventilation rate

50
Q

If you put a pt on a vent and ABG shows resp alkalosis, what should you do?

A

Decrease ventilation rate

51
Q

If your pt is vented and starts breathing on their own, you switch from assist control to what?

A

SIMV (synchronized intermittent mandatory ventilation)

52
Q

What is the difference between assist-control and SIMV?

A

In assist control, if the pt initiates a breath on his own, the vent delivers preset TV. In SIMV, if the pt initiates a breath, they pull whatever tidal volume they can

53
Q

If you have a pt on assist-control and they start breathing on their own and you don’t switch them to SIMV, what will develop?

A

Respiratory alkalosis (from overbreathing)

54
Q

An exudate has higher what than a transudate?

A

Protein and/or LDH

AGACNP Exam (14 decks)

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