Pulmonary Flashcards
Acute onset pleural effusion, ascites, LL edema in a medically free female after IVF
Ovarian hyperstimulation syndrome.
Rx: supportive
Obstructive lung disease
Centrilobular emphysema seen in? usually effect which lobe?
Smokers, upper lobe
Pulmonary hypertension
Patient with MPAP 40 And PCWP 28. Cause of P HTN?
High pulmonary venous return. 83 % of cases caused by HFpEF or HFrEF.
Rule: PCWP > 15 Indicates high pulmonary venous return
Diagnostic criteria for OHS?
1) Presence of hypoventilation. PaCO2 > 45 At day time.
2) Rule out other causes of hypoventilation
3) Obesity BMI > 30
Most common location for lung abscess?
Posterior segment of the right upper lobe
Management options for lung abscess?
Clindamycin (superior to PCN)
AMP-Sulbactam
Others:
Carbapenem
This skin lesion and lung disease
Sarcoidosis. Lupus pernio
Management options for PJP?
Bactrim is first line
Others:
- Clinda + primaquine
- Dapsone + Trimethoprim
- Atovaqoune
Thephiline side effects?
Ventricular arrhythmia, seizure (even in patient without history of seizure), confusion, tremor diarrhea, hyperglycemia and hypokalemia
Eggshell calcification
Chronic silicosis. After 10 years of exposure.
VS
Acute: within 1 year. Shows peripheral and basilar ground glass opacity in ct
Type of pneumonia observed in soldiers after they comeback from iraq and Afghanistan
Acute esonophilic pneumonia
Chronic silicosis causes fibrosis mainly in upper or lower lobe?
Upper lobe. Eggshell calcification
Stages of sarcoidosis in lung?
Initial management of erythema nodusum in Sarcoidosis?
NSAIDs
Triad for Heerfordt syndrom
Parotitis + Facial nerve palsy + Anterior uveitis.
Rx: NSAID’s
known as ABVD (adriamycin, bleomycin, vinblastine, dacarbazine)
Which one of those can cause pulmonary toxicity after receiving this regimen in hodgkin lymphoma?
Bleomycin pulmonary toxicity usually after months to years. Relapse with stopping steroid
True or false
Anti TNF assosiated with drug induced lupus
True
What are the most common conditions associated with secondary pneumothorax?
COPD and PJP
ARDS + Thrombocytopenia + hemoconentration
Hanta virus. One of the hemorrhagic viruses
Diagnosis of Cystic fibrosis require?
2 documented test of sweat chloride test level >. 60 or identification of 2 CF genes + clinical syndrome
First test to do in a patient without history of recurrent sinupulmonary infections, CT shows lower lobe bronchiectasis PFT shows obstructive disease with no reversibility?
Immunoglobulin. As in adults hypogammaglubenemia can cause bronchiectasis + recurrent abdominal infections
Recurrent GI bleeding, epistaxis, oral and nasal hyperpigmentation with desaturation not improving with oxygen
hereditary hemorrhagic telangiectasia. AD disease. Main mechanism is AV Malformation
Dyspnea, buccal mucosal hyperpigmentation, melena and epistaxis. Diagnosis and management
Heriditary hemorrhagic talangectasia.
Management: embolization.
Cause of hypoxia: AVM
Nasal nitric oxide test is used as a screening test for?
Primary ciliary dyskinesia
What parameters can improve survival in ARDS?
1) Low tidal volume
2) Prone position
Note:
- High PEEP improve oxygenation with no mortality benefit
When to avoid home sleep apnea test and use in lab test?
1) Cardiopulmonary diseases
2) Mission- related
3) There is a suscpesion of non-respiratory sleep disorder like narcolepsy
Patient with asthma intubated.
After intubation the patient became hypotensive and this waveform showed. Next step?
1) Disconnect the ventilator. Or
2) Decrease minute ventilation (by decreasing respiratory rate or tidal volume)
The goal is to decrease intrinsic PEEP caused by air trapping in obstructive lung disease
Patients want to go for everest mountain. He is afraid from developing high altitude pulmonary edema.
What medication can be given to avoid this condition?
Nifedipine.
For High altitude cerebral edema: acetazolamide
Management of exercise induce bronchocostriction?
Daily inhaled ICS
And SABA PRN
Which pulmonary hypertension medications you will avoid in pregnancy?
Endothelin receptor blocker is CI in pregnancy and interact with OCP.
Ex: -Santan
زنطان يزنط البيبي
Which pulmonary hypertension medications is used for critical limb ischemia?
Prostacyclin analogue.
That is why it increases risk of bleeding with the use of anticoagulation
Ex: Lipoprost + EPOprestenol
Which pulmonary hypertension medications causes blue vision?
PDE-5 inhibitors
Which pulmonary hypertension medications should be avoided if the patient on cyclosporine?
ER-B
