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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
what causes a young person to have emphysema and liver problems
alpha 1 antitrypsin disease
26
difference between asthma and copd
asthma- primary cells eosinophils- cause hypertrophy over time copd- primary cells neutrophils- carry proteases and oxidases that destroy lung
27
can you put o2 on chronic bronchitis (blue bloater)
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
what kills pts with copd
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
most common lung cancer
adenocarcinoma (one type of lung cancer that NON SMOKERS get)
30
worst lung cancer
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
squamous cell cancer
hypercalcemia (stones, bones, groans, psychiatric overtones) (due to PTh-rp production) metastasize to same sites as small cell
32
carcinoid syndrome
flushing, diarrhea, wheezing, bronchospasm due to serotonin and histamine release octreotide scintigraphy tx- remove
33
most common type of ovarian cancer
epithelial
34
best med for dilated cardiomyopathy with ef
ace inhibitor
35
most common cause of bells palsy
herpes
36
bilateral hilar lymphadenopathy
hodgkins or sarcoidosis
37
most common cause of ards
sepsis | other cause- trauma, overdose, near drowning, etc
38
ards tx
``` small tv (4-6) permissive hypercapnia; o2 90% ```
39
foreign body cxr lateral
expect the lung that is on the ground to collapse due to gravity but if obstruction then it won't collapse
40
different pleural effusions
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
increase in tactile fremitus
consolidation | fibrosis
42
decrease tactile fremitus
pneumothorax copd pleural effusion
43
what do you need to be careful with when using beta blocker
pulmonary disease | diabetes
44
htn emergency
bp >220/125. end organ damage encephalopathy, nephropathy, intracranial hemorrhage, aortic dissection, pulmonary edema, unstable angina, MI
45
dark field microscopy
syphillis
46
tzanck smear
herpes | multinucleated giant cells
47
acid fast bacilli
TB
48
TB tx
2 months RIPE | 4 months RI
49
what can rsv cause in ppl
apnea
50
most common bacteria causing pneumonia after viral
Staph aureus
51
TB drug side effects
INH- injures nerves and hepatocytes- pyridoxine b6 ethambutol- optic neuritis rifampin- orange body fluid pyrazinamide- hyperuricemia
52
strep pneumona
gram positive diplococci
53
what is flu vaccine contraindicated in
ppl older then eggs can't give live virus to immune suppressed give to ppl >6 months
54
tx for pneumonia
outpatient healthy- azithromycin, doxy, fluoroquinolone CA inpatient- ceftriaxone + azithromycin or fluroquinolone Nosocomial- same as inpatient + zosyn, cefepime, meropenem (pseudomonas and gram -)
55
college student pneumonia
mycoplasma | chlamydia
56
alcoholic pneumonia
klebsiella (currant jelly sputum)
57
less then 2 yr old pneumonia
RSV
58
cystic fibrosis
pseudomonas
59
immigrants
TB
60
most common pneumonia
strep pneumonia (rust colored sputum)
61
copd pneumonia
haemophilus influenzae
62
exposure to air conditioner and aersolized water
legionella
63
bird droppings pneumonia
histoplasmosis | chlamydia psittaci
64
restrive lung disease sxs
dry crackles is big cough sob wheezes
65
idopathic fibrosis
erythema nodosum uveitis dry crackles
66
sarcoidosis
african american bilar hilar adenopathy sarcoid skin lesions hypercalcemia, high alp, decreased hgb
67
drugs that can cause stiff lungs
nitrofurontoin | amiodarone

PANCE (14 decks)

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