Pulmonary Flashcards

1
Q

Pertussis treatment

A

Macrolide- azythromycin

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2
Q

Older adults with CAP, sicker- what pathogen? How would you treat?

A

Strep pneumo
B-lactam ie amoxicillin or doxycycline

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3
Q

Younger patients with community acquired pneumo- what pathogen and how to treat?

A

-Atypical pathogens ie. mycoplasma pneumo or chlamydiphilia pneumo
- macrolide ie. azythromycin or doxy

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4
Q

Patients with CAP and other comorbid conditions- what pathogen?
Treatement?
If pregnant or CI?

A

Drug resistant strep pneumo
Resp quinalone- ie. moxi/levofloxacin
Preg- macrolide + beta lactam ie. azythromycin + amoxicillin

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5
Q

Three meds used to treat CAP

A

Macrolide- azythromycin
Resp qinalones- moxi/levo
Beta lactams- amoxicillin +/- clav

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6
Q

Diagnostic criteria COPD spiro?

A

FEV1/FVC <0.7

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7
Q

Stages of COPD

A

4 stages

1- FEV1 > 80%
4- FEV1 < 30%

4 = worst

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8
Q

SABA onset and duration

A

Onset 10 mins- duration 4-6h

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9
Q

LABA onset and duration

A

10-20 mins
Last 12h

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10
Q

Steroid treatment of COPD exacerbation

A

Prednisone 40mg PO OD x 5 d

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11
Q

Side effects of anti cholinergics saying-

A

Oh this drug it makes me pink
Sometimes I can’t think, or even blink
I can’t see
I can’t pee
I can’t spit
I can’t shit

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12
Q

What COPD meds do you avoid in ppl with BPH

A

Antocholinergics ie SAMA/ LAMA

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13
Q

Long term side effects of inhaled steroids x2

A

Increased risk of cataracts - annual eye exams
Increased r/o Osteopenia

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14
Q

Normal upper and lower lobe breathe sounds

A

Upper- vesicular- soft and low
Lower- bronchial- louder

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15
Q

Name the condition-
Increased breathe sounds
Increased tactile Fremitus
Percussion- dull

A

Consolidation ie. lobar pneumonia

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16
Q

Name the condition-
Decreased/ absent breathe sounds
Decreased tactile fremitus
Percussion- dull

A

Pleural effusion
Mediastinal shift away from effusion (if large)

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17
Q

Name the condition-
Decreased or absent breathe sounds
Decreased tact frem.
Hyper resonance- percuss

A

Pneumothorax
Mediastinal shift aware from the tension pneumo

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18
Q

Name the condition-
Decreased or absent breathe sounds
Decreased tat frem.
Dullness on percuss

A

Atelectasis ie. mucus plugging
Mediastinal shift towards the atelctasis.

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19
Q

Who qualifies for lung cancer screening?
What is the screening test?

A

Low dose CT of chest.

Ppl aged 50-80
> / = 20 pack year history and current smoker/ quit within 15 yrs

Stop screening if have quit for >15 yrs

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20
Q

Chronic bronchitis definition

A

Coughing with excessive mucus for > 3 months for 2 consecutive yrs

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21
Q

Treatment step wise approach for COPD x 4

A

SABA +/- SAMA prn
LAMA
LAMA + LABA
LAMA + LABA + ICS

22
Q

Albuterol med class

23
Q

Salmetrol med class

24
Q

Formoterol Med Class

25
Levalbuterol med class
SABA
26
Vilanterol med class
LABA
27
Ipratropium med class
SAMA
28
Tiotropium med class
LAMA
29
Umeclidinium pwder med class
LAMA
30
COPD pt failing on SABA- what do you add?
SAMA
31
COPD pt failing on SABA + SAMA- what’s next?
LABA or LAMA Then combo them for next step Keep PRN SABA
32
Rescue med inhaler class?
SABA
33
Gold standard definitive test for CAP?
X-ray- repeat in 6 weeks to document clearing
34
If treating a pt with CAP who has antibiotics within last 3 months- treat with what?
Doxycycline or levofloxacin
35
Young person with CAP- treatment?
Think atypical pathogen and treat with azythromycin or doxycycline
36
Older person with CAP- treatment?
Think S.Pneumo - treat with beta-lactam or doxycycline
37
If DRSP CAP is suspected- treatment is?
Resp Quinalonee ie. moxifloxi or levofloxi
38
CURB 65 ?
Confusion BUN elevated Resp > 30 BP <90/60 65 yrs or older Score >1 == hospitalize
39
Top 2 bacteria in CAP
S. Pneumo H. Influenza
40
2 Top bacteria in Atypical Pneumonia
Mycoplasma pneumo Chlamydia pneumo
41
Suspect pertussis after pt experiences what?
Coughing for >2-3 weeks Or failed on abx and is getting worse
42
Duration and treatment of common cold?
Duration of symptoms 4-10 days Treatment is supportive care
43
CXR shows cavitations and adenopathy and granule as in the hill of the lungs—-?
Reactive TB
44
Present in younger children and elderly -milia seed on CXR
Military TB
45
Quad therapy- rifampin + ethambutol + pyrazinamide + INH Treatment of what disease? How long for?
TB 2 months of intensive treatment 18 weeks continuation phase treatment
46
Positive PPD TB test
< 10mm Induration at site
47
ICS + LABA Combo names x 2
Advair- fluticasone + salmeterol Symbicourt- budesonide + formoterol
48
Step 3 Asthma criteria Treatment-
FEV1 60-80% Nightly awakenings 1/wk (not nightly) Tx- low-dose ICS + LABA
49
1st line treatment for severe asthma exacerbation
Epinephrine injection
50
Two medications that cause interstitial lung disease
Amiodarone and methotrexate