Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NPLEX II TIA > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

normal vs restrictive vs obstructive values for pulmonary function tests: FVC

A

normal FVC: 5 L
restrictive: lower
obstructive: normal or lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

normal vs restrictive vs obstructive values for pulmonary function tests: FEV1

A

normal: 3.75 L
restrictive: lower
obstructive: much lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

normal vs restrictive vs obstructive values for pulmonary function tests: FEV1/FVC

A

normal: 70-75%
restrictive: higher
obstructive: lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

which blood has a higher hemoglobin saturation and thus higher Po2; venous or arterial blood?

A

arterial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

explain the following lung imaging finding:

border between same density organ is lost

A

silhouette sign; usually caused by a pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

explain the following lung imaging finding:

dark markings on abnormal white lung

A

alveoli are fluid filled; air in bronchi visible on xray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

at what cardiac size is imaging positive for enlarged cardiac silhouette?

A

if the size of the heart is greater than half the width of the chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

explain the following lung imaging finding:

fundus of stomach appears as a fluid density or air fluid level behind the heart

A

hiatal hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

explain the following lung imaging finding:

jagged edges at the lateral aspect of the image

A

rib fracture; watch for pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

explain the following lung imaging finding:

“fluffy” multiple white lines

A

diffuse interstitial pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

explain the following lung imaging finding:

blunt costophrenic angles

A

pleural effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

causes of lungs appearing too white on xray

A

pneumonia
TB
atelectasis
lung cavity, nodule, or mass
pleural effusion
congestive hearrt failure
chronic interstitial disease (confined to a particular area)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

more common causes of diffuse interstitial pneumonia

A

viral agents or mycoplasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

primary and secondary TB infection lung findings

A

primary infxn seen in upper lobes with pleural effusion and hilar lymph node enlargement

secondary infxn xray is normal or shows small calcifications in lungs and lymph nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

causes of lungs to appear too black on xray

A

pneumothroax (air b/w pleura rising to highest point in chest; black w dec number of vessels)

PE (blood supply to lungs cut off)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

____ collects at the highest point in the chest, as opposed to ____ which collects at the lowest point

A

air = highest
fluid = lowest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

image of choice for lung / chest masses

A

CT to avoid motion artifact from breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

NON sedating H1 receptor antagonists names and doses

A

fexofenadine (allegra): 30, 60, 180 mg
loratadine (claritin) : 5-10 mg
certirizine (zyrtec): 5 and 10 mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

NON sedating H1 antagonist AE and CI

A

loratadine & fexofenadine:
CI with use of erythromycin, ketoconazole, or itraconazole due to fatal arrythmias
avoid in severe renal impairment
no grapefruit/OJ/apple for 4 hours

certirizine:
avoid alcohol, sedative, tranquilizers > CNS depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

diphenhydramine medication class and uses

A

sedating h1 receptor antagonists
used for allergic rxns from type 1 allergies and insomnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

diphenhydramine AE and CI

A

AE: seizures, sedation, n/v, dry mouth, epigastric distress, thrombocytopenia, agranulocytosis

CI with CNS depressants and MAO inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

diphenhydramine dosage

A

12.5, 25, 50 mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

epinephrine MOA and uses

A

anaphylactic shock; vasodilation of B2 receptors (and vasoconstriction a1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

epinephrine AE

A

cerebral hemorrhage, CVA, HTN, tachycardia, v fib, shock, n/v, HA, drowsiness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

oxymetazoline MOA and uses

A

nasal spray or eye drop; a1 receptor stimulant; vasoconstriction

used for congestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

oxymetazoline AE/CI

A

arrythmia, anaphylaxis, asthmatic episodes, HA

do not use with MAO inhibitors or severe HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

albuterol MOA and uses

A

short acting b2 adrenergic agonists that causes bronchodilation; acute ashtma; acts in <15 mins, lasts 3-4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

medications for short term asthma management

A

short acting beta agonists
anticholinergics
systemic corticosteroids
magnesium sulfate (IV) - emergency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

long term asthma control medications

A

inhaled corticosteroids
long acting beta agonists
leukotriene modifiers
mast cell stabilizers
biologics (immune; for severe asthma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

albuterol AE /CI

A

nervousness, tremor, tachycardia, HA, palpitations, n/v, bronchospasm

avoid use with CNS stimulants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

ipratropium med class and uses

A

anticholinergic bronchodilator (parasympathoLYTIC); asthma/COPD bronchospasm relief in combo with SABAs; esp in emergency settings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

fluticasone/budesonide med type, asthma use, dosage

A

inhaled corticosteroids; dec inflammation in airways
used daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

salmeterol med type, asthma use, dosage

A

long acting beta 2 agonist; used with ICS for long term control, not for acute sx

1-2 inhalations daily; 1.5 hours before exercise for exercise induced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

montelukast med type, asthma use, dosage

A

leukotriene modifier, dec inflammation/bronchoconstriction, taken daily PO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

cromolyn med type, asthma use, dosage

A

mast cell stabilizer, prevents degranulation of inflammatory mediators from mast cells

usually inhaled/nasal/opti - dosed frequently

prophylaxis only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

guaifenesin med class, MOA, uses

A

mucolytic; decreases viscosity of secretions, expectorant (does NOT suppress cough)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

acetylcysteine med class, MOA, uses

A

reduces viscocity of respiratory tract fluid; mucolytic at high doses

used for pneumonia, bronchitis, TB, CF, emphysema, etc

antidote for acetominophen overdose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

acetylcysteine SE/cautions

A

rhinorrhea, stomatitis, n/v, bronchospasm

activated charcoal dec effectiveness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

glucocorticoid AE/caution

A

water retention and CV problems

long term: osteoporosis, peptic ulcer

inhaled steroids less systemically absorbed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

steroid drug suffixes

A

-sone
-zone
-onide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

cromolyn AE/caution

A

throat irritation
do not use during acute asthma attacks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

ipratropium bromide AE/CI

A

arrythmias
not for single use in acute attack bc no sympathetic activity

43
Q

rescue/acute inhalers versus maintenance inhalers

A

rescue/acute:
- sympathomimetics only: epinephrine, albuterol, metoproterenol

maintenance inhalers:
- steroids, advair, intal, atrovent

44
Q

black box warning for long acting beta 2 agonists

A

inc risk of asthma related death; works very well at managing sx, not treating cause of asthma so person is just as asthmatic - sudden rebound attack when meds leave system (usually happening with missed doses)

ex of med: salmeterol

45
Q

a-adrenergic agonists names and MOA/uses

A

psuedoephedrine (sudafed) -
phenylephrine (sudafed PE) - less eff/AEs

decongestants; stimulates a1 receptors > vasoconstriction

46
Q

phenylephrine AE/CI

A

arrythmia, anaphylaxis, asthmatic episodes, HA

DO NOT USE W MAO INHIBITORS or severe HTN

47
Q

pseudoephedrine HCl AE/CI

A

anxiety, nervousness, palpitatinos, HA, insomnia

DO NOT USE WITH MAO INHIBITORS

48
Q

a-adrenergic agonists (pheynephrine, psuedoephedrine) AE

A

exacerbation HF, pulmonary HTN, renal toxicity, visceral ischemia

49
Q

antitussives

A

opiates: codine/hydrocodone; dec central respiratory drive

dextromethorphan (robitussin): cough suppressant, acute coughs/flu

benzonatate: non narcotic, local anesthetic, acute/coughs/flu

50
Q

benzonatate (tesselon pearles) AE/CI

A

ester or PABA allergy, use with other anesthetics

51
Q

cough duration classifications

A

acute: 0-3 weeks
subacute: 3-8 weeks
chronic: >8 weeks

52
Q

acute cough algorithm

A

life threatening (pneumonia, severe asthma/COPD exacerbation, PE, HF)

non life threatening:
- infections (URI, LRI)
- exacerbations (asthma, bronchiectasis, UACS/post nasal drip, COPD)
- environmental/occupational

53
Q

subacute cough algorithm

A
  • postinfectious (pneumonia, pertussis, bronchitis, new onset/exacerbation UACS, ashtma, GERD, bronchitis)
  • non-post infectious: chronic cough workup
54
Q

chronic cough algorithm

A

chest xray if hasn’t been done!

ACEis, smoking, cancer, UACS, GERD, asthma

55
Q

ashtma signs/sx

A

wheezing, dyspnea, cough, nocturnal sx
bilateral wheezing, hyperresonance to percussion, PFTs normal/abnormal

56
Q

conditions that can mimic asthma

A

CHF
PE
GERD
foreign body aspiration
upper airway obstruction > stridor (tumors, tracheal stenosis)

57
Q

how do NSAIDs cause asthma exacerbation?

A

NSAIDS only block COX pathway, so all arachadonate goes through lipoxygenase pathway > leukotrienes

58
Q

exercise induced asthma usually occurs when during exercise?

A

5-10 mins after starting

59
Q

what drugs can induce/exacerbate asthma?

A

ASA
NSAIDs
beta blockers
histamine

60
Q

asthma four step classification

A

(higher step = more chance of death = more medication)

1: mild intermittent (<2/week) - short acting rescue inhaler
2: mild persistent (>2/week, <1/day)
3: moderate persistent (daily)
4: severe persistent (constant)

61
Q

pneumothorax vs

A

pneumothorax: lung being collapsed by area, trachea deviates AWAY from lesion

atelectasis: lung losing body and collapsing in on itself; trachea deviates TOWARD lesion

62
Q

types of pleural effusion

A

transudate (CHF; starling forces)
exudate (infectious; immune proteins)
empyema (walled off infxn)
hemorrhagic (PE)
chyliform (lymph fluid)

63
Q

pleural effusion vs pneumothorax lung sounds

A

pneumo: dec lung sounds
pleual effusion: inc breath sounds

64
Q

bronchiolitis

A

dangerous in infants and elderly; usually viral in nature
xray shows hyperinflation and peribronchial infiltrates

65
Q

acute bronchitis common causes

A

acute inflammation trachea/bronchi usually due to: influenza, RSV, coxsackie, adenovirus, rhinovirus

often follows or is associated with acute sinusitis or pharyngitis

bacteria less common: strep pneumo, h flu, morazella catarrhalis

66
Q

consolidated/lobar pneumonia etiology

A

strep pneumo, h flu, gram neg bacteria, moraxella catarrhalis, staph aureus

klebsiella pneumo in chronic alcoholics, e coli in diabetics

67
Q

atypical/”walking” pneumonia etiology

A

mycoplasma, chlamydia pneumoniae
viral pneumonias

68
Q

what lung pathology should be considered in ddx of altered mental status in the elderly?

A

pneumonia; elderly pts often have fewer/less severe sx or atypical presentations

69
Q

most common causes of hospital acquired pneumonia

A

gram negative bacilli

70
Q

lung abscess etiology, signs/sx

A

mostly bacterial;

50% due to aspiration of bacteria when pt is recumbant (coma, anesthesia, substance use, stroke), or those with problems swallowing or coughing

sx: fever, chills, pain, weakness, wt loss, foul/musty smelling sputum mixed w blood (rusty sputum)

71
Q

TB patho

A

acid-fast intracellular parasitic mycobacteria

usually starting in upper lobes; primary infxn becomes walled off, lesions shrink and heal, leaving behind caseating granulomas

72
Q

testing/dx TB

A

tuberculin skin test; bacteriologic culture is dx
airborne transmission
often asx
reactivation = upper lobe infiltrates on CXR

73
Q

aspergillosis transmission, dx

A

fungal infection caused by soul pathogens; airborne transmission (construction)

XR: solitary lesions, round intracavitary mass

74
Q

cryptococcal pneumonia transmission, dx

A

encapsulated yeast in pigeon droppings; portal of entry in lung but often causes meningitis

asx, XR shows large solitary nodule, pneumonitis

dx biopsy and culture; LP to r/o meningitis

75
Q

cryptococcal pneumonia tx

A

amphotericin B

76
Q

histoplasmosis dx/transmission

A

most common US mycosis; midwest/south central US

asx or atypical pnuemonia; patchy ilfiltrates on XR with hilar/medistinal adenopathy, flu like sx

XR: apical lung lesions, cavitation, fibrosis

dx: sputum culture/biopsy

77
Q

coccidiomycosis/valley fever etiology

A

infectious fungal lung; arthospores become airborne from fungal mycelia in soil

common in deserts after rainstorms

78
Q

coccidiomycosis/valley fever signs/sx/dx

A

incubation up to 28 days: fever, malaise, dry cough, chest pain, night sweats, anorexia

NO hemoptysis

fine macular, urticarial rash, erythema nodosum (good prognosis)

tx: antifungal

79
Q

first two ddx to consider with hemoptysis

A

TB
lung cancer

80
Q

general description of chronic obstructive lung disease

A

airflow limitation from obstruction that is not fully reversible; lungs fill with air behind obstruction and become over inflated. difficult to breathe overcoming that resistance

lung tissue destroyed from chronic infection

81
Q

interstitial (restrictive) lung dz general description

A

infiltration of inflammation and scarring of lung parenchyma > wide spread lung fibrosis > inc elastic recoil, dec compliance

lung is smaller in volume, patient has to work harder to breath against decreased compliance (lungs more like rubber)

82
Q

two major lower respiratory diseases/COPD dx

A

emphysema “pink puffers” - normal pCO2 due to reactive polycythemia adjusting to new normal

chronic bronchitis “blue bloaters” - increased pCO2 bc episodic

83
Q

why would you give a bronchitis patient antibiotics if acute bronchitis is usually viral?

A

if they have an acute exacerbation with chronic bronchitis it is likely bacterial superinfection

84
Q

acute onset of dyspnea or hypoxemia with normal chest XR first ddx

A

PE until proven otherwise

85
Q

PE dx and tx

A

V/Q scan, CT angio
anticoagulation, preventing recurrence

86
Q

cystic fibrosis etiology and patho

A

AR disorder of exocrine glands; in respiratory tract inadquate hydration of tracheobronchial epithelium impairs mucociliary function

dx: >80 adult, >60 kids sweat chloride. pancreatic insufficiency, esp in kids

chronic pseudomonas aeruginosa or staph aureus bronchitis and beconhiectasis with recurrent exacerbation

87
Q

what is bronchiectasis

A

irreversible dilatation of bronchial tree; obtruction can arise from tumor, foreign bodies, impacted mucus, external compression

congenital form rare, cystic fibrosis most common form

88
Q

signs/sx bronchiectasis

A

prurlent sputum, or dry cough
rales and clubbing
recurrent pulmonary infxn
hemoptysis
loss of lung volume and honeycombing and cystic spaces

89
Q

collagen vascular disease etiology/patho

A

common in SLE, scleroderma
2/3 pts with CVD will have clinical pulmonary dz; pleural dz in all CVD except poly/dermatomyosis
pulmonary nodules can occur in RA

90
Q

ddx hemoptysis and hematuria

A

goodpastures

dx IgG deposits in glomeruli and presence of antiglomeruli BM ab in serum

91
Q

silicosis etiologic agent & mechanism of lung injury

A

crystalline silicon dioxide via inhalation; alveoli filled with eosinophilic debris

sandblasting, mining, tunnerling, quarrying, stonecutting, polishing

92
Q

asbestosis etiologic agent & mechanism of lung injury

A

strength/flexiblity/resistance

pulmonary fibrosis with asbestos bodies; pleural collagen plaques, pleural effusion

inc risk bronchogenic carcinoma and mesothelioma

93
Q

most common cause of death due to cancer in the US for men and women

A

bronchogenic carcinoma

94
Q

adenocarcinoma radiologic findings & 5 year survival rate

A

most common
peripheral mass, solitary nodules
27%

95
Q

squamous cell bronchiogenic carcinoma radiologic findings & 5 year survival rate

A

common
hilar mass, atelectasis, post obstructive pn
37%

96
Q

large cell bronchiogenic carcinoma radiologic findings & 5 year survival rate

A

large peripheral mass
27%

97
Q

small cell bronchiogenic carcinoma radiologic findings & 5 year survival rate

A

hilar mass, adenopathy
<1%

98
Q

central vs obstructive apnea

A

central- cessation of air flow, no movemnt of rib cage or abdomen

obstructive - paradoxical motion of rib cage and abdomen without air flow

can also be a mixed type. all typed have fall in O2 sat

99
Q

ARDS etiology/path

A

life threatening condition in which inflammation in the lungs and accumulation of fluid in the air sacs (alveoli) leads to low blood oxygen levels

common causes: pneumonia, septic shock, trauma, aspiration of vomit, chemical inhalation

100
Q

ARDS signs/sx

A

SOB
labored, rapid breathing
low BP/shock
so sick theyre unable to complain of sx

101
Q

acute pulmonary edema is usually associated with what pathology?

A

usually associated with CHF; may appear suddenly with chronic heart failure or be first manifestation of cardiac dz

102
Q

acute pulmonary edema signs/sx

A

severe dyspnea, worse with lying supine
productive frothy pink sputum
diaphoresis
tachycardia
cyanosis
wheezing
rales
CXR: blurred vascular outline, inc heart size and interstitial markings

103
Q

cheyne stokes respiration is often seen when?

A

advanced CHF and neuro dz
alternating tachypnea and apnea

104
Q
A

NPLEX II TIA (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions