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DIT STEP 2 > PULMONARY > Flashcards

PULMONARY Flashcards

1
Q

Abx tx of peritonsillar abscess

A

Augmentin or Clindamycin

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2
Q

Abx tx of acute bacterial sinusitis

A

Amox or Augmentin

Cephalosporins > FQ or Bactrim > Macrolides

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3
Q

MCC of PNA in newborn

A

GBS > E. coli

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4
Q

Tx of PNA in newborn

A

Amp + gent +/- vanco

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5
Q

Tx of chlamydia PNA

A

Erythromycin

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6
Q

MCC of PNA in 1-4 month old

A

RSV, Chlamydia

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7
Q

Tx of PNA in 1-4 month old

A

Macrolide +/- cefotaxime

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8
Q

MCC of PNA in 4m-4yr old

A

RSV or other virus, S. pneumo

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9
Q

Tx of PNA in 4m-4yr old

A

Amox or amp

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10
Q

MCC of PNA in 5-15 yr old

A

S. pneumo > Mycoplasma

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11
Q

Tx of PNA in 5-15 yr old

A

Amox + clarithro/erythro
Azithro
Amox + doxy

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12
Q

Populations more likely to get PNA

A

Alaskan Native or from certain native american populations

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13
Q

Tx for pseudomonas PNA

A

Antipseudomonal beta lactam for at least 2 weeks along with:
Antipseudomonal quinolone (cipro or levo)
Aminoglycoside + azithro
Aminoglycoside + cipro/levo

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14
Q

Antipseudomonal beta lactams

A

pip-tazo, cefepime, imipenem, meropenem, aztreonam

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15
Q

Random lab level that should point you to possible PCP PNA

A

LDH level usually >220, and a rising LDH despite appropriate tx portends a poor prognosis

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16
Q

PCP PNA tx

A 
21 days of:
TMP SMX
Pentamidine
Trimetrexate + leucovorin
Primaquine + Clinda
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17
Q

DDX for ground glass opacities (diffuse hazy infiltrate)

A 
Interstitial PNA
PCP
Pulm edema
Pulm hemorrhage
Hypersensitivity pneumonitis
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18
Q

Common cause of PNA in immunocompromised pts

A

PCP

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19
Q

Often cause of PNA in a pt with hx of exposure to bats and bat droppings

A

Histoplasma

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20
Q

Often cause of PNA in pt who has recently visited SC, New Mexico, or West Texas

A

Coccidioides

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21
Q

MCC of PNA in children

A

RSV

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22
Q

Common cause of PNA in pts with other health problems

A

Klebsiella

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23
Q

MCC of viral PNA

A

RSV, H influ is #2

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24
Q

Common bacterial cause of COPD exac

A

H. influenzae

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25
Common PNA in ventilator pts and those with CF
Pseudomonas
26
Pontiac fever
Legionella
27
Cause of PNA in 80 y/o with gram - rods
E. coli
28
Cause of PNA in neonate with gram + cocci
GBS
29
Goal CVP in patient with ARDS
4-6 H2O
30
Hb level that you'd transfuse blood in ARDS patient
Only if drops below 7 as transfusion may increase risk of death in ARDs patient
31
Tx for atypical pneumo
Macrolide
32
Causes of a high A-a gradient
Having a hard time getting oxygen to alveoli. PE, pulm edema, R-->L vasc shunt, high inspiratory O2 fraction
33
In a patient with pulm edema, how can PCWP distinguish dx of ARDS from cardiogenic edema?
PCWP 18, likely cardiogenic.
34
What should you look for in patient with pulm hemorrhage?
Most likely due to drug use
35
Drug that has been known to cause hypersensitivity PNA
Methotrexate
36
3 conditions that cause acidic pH in pleural effusion
empyema, TB, malignancy
37
When do you see high TG levels in pleural effusion?
Thoracic duct rupture
38
Lights criteria
Serum: effusion protein ratio >0.5 Serum: effusion LDH ratio >0.6 Effusion LDH > 2/3 ULN LDH
39
Which portion of breathing cycle is ventilator driven?
Inspiration
40
MCC of croup
Parainfluenzae viruses 1 and 2
41
Steeple sign
"subglottic narrowing" .. seen in Croup
42
In cases of suspected epiglottitis, when should you examine throat?
ONLY in places where immediate intubation is available as examination can cause further resp distress and resulting occlusion.
43
Swollen, opacified epiglottis that partially obstructs airway
Thumbprint sign seen in epiglottitis
44
Kiddos with bronchiolitis are at increased risk for developing?
Asthma
45
Most common fatal autosomal recessive disorder in US?
CF
46
Rx that aids in decreasing viscosity of secretions in CF
DNase
47
What is the CURB 65 crieteria
``` Confusion Urea > 20 mg/dL Respiratory rate >30 BP Age > 65 ``` Scores ranging from 0-1 are low risk, treated outpatient. 2 is considered appropriate for hospitalization 3-5 considered for ICU care.
48
2 meds used in ARDs to help prevent pulmonary edema
Furosemide, albumin
49
Placing a patient in what position helps to improve oxygenation in ARDs
Prone. DOESNT IMPROVE SURVIVAL.
50
Dx characteristics of ARDS
Bilateral fluffy interstitial infiltrates (due to pulm edema) PCWP
51
Grade the asthma: 80%
Mild intermittent.
52
Grade the asthma: 3-6 daytime episodes/week or 3-4 nighttime episodes/month. FEV
Mild persistent
53
Grade the asthma: daily daytime episodes or >1 nighttime episode/week. FEV 60-80%
Moderate persistant
54
Grade the asthma: continual daytime episodes of frequent nighttime symptoms. FEV
Severe [ersostemt
55
Stage of COPD at FEV1/FVC 80%
Stage 1, mild
56
Stage of COPD at FEV1 30-50%
Stage 3, severe
57
When do you add home O2
Pulse ox
58
What is young syndrome
Bronchiectasis Rhinosinusitis + Infertility
59
Serum markers for interstitial fibrosis
SP-A SP-B MCP-1 KL-6
60
Treatment for idiopathic pulmonary fibrosis
Steroids Azathioprine or cyclophosphamide N-acetylcysteine
61
2 pneumoconiosis that cause progressive fibrosis
Coalminers or silicosis
62
Which pneumoconiosis is a/w working with electronics and has increased cancer risk
Berryliosis
63
Tx of SVC syndrome
Steroids. Also treat the underlying cause.
64
Most common EKG finding in PE
Sinus tach
65
Most common surgery in adults for OSA
Uvulo palato pharyngo plasty
66
Pretreatment for rapid sequence intubation
Lidocaine which blunts ICP elevations Fentanyl to blunt the pain response and BP elevations Atropine to decrease airway secretions and prevent bradycardia in children during intubation
67
Rapid induction agents (for intubation)
Etomidate Ketamine Midazolam Propofol
68
Rapid paralytic agents (for intubation)
Succinylcholine | Rocuronium

DIT STEP 2 (17 decks)

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