Pulmonary Flashcards
ABGs in asthma
Mild hypoxia and respiratory alkalosis
What happens to the I:E ratio in asthma
It decreases (expiration is prolonged)
What do PFTs look like with obstructive disease?
FEV1 is decreased (decreased FEV1/FVC) and RV is increased
What do PFTs look like with restrictive disease?
FVC is decreased and RV is decreased
Treatment of acute asthma
O2, bronchodilating (short-acting B2-agonists are first line, ipratropium, steroids, magnesium)
Treatment of chronic asthma
Long acting bronchodilators and/or inhaled corticosteroids, systemic corticosteroids, cromolyn
Is albuterol long or short acting?
Short acting beta-2 agonist
Is salmeterol long acting or short acting?
Long acting beta-2 agonist for prophylaxis
Zileuton
Antileukotriene; 5-lipoxygenase pathway inhibitor (blocks conversion of arachidonic acid to leukotrienes)
Montelukast
antileukotriene (blocks leukotriene receptors)
Zafirlukast
antileukotriene (blocks leukotriene receptors)
Definition & treatment of mild persistent asthma
> 2 days/week (not everyday) & >2nights/month
–Daily low-dose inhaled corticosteroids; PRN short-acting bronchodilator
Definition & treatment of moderate persistent asthma
Daily & >1night/week
-Low to medium dose inhaled corticosteroids + long-acting inhaled beta-2 agonist; PRN short-acting bronchodilator
Definition & treatment of severepersistent asthma
Continual, frequent
-High dose inhaled corticosteroids + long acting inhaled Beta-2 agonist; possible PO corticosteroids
PRN short-acting bronchodilator
What 2 diseases cause COPD?
Emphysema & chronic bronchitis
What are the pneumoconioses?
- Asbestosis
- Coal miner’s disease
- Silicosis
- Berylliosis
Complications of coal miner’s disease
Progressive massive fibrosis
Complications of silicosis
increased risk of TB
Causes of hypoxemia
V/Q mismatch, right to left shunt, hypoventilation, low inspired O2 content, diffusion impairment
How do you calculate the A-a gradient?
[(Patm-47)x FiO2 - (PaCO2/.8)] - PaO2
How do you diagnose ARDS?
ARDS:
Acute onset
Ratio (PaO2/FiO2) < 18 mmHg
Paraneoplastic syndromes of small cell lung cancer
ACTH (cushing’s), SIADH,
Paraneoplastic syndromes of squamous cell carcinoma
hypercalcemia
What causes a transudate?
Increased pulmonary capillary wedge pressure or decreased oncotic pressure
What causes an exudate?
Increased pleural vascular permeability
Light’s Criteria
Pleural protein:serum protein ratio >.5
Pleural LDH: serum LDH >.6
Pleural LDH > 2/3 ULN
