Pulmonary Flashcards
What is the range of FEV1 for mild, moderate, and severe obstructive disease?
Mild = (75,60] Moderate = (60, 40] Severe = less than 40
What is the MOA of theophylline?
Probably causes bronchodilation by inhibiting phosphodiesterase,
What is the MOA and use of cromolyn?
Prevents the release of vasoactive mediators from mast cells
What is the MOA and use of Zileuton?
5-lipoxygenase inhibitor
What is the MOA and use of Montelukast?
Blocks leukotriene receptors
What is the MOA and use of Zafirlukast?
Blocks leukotriene receptors
How many days/week or nights/month of asthma exacerbations fall into the “mild intermittent” category?
2 or less days / week or nights per month
How many days/week or nights/month of asthma exacerbations fall into the “mild persistent” category?
More than 2x per week, but less than 1 per day, and greater than 2 per month
How many days/week or nights/month of asthma exacerbations fall into the “moderate persistent” category?
Daily asthma exacerbations
More than 1 night per week
How many days/week or nights/month of asthma exacerbations fall into the “severe persistent” category?
Continual, frequent
What is the medication regimen for mild intermittent asthma?
PRN short acting bronchodilators
What is the medication regimen for mild persistent asthma?
Daily low dose inhaled corticosteroids
PRN short acting bronchodilators
What is the medication regimen for moderate persistent asthma?
Low- to medium-dose inhaled corticosteroids + long-acting inhaled β2 -agonists.
PRN short-acting bronchodilator.
What is the medication regimen for severe persistent asthma?
- High-dose inhaled corticosteroids + long-acting inhaled β2 -agonists.
- Possible PO corticosteroids.
- PRN short-acting bronchodilator.
What is the FEV1 value for mild intermittent asthma?
Over 80%
What is the FEV1 value for mild persistent asthma?
Over 80%
What is the FEV1 value for moderate persistent asthma?
60-80%
What is the FEV1 value for severe persistent asthma?
Less than 60%
What are tram lines on CXR that are seen in bronchiectasis?
Parallel lines outlining dilated bronchi as a result of peribronchial inflammation and fibrosis
What is the definitive test for bronchiectasis? What will it show?
high resolution CT
Dilated airways and ballooned areas at the end of the airways
What is the pharmacotherapy for bronchiectasis?
Abx and maybe inhaled corticosteroids
What is the definitive treatment for bronchiectasis?
Lung transplant
What is the duration that is needed to diagnose chronic bronchitis?
Productive cough for more than 3 months per year for 2 consecutive years
What causes centrilobular vs panlobular emphysema?
Centi = smoking Panacinar = alpha-1-antitrypsin
What are the only two interventions shown to increase survival in COPD patients?
Smoking cessation and oxygen therapy
Which has early and which late hypercapnia: emphysema vs chronic bronchitis?
Emphysema is late
Chronic bronchitis is early
What is the treatment for COPD
Corticosteroids
Oxygen
Prevention (pneumococcal vaccine, flu vaccine)
Dilators (beta 2 agonists)
What are the components of the AINT mnemonic for restrictive lung etiologies?
- Alveolar (edema, hemorrhage, pus)
- Interstitial/Inflammatory (Sarcoid, COP, idiopathic pulmonary fibrosis
- Neuromuscular (Myasthenia, phrenic nerve palsy)
- Thoracic wall (kyphoscoliosis, ascites, prego, ankylosing spondylitis)
What are the high res CT findings of interstitial lung disease?
Honeycombing
What type of breathing do patients with restrictive lung diseases usually present with?
Shallow, rapid breathing
DOE
What happens to DLCO with restrictive lung diseases?
Decreases
What is the pathological feature of sarcoidosis?
noncaseating granulomas
What are the s/sx of sarcoidosis?
Fever
Cough
Malaise
Arthritis
What dermatologic manifestation can appear with sarcoidosis?
Erythema nodosum
What is the treatment for sarcoidosis?
Corticosteroids
What are the pathological changes that occur with hypersensitivity pneumonitis?
Alveolar thickening and noncaseating granulomas 2/2 environmental exposures
What are the acute s/sx of hypersensitivity pneumonitis?
Dyspnea
Fever /systemic inflammatory s/sx
Cough
What are the chronic s/sx of hypersensitivity pneumonitis?
Progressive DOE
What is a common CXR finding of hypersensitivity pneumonitis?
upper lobe fibrosis
What is the treatment for hypersensitivity pneumonitis?
Corticosteroids and avoidance of the trigger
What is pneumoconiosis?
a disease of the lungs due to inhalation of dust, characterized by inflammation, coughing, and fibrosis.
What are the classic imaging findings of asbestosis?
Linear opacities at the lung bases, and interstitial fibrosis
What is the major risk with coal worker’s disease?
Progressive massive fibrosis
What is the major complication with berylliosis?
Requires chronic corticosteroid treatment
What are the classic CXR findings of silicosis?
Eggshell calcifications
What is the major complication associated with silicosis?
Increased risk of TB