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PANCE Review > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

influenza - clinical findings and diagnosis

A

abrupt onset, fever/chills, HA, myalgias, sore throat, non-productive cough

Dx: usually clinical, nasopharyngeal swab

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2
Q

influenza - prophylaxis and treatment

A

anti-viral

  • oseltamivir/tamiflu PO (>1 yr)
  • zanamivir/relenza inhaled (>7 yr)

Prevention: vaccine
- approved for > 6mo

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3
Q

Reye’s syndrome

A

mixing aspirin with viral illness in children

  • presents with hepatitis and CNS complications
  • 30% mortality
  • typically use acetaminophen in children < 19
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4
Q

acute bronchitis - sxs, PE, Dx

A

usually viral
sx: cough w/ or w/o sputum, fever, substernal pain

PE: expiratory rhonchi or wheezes

Dx: can use CXR to distinguish from pneumonia (see absence of markings with bronchitis)

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5
Q

acute bronchitis - tx

A

usually symptomatic

ABX only for elderly, lasting 7-10days, immunocompromised

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6
Q

community acquired pneumonia (CAP) - general info and cause

A 
#1 infectious cause of death in US
 - acquired by aspiration of colonized upper airway

cause:
- typically bacterial (S. Pneumo > H. influenza > M. cat)
- atypical: Legionella, mycoplasma, chlamydia

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7
Q

community acquired pneumonia (CAP) - clinical findings and dx

A

tachycardia, tachypnea
fever/chills
cough +/- sputum
altered breath sounds, rales, dullness to percussion due to consolidation

dx: CXR shows patchy, segmental lobar consolidation

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8
Q

community acquired pneumonia (CAP) - outpatinet tx

A

Typical:
• 1st line: doxycycline (abx type: Tetracycline)
• 2nd line: azithromycin (abx type: Macrolide)

Chronic comorbid or recent ABX use: levofloxacin/moxifloxacin (abx type: Fluoroquinolone)

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9
Q

community acquired pneumonia (CAP) - prevention

A

pneumococcal vaccine

- age >65 or co-morbid conditions

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10
Q

community acquired pneumonia (CAP) - hints to fungi, bacteria, and viruses involved

A

P. jirovaci: hypoxemic, “ground glass” infiltrates on CXR
- HIV/AIDS

C. psittaci: birds, zoonotic disease

S. pneumoniae: single rigor, rust-colored sputum

Klebsiella pneumoniae: alcoholics, current jelly sputum

Pseudomonas: cystic fibrosis

Atypicals (mycoplasma or chlamydia): college students

Legionella: air conditioning

RSV: children <1

H. Influenza: COPD

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11
Q

nosocomial pneumonia (hospital-aquired pneumonia) - definition, dx, tx

A

sxs similar to CAP, but onset is after 48 hours post admission to hospital

dx: blood culture, WBC count, CXR
tx: no uniform consensus (varies)

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12
Q

pneumonia: HIV related - fungi involved, general info, sxs

A 
pneumocystis jiroveci (PCP)
 - most common opportunistic infection associated with AIDS (CD4<200)

Sx: fever, tachypnea, SOB, non-productive cough (non-specific)

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13
Q

pneumonia: HIV related - dx, tx, prophylaxis

A

Dx: CXR classic finding - peri-hilar infiltrates in a butterfly wing distribution (no effusion)

Tx: TMP/SMX (Bactrim)
- fatal if not treated

Prophylaxis: TMP/SMX for all AIDS puts with CD4<200

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14
Q

tuberculosis - general info and cause

A

Primary TB
- 95% become latent TB infections (not infectious, asymptomatic, but have inactive TB in their body)

Secondary TB:
- reactivation TB develops from latent TB infection

cause: M. tuberculosis
- transmitted by resp. droplets
- only 10% infected develop dz

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15
Q

tuberculosis - sxs and dx

A

Sxs: cough, chest pain, SOB, hemoptysis
- classic sxs complex: fever, drenching night sweats, anorexia, weight loss

PE: post-tussive rales (classic)

Dx:

  • CXR (cavitations - dark spots of air in active dx, Ghon complex - in latent dz)
  • Sputum culture
  • PPD: measure induration (not erythema); positive indicates exposure (not necessarily active dz)
  • biopsy: caseating granulomas (hallmark)
  • If vaccinated, must get a serum test (Quantiferon)
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16
Q

Pott’s disease

A

extrapulmonary TB

- commonly in thoracic spine

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17
Q

Ghon/Ranke complexes

A

seen on CXR in healed primary infection of tuberculosis

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18
Q

PPD: TB skin test reaction

A

measure induration (not erythema)

positive indicates exposure (not necessarily active dz)

> 5mm: immunocompromised, evidence of TB on CXR

> 10mm: at risk

> 15mm: persons w/ no risk factors

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19
Q

tuberculosis - TX (latent vs. active)

A

Note: multiple drugs are needed due to resistance

latent:

  • INH (isoniazid) x 9mo or
  • PZA and RIF x 2 mo or
  • RIF x 4 mo

active:

  • INH/RIF/PZA/EMB x 2 mo
  • INH/RIF x 4mo
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20
Q

side effects of anti-TB medications

A

INH: hepatitis, peripheral neuropathy (prevent via vit. B6 - pyridoxine)

RIF: hepatitis, orange body fluids, rash

PZA: hepatitis, GI sxs, gout/arthalgias

EMB: optic neuritis, red-green vision loss

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21
Q

epiglottitis - sxs, dx, tx

A

sxs: rapidly developing sore throat or odynophagia (painful swallow) out of proportion to PE
dx: laryngoscopy, XR (thumb print sign)
tx: 2nd/3rd gen cephalosporin (ceftizomine, cefuroxime) AND dexamethasone to limit pharyngeal edema
prevention: Hib vaccine

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22
Q

pertussis - background, cause, sxs

A

usually infants, children (inc. in adults since vaccine from childhood wears off)

cause: Bordetella pertussis (via resp. droplets)

sxs: resembles common cold, bronchitis
- “whoop” in children (less common in adults)
- post-tussive emesis

“cough of 100 days”

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23
Q

pertussis - dx, tx, and prevention

A

dx: PCR is diagnostic standard

tx: ABX to stop spread but does not alter course of sxs
- macrolides 1st line (azithromycin, clarithromycin, erythromycin)

prevent: Tdap, DTaP

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24
Q

pulmonary nodule - definiton and causes

A

lung nodules, <3cm (if >3cm = mass), isolated, rounded opacity surrounded by normal lung
- 40% are malignant (most are not)

Causes:

  • infectious granulomas (most)
  • carcinoma
  • hamartoma
  • metastasis (usually multiple)
  • bronchial adenoma (95% carcinoid tumors)
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25
Q

pulmonary nodule - sxs, dx

A

sxs: most asymptomatic

dx:
1. CXR and compare to old image
- got larger over 30-50 days = malignancy
- rapid growth <30 days = infection
- no growth in 2 yrs = benign
2. CT (w/ biopsy for dx)
- smooth, well-defined = benign
- lobular, speculated, peripheral halo = often cancer

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26
Q

pulmonary nodules - hints to benign vs. malignant

A

malignant: older (>45 y/o), absent or irregular calcifications, larger (>2cm), new or growing, irregular margins

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27
Q

pulmonary nodules - tx

A

> 35 y/o: resect unless no change in 2 yr

<35 w/ unchanged lesion: repeat study in 3-6 mo

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28
Q

bronchogenic cancer - general info

A
  • 90% of lung cancer
  • leading cause of cancer deaths in men and women
  • 5-year survival is 15%
  • cigarette smoking is #1 risk factor
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29
Q

bronchogenic cancer - classification and clinical findings

A

SCLC (small cell): early mets, aggressive clinical course

NSCLC (adeno, squamous, large cell): slower spreading
- more amenable to tx (surgery)

sxs: age 50-80, cough, dyspnea, hemoptysis, anorexia, weight loss

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30
Q

bronchogenic cancer - histological types

A

adenocarcinoma (most common - 35-40% cases)
- peripheral mass

squamous (25-35% cases)
- central mass (hemoptysis)

large cell (5-10% cases)
 - peripheral mass
small cell (15-20% cases)
 - central mass (hemoptysis)

Hint: LA is on coast (peripheral lesion - no hemoptysis)

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31
Q

bronchogenic cancer - dx, tx, sites of METS

A

Dx: biopsy, cytology (also CT and PET scan)

Tx: depends on type and extent (surgery, chemo, radiation)

METS: bone, brain, adrenal glands, liver

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32
Q

carcinoid tumor - definition and cause

A

well-differentiated neuroendocrine tumors
- found in GI tract (most common) and lung

cause: low-grade, malignant neoplasm
- rarely METS

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33
Q

carcinoid tumor - sxs, dx, tx

A

Sxs: asymptomatic, localized bronchial obstruction, hemoptysis, cough, recurrent pneumonia
- carcinoid sundrome (10% of pts): flushing, diarrhea, wheezing, hypotension

Dx: CT

Tx: surgical excision

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34
Q

mesothelioma - definition, cause, sxs

A

primary tumors of pleural liming (80%) and peritoneum (20%)

cause: asbestos
sxs: SOB, non-pleuritic CP, weight loss, dec. breath sounds, digital clubbing

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35
Q

mesothelioma - Dx, Tx, prognosis

A

Dx: CT with biopsy

Tx: none are effective (chemo, surgery)

Prognosis: mean 8-14 mo

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36
Q

secondary lung cancer - definition, dx, tx

A

extra-pulmonary metastases

Breast, liver, and colon cancer: most common METS to lung
- almost any cancer can MET to lung

dx: CXR reveals multiple nodules
tx: dx and tx primary tumor

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37
Q

obstructive pulmonary disease - definition and examples of dz

A

dec. FEV1/FVC
- normally >80%

Total lung capacity normal or increased due to air trapping

asthma
chronic bronchitis
emphysema
cystic fibrosis

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38
Q

asthma

A

“reversible” airway condition characterized by:

  • acute inflammation
  • bronchial hyper reactivity
  • mucus plugging
  • smooth muscle hypertrophy

Atopy: strongest identifiable factor

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39
Q

atopic triad

A

asthma, eczema, seasonal rhinitis

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40
Q

asthma - causes, sxs

A

causes:
- allergens (dust), exercise, URI, post-nasal drip, GERD, medictions (beta blockers, ACE-I, aspirin, NSAIDS), stress, cold air

sxs: breathlessness, cough, wheeze, diffuse expiratory wheeze

41
Q

asthma - dx

A

spirometry (pre and post therapy)

  • decreased FEV1/FVC (<75%)
  • positive bronchodilator response (>10% inc, in FEV1)

Definitive test: methacholine challenge

  • FEV1 dec. by > 20%
  • used if spirometry is non diagnostic
42
Q

asthma - tx (step therapy)

A

intermittent vs. persistent

Intermittent:

  • <1 per week
  • SABA prn

Persistent (mild, moderate, severe)

  • Rules of 2’s
  • Combo of ICS (inhaled or PO) and LABA / LTRA
43
Q

asthma - tx (lifestyle and medications)

A

remove irritants
education on peak flow measures
desensitization
oxygen

Meds:

  • inhaled beta-2 agonists (albuterol)
  • glucocorticoids (e.g. prednisone)
  • anticholinergics (e.g. ipratropium)
44
Q

asthma - long-term control therapy

A 
inhaled corticosteroids (fluticasone, budesonide)
 - mainstay for PERSISTENT asthma

long-acting bronchodilators (LABA)
- inhaled beta-2 agonists (salmeterol)

leukotriene inhibitors (montelukast/singulair)

phosphodiesterase inhibitors (theophylline)

45
Q

bronchiectasis - definition, cause, sxs

A

permanent dilation/destruction of bronchial walls

cause: congenital (cystic fibrosis), acquired (tumor obstruction or recurrent infections)
- CF: pseudomonas
- non-CF: H. flu

sxs: foul breath, chronic cough w/ copious/purulent sputum, hemoptysis, recurrent pneumonia, weight loss, anemia, persistent basilar crackles

46
Q

bronchiectasis - dx

A

CT (high resolution): thickened bronchial walls with dilated airways (“tree and bud” appearance)

  • diagnostic test of choice
  • “tram track” appearance
47
Q

bronchiectasis - tx

A 
oxygen
aggressive ABX
 - guided on sputum cx or empiric
inhaled bronchodilators
 - maintenance and acute exacerbationis
lung transplantation
48
Q

COPD: chronic bronchitis/emphysema - definition, cause, dx

A

airflow obstruction due to chronic bronchitis and emphysema

  • most puts have features of both
  • 3rd leading cause of death world-wide

cause: smoking (80%), pollutants, recurrent URIs, eosinophilia

Dx: PFT

  • normal in early dz
  • dec. FEV1/FVC
  • inc. RV (residual vol.) and TLC w/ air trapping that occurs
49
Q

emphysema - definition

A

permanent air space enlargement distal to terminal bronchiole with alveolar wall destruction

“pink puffers”: cough rare, quiet lungs, thin, barrel chest, pursed lips
Hallmark: exertional dyspnea

CXR: parenchymal bullae and blebs; diagram flattened/hyperinflation
- think, large heart

50
Q

chronic bronchitis - definition

A

increased bronchial secretions
cough for >3 mos over at least 2 years

“blue bloaters: mild dyspnea, chronic productive cough, noisy lungs (rhonchi and wheeze), peripheral edema, overweight and cyanotic

CXR: diaphragm not flattened

51
Q

COPD: treatment

A 
smoking cessation
oxygen
bronchodilators
 - LAMA (ipatropium)
 - SABA and LABA

ABX: for acute exacerbations (TMP/SMX, augmenting/clavulanate, doxycycline)

Influenza and pneumococcal vaccines

surgery: transplant

52
Q

restrictive pulmonary diseases - definition, three on boards

A

smaller volume of air in lungs (dec. TLC) and less compliance of lung tissue (FEV1/FVC can be normal or increased)

idiopathic pulmonary fibrosis
pneumoconioses
sarcoidosis

53
Q

idiopathic pulmonary fibrosis - background and clinical findings

A

most common dx among pts with interstitial lung disease
- confirm idiopathic since most caused by infection, drugs, or environmental/occupational exposure

collagen deposition in lungs with little inflammation

PE: insidious dry cough, exertional dyspnea, diffuse, fine crackles (velcro at bases) w/ inspiration, clubbing (w/ chronic hypoxia)

54
Q

idiopathic pulmonary fibrosis - dx, tx. prognosis

A

Dx:
CXR: low lung vol., patchy, diffuse fibrosis, pleural honeycombing
- biopsy helps to confirm

Tx: controversial (corticosteroids vs. interferon)

Survival: 2-3 yrs after dx

55
Q

pneumoconioses - definition, causes, tx

A

chronic lung diseases caused by various precipitating agents

  • industrial, inhalation fo mineral and metal dusts
  • fibrotic lung develops from ingestion of agents by macrophages leading to cell injury and death
  • asbestosis, coal workers pneumoconiosis, silicosis, berryliosis

Tx: supportive

56
Q

asbestosis - what are people at risk for?

A

lung cancer and mesothelioma, especially if also a smoker

57
Q

silicosis - what are people at risk for?

A

TB - tuberculosis

58
Q

sarcoidosis - definition, labs, imaging, dx, tx

A

type of restrictive lung dz that causes inflammatory cells (called granulomas) to form in the body

Labs: ACE elevated (created in lungs), hypercalcemia

biopsy: NON-CASEATING GRANULOMAS
- hilar adenopathy better prognosis; parenchymal worse

Tx: prednisone

59
Q

features of sarcoidosis - GRUELING

A 
Granuloma
RA
Uveitis
Erythema nudism
Lymphadenopathy
Interstitial fibrosis
Negative TB test
Gammaglobulinemia (immunoglobulins increased since may be immune-related)
60
Q

pleural effusion

A

abnormal collection of fluid in the pleural space

  • 25% associated with malignancy
  • MUST distinguish b/t transudate and exudate
61
Q

transudate pleural effusions

A

transudative contains fluid

  • results from increased hydrostatic pressure pushing fluid out of vessels (e.g. heart failure) and/or decreased osmotic pressure pulling fluid in due to decrease proteins within vessels (dec. protein synthesis in liver disease or inc. protein loss in kidney disease)
  • INTACT capillaries
62
Q

exudative pleural effusions

A

exudative contains fluid and protein

  • inflammation causes vasodilation and stasis of fluid in vessels as well as increased inter endothelial spaces (so protein leak out)
  • related to an inflammatory process (e.g. malignancy)
  • LEAKY capillaries
63
Q

pleural effusions - 5 types

A
  1. exudates: malignancy, infection, trauma, PE
    - note: PE can be transudative (20%)
    - unilateral
  2. transudate: CHF, atelectasis, renal/liver dz
    - bilateral
  3. empyema: direct infection of exudate
  4. hemothorax: trauma
  5. chylothorax: TB
64
Q

pleural effusions - clinical findings

A 
asymptomatic (if small)
dyspnea/cough (if large)
percussion dullness
decreased tactile fremitus
diminished/absent breath sounds
bilateral (transudates) vs. unilateral (exudates)
65
Q

pleural effusion - dx

A

Dx: thoracentesis is GOLD STANDARD for dx and tx (therapeutic to remove fluid)
- send for protein, LDH, pH, total and cell counts, glucose (bacteria eat), cytology

66
Q

pleural effusion - role of imaging

A

Imaging: helps to define size

CXR can detect as little as 50mls

  • lateral decubitus for free flowing v. loculated
  • upright (blunting of costophrenic sulcus)

CT can detect as little as 10mls

67
Q

pleural effusion - tx

A

transudates

  • correct underlying condition
  • therapeutic thoracentesis if dyspnea

exudates

  • drain empyemas
  • pleurodesis (prevents fluid build-up) for malignency
68
Q

pleural effusion - how to distinguish transudate vs. exudate

A

Light’s criteria:

  • compares amount of protein or LDH in the fluid vs. serum
  • higher than normal protein or LDH in pleural fluid compared to serum are signs of exudate (infection/inflammatory process)
69
Q

lactate dehydrogenase (LDH)

A

LDH is an enzyme found in almost every cell of your body

When cells are damaged or destroyed, this enzyme is released

70
Q

pneumothorax

A

abnormal accumulation of air in pleural space

71
Q

pneumothorax - 3 types

A

spontaneous
- can be primary (no underlying dz, usually tall, think male) or secondary (due to underlying dz, COPD, asthma, CF, ILD)

traumatic: penetrating or blunt trauma

tension: MEDICAL EMERGENCY
- lung collapse due to penetrating trauma, CPR
- see contra lateral mediastinal shift
- get hypotension from impaired venous return

72
Q

pneumothorax - clinical findings (spontaneous vs. tension)

A

spontaneous:

  • ipsilateral/unilateral CP (sudden and pleuritic)
  • absent breath sounds
  • hyper resonance, dec. tactile fremitus

tension (in addition to above):

  • resp. distress, falling O2
  • hypotension, distended neck veins, tracheal deviation
73
Q

pneumothorax - dx

A

CXR: end expiratory chest film shows visceral pleural air
- see lung line (absence of lung markings beyond line)

tension: air on affected side w/ contralateral mediastinal shift

74
Q

pneumothorax - tx

A

spontaneous:

  • small (<15% diameter of hemithorax on CXR): rest, cough and CP relief, serial CXRs
  • large (>15%): chest tube and above measures

tension: immediate needle decompression
- 2nd ICS and MCL

75
Q

pleuritic chest pain

A

pain worsens with movement of pleura - breaths, coughs, sneezes

76
Q

virchow’s triad

A

risk factors for PE

  • hyper coagulable state (e.g. cancer)
  • venous stasis (prolonged rest, cast)
  • vascular intimal inflammation or injury (e.g. surgery/trauma)
77
Q

pulmonary embolism (PE) - definition and risk factors

A

occlusion of pulmonary arterial circulation from an embolized substance
- #3 leading cause of death in hospital pts

risk factors:

  • virchow’s triad
  • consider: surgical procedures, abdominal cancer, OCPs, pregnancy
78
Q

pulmonary embolism - etiology

A

Most come from thrombus:

  • 95% deep calf veins (DVT)
  • also air (central lines), amniotic fluid (active labor), and fat (long bone fx)
79
Q

pulmonary embolism - clinical findings

A

SUDDEN dyspnea, tachypnea, pleuritic chest pain (on inspiration)

MOST COMMON SXS: dyspnea w/ tachypnea

MOST COMMON SIGN: tachycardia

homan’s sign: calf pain w/ passive dorsiflexion of foot w/ knee flexed

80
Q

pulmonary embolism - ECG findings and labs

A

ECG: NOT diagnostic

  • sinus tachycardia
  • S1-Q3-T3

ABG: hypoxia

D-dimer: negative w. low clinical suspicion = strong evidence AGAINST DVT

81
Q

D-dimer

A

blood test that measures plasma levels of degraded fibrinogen

  • if low clinical suspicion of PE (PERC score, Wells criteria), negative result can be used to r/o PE
  • if high clinical suspicion, cannot be used to r/o PE and further imaging (CT) must be used
82
Q

pulmonary embolism - CXR and VQ Scan

A

CXR:

  • most common is atelectasis at bases
  • Westermark’s sign: vasoconstriction in embolized zone
  • Hampton’s hump (classic): wedge shaped infarct

VQ scans:

  • normal practically rules out PE
  • abnormal is non-specific (need further eval)
83
Q

pulmonary embolism - dx

A

spiral CT angiography
- method of choice

pulmonary arteriography
- gold standard, but not used as much since CT is easier

venography

  • gold standard for dx of LE DVT (not PE)
  • LE venous doppler used for DVTs but not good for PE dx
84
Q

pulmonary embolism - tx

A

anticoagulation: 3-6 months
- heparin to Coumadin (INRs 2-3 x normal)
- LMWH
- novel oral anticoags (NOACs): rivaroxaban, apixaban, dabigatran

thrombolytic therapy

  • streptokinase, alteplase, urokinase
  • only if hemodynamically unstable

IVC filter

surgery: only for saddle emboli

85
Q

pulmonary embolism - prevention

A

early ambulation
pneumatic compression
low dose heparin
LMWH (low molecular weight heparin)

86
Q

pulmonary hypertension - definition

A

pulmonary artery pressure rises to level inappropriate for given cardiac output

  • self-perpetuating once initiated
  • women>men
  • 30-50 y/o
87
Q

pulmonary hypertension - causes

A

most common it is secondary to other causes:

  • COPD, connective tissue disorder, scleroderma
  • inc. pulmonary venous pressure
  • constrictive pericarditis, LV failure, mitral stenosis
88
Q

pulmonary hypertension - clinical findings, labs, and ECG

A

dull, retrosternal chest pain (angina-like), dyspnea, fatigue, effort syncope
- sxs related to underlying cause

labs: polycythemia

ECG (right-sided findings): rt axis deviation, rt ventricular hypertrophy

89
Q

pulmonary hypertension - dx

A

multifactorial

  • CXR/CT: inc. vasculature
  • PFTs: lung pathology
  • ECHO/TTE: RVH, pulm. artery pressure
  • catheterization: determine degree of HTN
90
Q

pulmonary hypertension - tx

A

treat underlying cause (e.g. oxygen for COPD, anticoags for emboli, diuretics or salt restriction for for pulmonale)

vasodilators: CCBs, epoprostenol (PGI2), prostacyclin

91
Q

cor pulmonale - definition

A

failure of rt side of heart caused by prolonged high blood pressure in the pulmonary arteries (pulmonary HTN) and rt ventricle of the heart

rt ventricular enlargement leads to rt ventricular failure

92
Q

cor pulmonale - cause

A

acute: think PE
chronic: think COPD

pulmonary vascular dz: 
 - PE, vasculitis, ARDS
respiratory disease:
 - obstructive (asthma, COPD)
 - restrictive (ILD, lung resection)
93
Q

cor pulmonale - clinical findings

A

fatigue, exertional dyspnea, syncope w/ exertion

inc. chest diameter

labored resp effort w/ retractions

hyper-resonance to percussion
- diminished breath sounds, wheezing, distant heart sounds, cyanosis

94
Q

cor pulmonale - dx and tx

A

Dx:

  • CXR
  • ECG: RAD > 30, inverted t waves in RV precordial leads

Tx:

  • oxygen
  • dec. pulm vasc. resistance and pulm. HTN
  • treat underlying disorder
95
Q

Acute Respiratory Distress Syndrome (ARDS) - definition

A

acute (12-18 hrs) hyperemic respiratory failure after systemic or pulmonary insult W/O heart failure

96
Q

Acute Respiratory Distress Syndrome (ARDS) - cause

A

sepsis: MOST COMMON
others: toxic inhalation, near drowning, aspiration

97
Q

Acute Respiratory Distress Syndrome (ARDS) - clinical findings

A

respiratory distress, tachypnea, fever, crackles, rhonchi

98
Q

Acute Respiratory Distress Syndrome (ARDS) - CXR, Dx, and Tx

A

CXR: diffuse pulmonary infiltrates that SPARES costophrenic angles
- normal heart size (NOT related to HF)

Dx: clinical

Tx: underlying cause plus supportive care
- high mortality rate!

99
Q

ground glass opacities on CXR

A

indicates exudative or transudative fluid in lungs

- lines apparent in CXR

PANCE Review (16 decks)

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