Pulmonary 2 Flashcards
Progressive diffuse pulmonary fibrosis from exposure to old buildings and insulation.
CXR shows pleural plaques in lower lobes.
PFT’s show restrictive lung pattern.
Asbestosis
What are the complications of asbestosis?
bronchogenic carcinoma (MC) malignant mesothelioma
Genetic disorder that leads to panacinar emphysema?
Exam also shows hepatomegaly, signs, and symptoms of cirrhosis,
Alpha-1 Antitrypsin deficiency
Hypersensitivity pneumonitis from nitrogen dioxide gas exposure released from plant matter.
Silo Filler Disease.
Infection with chlamydophila psittaci due to exposure to infected birds.
Clinical manifestations are flu-like symptoms
Parrot fever (Psittacosis)
What is the managemnt for Parrot fever (psittacosis)?
Tetracyclines
Highly contagious gram-negative coccobacillus infection.
MC in kids < 2 years of age.
URI symptoms lasting 1-2 weeks. Most contagious during this phase.
Severe paroxysmal coughing fits. May have post cough emesis.
Pertussis
How do you dx pertussis?
Throat culture and PCR.
If only one is available, throat culture sensitive during the first 2 weeks, PCR sensitive up to 4 weeks of illness.
What is the treatment for pertussis?
supportive +/- Azithromycin
MC caused by RSV and in infants 2 mo to 2 yr.
Presents as a viral prodrome for 1-2 days followed by respiratory distress such as wheezing, tachypnea, nasal flaring, cyanosis, retractions, rales.
Acute bronchiolitis
What is the Tx for acute bronchiolitis?
humidified oxygen, IV fluids, +/- beta agonists, nebulized racemic epi.
MC in kids 3 mo to 6 yr old.
Haemophilus influenza B mc cause in unvaccinated kids or foreign immigrants.
If immunized, suspect streptococcal species.
Dysphagia, drooling and distress. Fever, odynophagia, inspiratory stridor, tripoding, muffled hot potato voice.
Acute epiglottitis
How do you dx Acute Epiglottitis?
Laryngoscopy showing cherry-red epiglottis with swelling performed when securing the airway.
Thumbprint sign on soft tissue lateral cervical radiographs.
What is the management for acute epiglottitis?
Maintain airway ideally in the OR setting.
+/- Cetriaxone or Cefotaxime.
As prevention for acute epiglottitis, what do you give to all close contacts of an infected patient?
Rifampin +/- Hib vaccine.
