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Pulmonary 2 Flashcards

1
Q

restrictive lung disease s/s

A

progressive dyspnea
dry cough
tachypnea
digital clubbing
inspiratory crackles
normal-high FEV1/ FVC ratio

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2
Q

Dx of idiopathic pulmonary fibrosis

A

HRCT scan–> honeycombing

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3
Q

tx of idiopathic pulmonary fibrosis

A

O2, steroids
fibrinolytics–> nintedanib and pirfenidone
definitive–> lung transplant

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4
Q

sarcoidosis cause

A

autoimmune non-caseating granulomas

common in African American women

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5
Q

sarcoidosis s/s

A

erythema nodosum
lupus pernio
iritis

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6
Q

dx of sarcoidosis

A

biopsy–> noncaseating granulomas
CXR- bilateral hilar lymphadenopathy
elevated ACE

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7
Q

sarcoidosis stages

A

stage 1- hilar lymphadenopathy
stage 2- hilar lymphadenopathy + parenchymal
stage 3- parenchymal
stage 4- upper lobe fibrosis

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8
Q

tx of sarcoidosis

A

oral steroids

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9
Q

coal worker’s findings

A

upper lobes
complicated–> progressive massive fibrosis

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10
Q

silicosis findings

A

eggshell calcification
MC in upper lobes
increased risk TB

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11
Q

s/s of lung cancer

A

WL
cough/ hemoptysis
digital clubbing
hoarseness

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11
Q

asbestosis findings

A

linear streaking at lung bases
complication–> mesothelioma

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12
Q

what two types of lung cancer are commonly found peripherally

A

adenocarcinoma
large cell carcinoma

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13
Q

what types of lung cancer are located centrally?

A

squamous cell carcinoma
small cell carcinoma

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14
Q

lung cancer screening guidelines

A

50-80 yrs old AND
current smoker OR quit in past 15 yrs

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15
Q

dx of lung cancer

A

CXR–> CT –> biopsy

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16
Q

lung cancer staging

A

stage 1- lung tissue only
stage 2- lung tissue with surrounding lymph nodes
stage 3- lung tissue or adjacent resectable structures and lymph nodes within mediastinum
stage 4- spread to opposite lung or other organ

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17
Q

tx of lung cancer

A

NSCLC- surgical removal
SCLC- chemotherapy (cisplatin and etoposide) and/or radiation

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18
Q

pulmonary nodule

A

3 cm or less

19
Q

pulmonary mass

20
Q

tx of pulmonary nodule

A

low risk- observation
intermediate risk- biopsy
high risk- surgical removal

21
Q

causes of pulmonary embolism

A

Fat
Air
Thrombus
Amniotic fluid
Less common- sepsis

22
Q

s/s of pulmonary embolism

A

dyspnea
pleuritic chest pain
cough
tachypnea/ tachycardia

*loud S2

23
Q

well’s score components

A

+3- PE #1 DDx; s/s of DVT
+1.5- HR > 100; stasis; hx of PE/ DVT
+1- hemoptysis; malignancy

24
Q

PERC score

A

1- age 50+
2- HR > 100
3- O2 < 95%
4- unilateral leg swelling
5- hemoptysis
6- anesthesia in past 4 wks
7- prior hx of PE or DVT
8- hormone use

25
Q

Dx of PE

A

CTPA is gold standard
CXR- normal, westermark or hamptom hump
ECG- tachycardia, S1Q3T3

26
Q

PE tx

A

start heparin drip ASAP
stable- DOACs
- 2nd line: IVC filter
unstable- thrombolytics (alteplase or streptokinase)
- 2nd line: embolectomy

27
Q

4 ARDS characteristics

A

1- occurs within 7 days of trigger
2- bilateral pulm opacities
3- respiratory failure
4- PaO2/FiO2 < 300 mmHg

28
Q

RFs for ARDS

A

sepsis
aspiration of gastric contents

29
Q

Dx of ARDS

A

CXR- air bronchograms and bilateral infiltrates that spare CPA

30
Q

tx of ARDS

A

intubation and PEEP (PaO2 > 55 or > 88%)

31
Q

pulmonary HTN s/s

A

fatigue, dyspnea and syncope with exertion, cough, RHF

*loud S2

32
Q

pulmonary HTN diagnostics

A

TTE–> right cardiac cath
elevated BNP

33
Q

pulmonary HTN tx

A

vasodilators–> sildenafil
O2
Diuretics

34
Q

causes of pleural effusion

A

transudative- HF, renal, liver, atelectasis
exudative- infection, inflammation, trauma

35
Q

s/s of pleural effusion

A

pleuritic CP
dyspnea
cough
dullness to percussion

36
Q

dx of pleural effusion

A

thoracentesis

37
Q

Light’s Criteria

A

transudative- <0.5 protein, < 0.6 plural: serum LDH, < 2/3 upper limit LDH

exudative- opposite

38
Q

tx of pleural effusion

A

thoracentesis

treat underlying cause-
transudative–> diuretics and low Na+

large–> drainage and pleurodesis
empyema–> drainage and abx

39
Q

types of pneumothorax

A

primary- no lung disease
secondary- lung disease
traumatic
tension

40
Q

s/s of pneumothorax

A

unilateral CP and dyspnea

hyperresonance to percussion

41
Q

dx of pneumothorax

A

CXR–> visceral pleural line

42
Q

tx of pneumothorax

A

small primary- observe
large primary- simple needle aspiration or chest tube
secondary- chest tube
surgery
tension- emergent decompression then chest tube placement

43
Q

acute respiratory failure requirements

A

PO2 < 60 or PCO2 > 50

44
Q

tx of acute respiratory failure

A

oxygenation- > 92% or 88% COPD
ventilation- intubation or BiPAP

Clinical Medicine (13 decks)

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