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PANCE > pulmonary > Flashcards

pulmonary Flashcards

1
Q

silicosis

A

cxr egg shell pattern and hilar node calcification

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2
Q

asbetos

A

pleural plaques and reticular patterns

can cause mesothelioma (pleura based mass)

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3
Q

sacrcoidosis

A

non caseating granulomas and hilar adenopathy

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4
Q

wegners granulomas

A

caseating granulomas and positive anca

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5
Q

pulmonary fibrosis

A

progressive fibrosis

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6
Q

cxr of foreign body aspiration

A

ipsilateral hyperlucency and ipsilateral hyper expansion of hemithorax

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7
Q

asthma 3 components

A

airway hyperactivity
airflow obstruction
chronic airway inflammation

IgE mediated. inflammatory disease

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8
Q

most common finding on cxr for asthma

A

normal

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9
Q

immune mediators in asthma

A

inhaled steroid
leukotriene modifiers- montelukast (singulair) (zyflo-ziluton)
mast cell stabilizer- cromolyn (nedocromil) (take 4 weeks to work)

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10
Q

bronchodilator

A

short/long beta agonist (long- salmeterol)
anticholinergic-ipratropium
magnesium
epi

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11
Q

intermittent

A
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12
Q

mild persistent

A

> 2 days/week
3-4 times per month at night
minor limitation

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13
Q

severe persistent

A

multiple times per day
every night
severe limitation

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14
Q

moderate persistent

A

daily
>1 time week but not nightly
some limitation

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15
Q

step wise approach to asthma

A 
1- saba
2- low dose ICS
3- low dose ics + laba or med dose ics
4- med dose ics + laba
5- high dose ics + laba
6- high dose ics + laba + oral steroid

see patients every 4-6 weeks to see if controlled
if pt controlled well for 3 months then try to step down
follow every 1-6 months

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16
Q

side effects of inhaled steroids

A

kids- might be a little shorter

adults- can get recurrent canadiasis

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17
Q

theophyline

A

methylxanthine
phosphodiesterase inhibitor
bronchial dilate

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18
Q

omalizumab (xolair)

A

last resort- tried everything else

anaphylaxis- must give shot at clinic

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19
Q

samters triad

A

nasal polyps
asthma
aspirin/nsaid sensitivity

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20
Q

atopy

A

eczema (atopic dermatitis), rhino sinusitis (allergies), asthma

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21
Q

tx for mycoplasma pneumonia

A

azithromycin

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22
Q

causes of asystole

A

patch 4 md

pneumo, acidosis, thromobosis, cardiac tamponadue, 4 h’s, massive mi/pe, drug toxicities

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23
Q

what organism do cystic fibrosis get

A

pseudomonas

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24
Q

organs cystic fibrosis affects

A

lungs, pancreas, intestines

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25
Q

what causes a young person to have emphysema and liver problems

A

alpha 1 antitrypsin disease

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26
Q

difference between asthma and copd

A

asthma- primary cells eosinophils- cause hypertrophy over time

copd- primary cells neutrophils- carry proteases and oxidases that destroy lung

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27
Q

can you put o2 on chronic bronchitis (blue bloater)

A

no because they are so use to having high c02 that the body stops using co2 as the determinant to breathe and starts using o2 instead. These pts usually have low o2 so if you put o2 on them their body doesn’t think it needs to breathe.

28
Q

what kills pts with copd

A

cor pulmonale
the chronic low o2 causes pulmonary vasoconstriction (chronic constriction causes the vessels to scar down) and causes pulmonary htn causes right sided heart failure

this is why o2 can increase the life expectancy in these pts

29
Q

most common lung cancer

A

adenocarcinoma (one type of lung cancer that NON SMOKERS get)

30
Q

worst lung cancer

A

small cell (oat cell)
usually occurs centrally
paraneoplastic (siadh, lambert eaton (like Myasthenia graves except getter better throughout day), cushing syndrome, clubbing, dermatomyositis)
metastasizes to adrenal, brain, bone, liver
complications- SVC obstruction (dilated veins in upper body, swollen face), horners syndrome (pan coast tumor-pressure on sympathetic nerves- ptosis, miosis)

31
Q

squamous cell cancer

A

hypercalcemia (stones, bones, groans, psychiatric overtones) (due to PTh-rp production)
metastasize to same sites as small cell

32
Q

carcinoid syndrome

A

flushing, diarrhea, wheezing, bronchospasm
due to serotonin and histamine release
octreotide scintigraphy
tx- remove

33
Q

most common type of ovarian cancer

A

epithelial

34
Q

best med for dilated cardiomyopathy with ef

A

ace inhibitor

35
Q

most common cause of bells palsy

A

herpes

36
Q

bilateral hilar lymphadenopathy

A

hodgkins or sarcoidosis

37
Q

most common cause of ards

A

sepsis

other cause- trauma, overdose, near drowning, etc

38
Q

ards tx

A 
small tv (4-6)
permissive hypercapnia; o2 90%
39
Q

foreign body cxr lateral

A

expect the lung that is on the ground to collapse due to gravity but if obstruction then it won’t collapse

40
Q

different pleural effusions

A

transudative: chf, cirrhosis, PE
edudative: malignancy, infection, trauma, empyema

lights criteria: >.5 protein ratio of pleura fluid vs serum
>.6 ldh ratio of pleura to serum
>2/3 of upper limits of normal of ldh

41
Q

increase in tactile fremitus

A

consolidation

fibrosis

42
Q

decrease tactile fremitus

A

pneumothorax
copd
pleural effusion

43
Q

what do you need to be careful with when using beta blocker

A

pulmonary disease

diabetes

44
Q

htn emergency

A

bp >220/125.
end organ damage encephalopathy, nephropathy, intracranial hemorrhage, aortic dissection, pulmonary edema, unstable angina, MI

45
Q

dark field microscopy

A

syphillis

46
Q

tzanck smear

A

herpes

multinucleated giant cells

47
Q

acid fast bacilli

A

TB

48
Q

TB tx

A

2 months RIPE

4 months RI

49
Q

what can rsv cause in ppl

A

apnea

50
Q

most common bacteria causing pneumonia after viral

A

Staph aureus

51
Q

TB drug side effects

A

INH- injures nerves and hepatocytes- pyridoxine b6
ethambutol- optic neuritis
rifampin- orange body fluid
pyrazinamide- hyperuricemia

52
Q

strep pneumona

A

gram positive diplococci

53
Q

what is flu vaccine contraindicated in

A

ppl older then eggs
can’t give live virus to immune suppressed
give to ppl >6 months

54
Q

tx for pneumonia

A

outpatient healthy- azithromycin, doxy, fluoroquinolone
CA inpatient- ceftriaxone + azithromycin or fluroquinolone
Nosocomial- same as inpatient + zosyn, cefepime, meropenem (pseudomonas and gram -)

55
Q

college student pneumonia

A

mycoplasma

chlamydia

56
Q

alcoholic pneumonia

A

klebsiella (currant jelly sputum)

57
Q

less then 2 yr old pneumonia

A

RSV

58
Q

cystic fibrosis

A

pseudomonas

59
Q

immigrants

A

TB

60
Q

most common pneumonia

A

strep pneumonia (rust colored sputum)

61
Q

copd pneumonia

A

haemophilus influenzae

62
Q

exposure to air conditioner and aersolized water

A

legionella

63
Q

bird droppings pneumonia

A

histoplasmosis

chlamydia psittaci

64
Q

restrive lung disease sxs

A

dry crackles is big
cough
sob
wheezes

65
Q

idopathic fibrosis

A

erythema nodosum
uveitis
dry crackles

66
Q

sarcoidosis

A

african american
bilar hilar adenopathy
sarcoid skin lesions
hypercalcemia, high alp, decreased hgb

67
Q

drugs that can cause stiff lungs

A

nitrofurontoin

amiodarone

PANCE (14 decks)

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