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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
Q

Common PNA in ventilator pts and those with CF

A

Pseudomonas

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26
Q

Pontiac fever

A

Legionella

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27
Q

Cause of PNA in 80 y/o with gram - rods

A

E. coli

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28
Q

Cause of PNA in neonate with gram + cocci

A

GBS

29
Q

Goal CVP in patient with ARDS

A

4-6 H2O

30
Q

Hb level that you’d transfuse blood in ARDS patient

A

Only if drops below 7 as transfusion may increase risk of death in ARDs patient

31
Q

Tx for atypical pneumo

A

Macrolide

32
Q

Causes of a high A-a gradient

A

Having a hard time getting oxygen to alveoli.

PE, pulm edema, R–>L vasc shunt, high inspiratory O2 fraction

33
Q

In a patient with pulm edema, how can PCWP distinguish dx of ARDS from cardiogenic edema?

A

PCWP 18, likely cardiogenic.

34
Q

What should you look for in patient with pulm hemorrhage?

A

Most likely due to drug use

35
Q

Drug that has been known to cause hypersensitivity PNA

A

Methotrexate

36
Q

3 conditions that cause acidic pH in pleural effusion

A

empyema, TB, malignancy

37
Q

When do you see high TG levels in pleural effusion?

A

Thoracic duct rupture

38
Q

Lights criteria

A

Serum: effusion protein ratio >0.5
Serum: effusion LDH ratio >0.6
Effusion LDH > 2/3 ULN LDH

39
Q

Which portion of breathing cycle is ventilator driven?

A

Inspiration

40
Q

MCC of croup

A

Parainfluenzae viruses 1 and 2

41
Q

Steeple sign

A

“subglottic narrowing” .. seen in Croup

42
Q

In cases of suspected epiglottitis, when should you examine throat?

A

ONLY in places where immediate intubation is available as examination can cause further resp distress and resulting occlusion.

43
Q

Swollen, opacified epiglottis that partially obstructs airway

A

Thumbprint sign seen in epiglottitis

44
Q

Kiddos with bronchiolitis are at increased risk for developing?

A

Asthma

45
Q

Most common fatal autosomal recessive disorder in US?

A

CF

46
Q

Rx that aids in decreasing viscosity of secretions in CF

A

DNase

47
Q

What is the CURB 65 crieteria

A 
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
Q

2 meds used in ARDs to help prevent pulmonary edema

A

Furosemide, albumin

49
Q

Placing a patient in what position helps to improve oxygenation in ARDs

A

Prone. DOESNT IMPROVE SURVIVAL.

50
Q

Dx characteristics of ARDS

A

Bilateral fluffy interstitial infiltrates (due to pulm edema)
PCWP

51
Q

Grade the asthma: 80%

A

Mild intermittent.

52
Q

Grade the asthma: 3-6 daytime episodes/week or 3-4 nighttime episodes/month. FEV

A

Mild persistent

53
Q

Grade the asthma: daily daytime episodes or >1 nighttime episode/week. FEV 60-80%

A

Moderate persistant

54
Q

Grade the asthma: continual daytime episodes of frequent nighttime symptoms. FEV

A

Severe [ersostemt

55
Q

Stage of COPD at FEV1/FVC 80%

A

Stage 1, mild

56
Q

Stage of COPD at FEV1 30-50%

A

Stage 3, severe

57
Q

When do you add home O2

A

Pulse ox

58
Q

What is young syndrome

A

Bronchiectasis
Rhinosinusitis
+
Infertility

59
Q

Serum markers for interstitial fibrosis

A

SP-A
SP-B
MCP-1
KL-6

60
Q

Treatment for idiopathic pulmonary fibrosis

A

Steroids
Azathioprine or cyclophosphamide
N-acetylcysteine

61
Q

2 pneumoconiosis that cause progressive fibrosis

A

Coalminers or silicosis

62
Q

Which pneumoconiosis is a/w working with electronics and has increased cancer risk

A

Berryliosis

63
Q

Tx of SVC syndrome

A

Steroids. Also treat the underlying cause.

64
Q

Most common EKG finding in PE

A

Sinus tach

65
Q

Most common surgery in adults for OSA

A

Uvulo palato pharyngo plasty

66
Q

Pretreatment for rapid sequence intubation

A

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
Q

Rapid induction agents (for intubation)

A

Etomidate
Ketamine
Midazolam
Propofol

68
Q

Rapid paralytic agents (for intubation)

A

Succinylcholine

Rocuronium

DIT STEP 2 (17 decks)

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