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EM > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

Upper Airway Obs. (UAO) Causes

A

Foreign body
Tongue
Swelling (angioedema, trauma)

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2
Q

Stridor indicated an _____ obstruction

A

Incomplete

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3
Q

Retropharyngeal abscess

A

Serious and can spread to mediastinum

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4
Q

Retropharyngeal abscess etiology

A

Children: lymph node
Adults: penetrating trauma, oral infxn, lymph nodes

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5
Q

X-ray of retropharyngeal abscess will show?

A

Expansion of the prevertebral tissues

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6
Q

Best imaging for retropharyngeal abscess

A

CT scan

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7
Q

S/S of retropharyngeal abscess

A

Fever, dysphagia, neck pain
Limited cervical ROM, lymphadenopathy
ST, muffled voice
Stridor in children

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8
Q

Retropharyngeal abscess tx

A 
Immediate ENT consult
Surgical I&D
IV hydration and abx
Clindamycin (600 - 900mg) or 
Unasyn (1500 - 3,000)
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9
Q

Angioedema

A

Subdermal or submucosal swelling
Diffuse and nonpitting
Can occur w/ or w/o urticaria

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10
Q

Mast cell mediated angioedema

A

Responds to epi, glucocorticoids and antihistamines

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11
Q

Bradykinin mediated angioedema

A

Secondary to ACE or

Hereditary

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12
Q

Tx of mast cell mediated angioedema

A

Intubate if in resp distress
Epi .3 mg IM
Methylpred 60 - 80mg IV
Diphenhydramine 25 - 50mg IV

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13
Q

Hereditary angioedema tx

A

Intubate if in resp distress

C1 inhibitor concentrate (Berinert)

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14
Q

2nd line tx for hereditary engioedema

A

FFP

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15
Q

Anaphylaxis presentation

A 
SUdden onset:
Urticaria
Angioedema
Flushing
Pruritis
Hypotension
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16
Q

Anaphylaxis tx

A

EPINEPHRINE
Adults: .3 - .5 mg IM
Children: .1 (max dose of .5)
Give q5-15 up to 3 doses

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17
Q

Other meds for anaphylaxis

A

H1 or H2 blocker
Glucocorticoid (solumedrol 125 mg IV)
Albuterol neb 2.5mg
Vasopressors prn for shock

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18
Q

Gurgling =

A

Pooling of liquids in the oral cavity or hypopharynx

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19
Q

Snoring =

A

Partial airway obs at the pharyngeal level form the tongue

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20
Q

Inspiratory Stridor

A

Obstruction at level of larynx

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21
Q

Expiratory stridor

A

Obstruction at level of trachea

22
Q

Wheezing

A

Narrowing of lower airways

23
Q

Stupor

A

Lack of critical cognitive fxn and low level of conciousness to only painful stimuli

24
Q

Coma

A

A state of unconciousless lasting for longer than 6 hours.

Person cannot be awakened, fails to respond to painful stimuli

25
Q

Spontaneous pneumothorax

A

Pneumo that occurs w/o precipitating event or lung dz

26
Q

Spontaneous pneumo risks

A

Thin, smoking men 20-40.

Marfans, family hx

27
Q

Spontaneous pneumo s/s

A 
Sudden onset dyspnea and pleuritic CP
Often occurs at rest
Decreased BS
Hyperresonance
Hypoxemia
Tracheal deviation
JVD
28
Q

Where is decompression done?

A

ABOVE rib
2nd or 3rd ICS midclavicular
and/or
5th ICS @ anterior axillary line

29
Q

Acute pulmonary edema S/S

A 
Pink frothy sputum
Dyspnea, edema, ascites
Rales, wheezing
HTN
Hypoxemia, restlessness, tachy
30
Q

Acute pulmonary edema patho

A

Sudden increase in L sided intracardiac filling pressures
or
Increased alveolar permeability

31
Q

Cardiogenic pulm edema causes

A 
Ischemia
Acute severe mitral regurg
Acute aortic regurg
Hypertensive crisis
Stress induced cardiomyopathy
32
Q

Noncadriogenic pulm edema causes

A 
ARDS is major cause
Altitude
Neurogenic
Narcotic OD
PE
Eclampsia
Transfusion related injury
Salicylate OD
33
Q

Diuretic for pulm edema

A

Furosemide (Lasix) 40-80 mg IV

34
Q

Massive aspiration =

A

Intubation

Suction lower airway

35
Q

Asthma

A

Inflammation of the airways w/ abnormal accumulation of inflammatory cells.

36
Q

Severe asthma peak flow

A

Less than 40% of expected

37
Q

Asthma medical therapy

A

Albuterol
Ipatropium bromide (atrovent)
Methylpred 60-125 mg IV

38
Q

Meds for severe asthma

A

Mag sulfate (after 1 hr of failed therapy)
Epi (for anaphylaxis)
Terbutaline (for unresponsive asthma)

39
Q

COPD exacerbation

A

Usually precipitated by an infxn

Dyspnea, cough, sputum

40
Q

Therapy for COPD exacerbation

A

O2
Solumedrol 60mg IV
ABX (levaquin)
Albuterol

41
Q

Pulmonary Embolism

A

Obs of pulm artery by clot, tumor, fat, air
Common and fatal
Acute or chronic

42
Q

S/S or PE

A

DYspnea, tachycardia, cough
Hemoptysis, syncope, edema
Cyanosis, diaphoresis, Hypotension

43
Q

2 most common S/S of PE

A

Dyspnea and tachycardia
followed by
Pleuritic CP and Rales

44
Q

PE diagnostics

A

CT angio w/ PE protocol
CXR, EKG
D-DImer?

45
Q

Hamptons hump

A

Found in PE

Consolidation at bottom of lung

46
Q

EKG changes in PE

A

S1 QT3
S waves in lead I
Q waves in lead III
Inverted T waves in lead III

47
Q

PE Tx

A 
O2
Fluid bolus if hypotensive
Vasopressin
LMWH
UFH if unstable
48
Q

Abx for noncomplicated pneumonia

A 
Levoquin
or
Ceftriaxone
or
Zithromax
49
Q

Complicated pneumonia abx

A

Ceftriaxone and Zithromax
or
Ceftriaxone and levofloxacin

50
Q

Gram+ diplococci

51
Q

Gram - rods

A

Pseudomonas

EM (10 decks)

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