Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

English 2 > Pulmonary > Flashcards

Pulmonary Flashcards

You may prefer our related Brainscape-certified flashcards:
Proverbs and Idioms flashcards
1
Q

Obstructive lung disease

A

Airway narrow: restrict air mvt + often air trapping
FEV1/FVC ratio <70% (bcz FEV1↓) and RV↑

Causes: Asthma, Bronchiectasis, COPD, Cystic fibrosis, Obstruction (tracheal, bronchial)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Asthma (triggers, PE)

A

Reversible airway obstruct* (bronch hyperreactiv, infl, mucous plug, smooth M. hypertrophy)
Trig: allergens, URIs (multiple), cold air, exo, meds (NSAIDs/aspirin), stress
Ass w/ childhood eczema

Dry cough, episodic wheez, dyspn +/- tight chest (worse night/early morn); prolong expirat*, ↑access M. use, tachypn, tachycard
Late: ↓breath sounds (no wheez), cyanosis, ↓SaO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Asthma (dg)

A
  • Spirometry/PFTs (#1): ↓FEV1/FVC, ↑RV, ↑TLC but all Nl betw/ exacerb
  • Methacholine challenge: if PFTs Nl but asthma suspic*
  • ABGs: first acute resp alkalo +/- mild hypoxia; if resp acid or sev hypox so sev resp distress !!! hospit
  • CXR: Nl to hyperinglat*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Asthma (ttt)

A

Avoid allergens/triggers
-Acute: O2, SABA (#1); ipratropium, systemic CS, Mg2+ if sev
Intubat*: sev or PCO2>50 or PO2<50

-Chronic: LABA +/or inhaled CS, systemic CS, cromolyn (just prophyl), theophylline (rare).
W/ inhaled ttt, can take PO antileukotr (zileuton, montelukast)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Asthma (4 types + chronic ttt)

A
  • Mild interm: ≤2d/wk or ≤2 nights/mo; just PRN SABA
  • Mild persist: >2x/wk but <1x/d or >2 nights/mo; low-dose inhal CS/day + PRN SABA
  • Mod persist: daily or >1 night/wk; low/med-dose inhal CS/day and LABA/day + PRN SABA
  • Sev persist: continual, fqt; high-dose inhal CS/day and LABA/day; possible PO CS; PRN SABA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Bronchiectasis (RF, PE)

A

Fibrosis, remodel, permanent dilat* of bronchi
By recurr inf/infl of bronch
Ass w/ Hx cystic fibr, pulm infs, hypersens, immdef, airw obstr, aspir, autoimm ds, IBD, ABPA, TB, MAC inf

Chronic productive cough, dyspn +/- hemoptysis; wheez, rhonchi, purulent mucus (yellow/green)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Bronchiectasis (dg, ttt)

A

Dg: CXR (↑bronchovasc marking, tram lines); high-resolut* CT (defin; dilated airw, balloon cysts); spirometry (↓FEV1/FVC)

ttt: AB (PO+inhal), inhal CS; bronch hygiene (cough, postural drainage, physiottt); surg (lobectomy or lung transplant)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Chronic obstructive pulmonary disease (2 types)

A

-Chronic bronchitis: product cough >3mo/y for 2 consecut years (dg clinic)
Overweight, edematous
Early hypercarbia/hypoxia (blue)

-Emphysema: destruc+dilat* distal to terminal bronchioles (dg histopath); 2* to smok (centrilobular) or to alpha1-antitr def (panlobular)
Thin, pursed lips
Late hypercarbia/hypoxia (pink)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Chronic obstructive pulmonary disease (PE, dg)

A

Most ptts combinat* of 2 types
Barrel chest, access chest M, JVD, end-expir wheez, dyspn on exert*, muffled breath sounds

Dg: PFTs (defin; ↓FEV1/FVC; Nl/↑TLC; ↓DLCO); CXR (hyperinfl lungs, parench bullae, subpleural blebs); ABGs (hypoxemia + resp acid, ↑PCO2); Gram/Cx sputum if inf

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Chronic obstructive pulmonary disease (ttt)

A

O2 and stop smok: only ttt to improve survival
!!! not high O2 bcz worsen ventil/perfus* mismatch

-Acute exac: SABA + ipra/tiotrop, IV+/-inhal CS, AB, O2,
If sev: NIV w/ BiPAP or intubat*

-Chron exac: LABA + tiotrop, syst/inhal CS, O2, smok cessat*, pneumoc+flu vaccines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Restrictive lung disease

A

Loss of lung compliance (↑stiff + ↓expans*)
FEV1/FVC ≥70; ↓FVC and Nl FEV1; ↓RV

Alveolar, interstitial lung ds, inflammatory, idiopathic pulm fibrosis, neuromuscular, thoracic wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Interstitial lung disease (causes)

A

Group of dso; inflammat* +/or fibrosis of interstitium

  • Expo related: coal work pneumocon, asbest, silic, berylli, hypersens pneumo, radiat*, drugs (amiod, busulf, bleomy, long-term high-dose O2)
  • Ass w/ system ds or connect T ds: polymyos, dermatomyo, sarcoid, amyloid, vasculitis, CREST
  • Idiop: idiop pulm fibrosis, COP, acute interst pneumo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Interstitial lung disease (PE, dg)

A

Shallow rapid breath, dyspn w/ exert*, chron nonprod cough +/- cyanosis, inspir squeaks, crackles, clubbing, RHF

Dg: CXR/CT (#1; retic/nodul/ground-glass, honey comb if sev); PFTs (↓TLC, ↓FVC, ↓FLCO, Nl FEV1/FVC); surg biopsy (defin, confirm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Interstitial lung disease (ttt)

A

Avoid expo
Anti-infl or immunosuppr (CS)
Antifibrotic (for IPF)
Surg (lung transplant)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Systemic sarcoidosis (PE)

A

Noncaseating granulomas; esp black women
~30-40yo
Fev, cough, malaise, ↓weight, dyspn, arthritis
Exam: lungs, liver, eyes, skin (eryth nodos), nerv, heart, kidney

Löfgren sd: type of sarc w/ triad arthritis, eryth nodosum, bilat hilar adenopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Systemic sarcoidosis (dg, ttt)

A

Dg: CXR/CT (#1; hilar LNpathy, nodules); biopsy (defin; LN or lung; noncaseating granulomas)
PFTs (restric or obstruct; ↓DLCO); ↑serum ACE; hyperCa; ↑ALP; …

ttt: systemic CS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Hypersensitivity pneumonitis (causes, PE)

A

Alv thick + noncaseat granulom
2* to environm expo (mold, hot tubs, down feather Ag)

  • Acute: dyspn, fev, mal, shiv, cough 4-6h after expo
  • Chronic: progr dyspn, fine bilat rales
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hypersensitivity pneumonitis (dg, ttt)

A

Dg: job/travel Hx; CXR/CT (esp upper lobe fibrosis in chronic)

ttt: avoid ongoing expo; CS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pneumoconiosis

A

RF: prolong expo + inhal of small inorganic particles
4 types: asbestosis, coal worker’s ds, silicosis, berylliosis

ttt: avoid triggers, support ttt, O2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Asbestosis

A

Insulat, construct, demolit*, shipbuilding
After 15-20y of expo

Linear opacities at bases, interst fibrosis, calcif pleural plaques, ferruginous bodies
↑R mesothelioma (rare), lung cancer (higher in smokers)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Coal worker’s disease

A

Underground coal mines
Small nodular opacities (<1cm) in upper lobes
Compl: progr massive fibrosis

22
Q

Silicosis

A

Mines, quarries or glass, pottery, silica
Small nodular opacities (<1cm) in upper lobes; eggshell calcifications

↑R of TB (skin test/y); progr massive fibrosis

23
Q

Berylliosis

A

Aerospace, nuclear, electronics plants, ceramics, dental, dye
Diffuse infiltrates, hilar adenopathy

ttt: chronic CS

24
Q

Eosinophilic pulmonary syndromes

A

Eosino pulm infiltrat + periph bld eosino
Includes ABPA, Löffler sd, acute eosino pneumonia, drug-induced (NSAIDs, nitrof, sulfonam)

Dyspn, cough, bld-tinged sputum, fev
Dg: CBC (eosino); CXR (pulm infiltrates)
ttt: remov cause or ttt underl inf (helminths); CS

25
Q

Hypoxemia (etiologies, PE, dg)

A

↓PO2 by V/Q mismatch, R-L shunt, hypoventil, altitude, diffus* impairment
Cyanosis, tachypn, SOB, pleur chest pain, alter ment stat

Dg: ABGs (#1; A-a gradient), ↓SpO2, CXR (r/o pneumonia, atelect, pleur effus, pneumothor, ARDS)
↑A-a gradient: shunt, V/Q mismatch, diffus impair

26
Q

Hypoxemia (ttt)

A

Underl cause
Give O2 before eval
If mechan ventil: ↑O2 (by ↑FiO2 or ↑PEEP) or ↑ventilat* (by ↑RR or ↑TV)
If hypercapnia: ↑ventilat* (to ↑CO2 exchange)

27
Q

Acute respiratory distress syndrome (RF)

A

Resp failure w/ refract hypoxemia + ↓lung compliance + noncardiog pulm edema + PaCO2/FiO2 ≤300
Endoth injury first

Trigg: sepsis, pneumonia, aspirat*, multiple bld transfu, inh/ing toxins, trauma
Morta 30-40%

28
Q

Acute respiratory distress syndrome (PE)

A

Acute (12-48h): tachypn, dyspn, tachycard, fev, cyano, labored breath, diffuse high-pitched rales, hypoxemia

Phase 1 (acute): Nl PE, resp alkal
Ph2: 6-48h: hyperventil, hypocapn, wide A-a grdt
Ph3: acute resp failure, tachypn, dyspn, ↓lung compl, diff rales, diff chest opacity (CXR)
Ph4: sev hypoxemia unresp to ttt, ↑intrapulm shunt, metab+resp acidosis

29
Q

Acute respiratory distress syndrome (dg, ttt)

A

Dg: Berlin criteria: acute onset (<1wk) resp distress; PaO2/FiO2 ≤300 w/ PEEP/CPAP5; bilat pulm infilt CXR; resp failure not complet explain by heart failure

ttt: underl cause + adeq perfus; mechan ventil w/ low TV; PEEP (then titrate); PaO2 >55 or SaO2 >88%; slowly wean from ventil then extubat trials

30
Q

Pulmonary hypertension / Cor pulmonale (types)

A

Cor pulm = right-side heart failure due to pulm HTN
PAP >25 (Nl =15); 5 categories

  • Pulm arterial HTN
  • ↑pulm venous pressure from left-side heart ds
  • Hypoxic vasoconstr 2* to chron lung ds
  • Chron thromboembolic ds
  • Pulm HTN w/ unclear/multifactorial etiology
31
Q

Pulmonary hypertension / Cor pulmonale (PE)

A

Dyspn on exert, fatig, lethargy, syncop w/ exert, chest pain, sympt of right CHF (edem, abdo dist, JVD)

Hx of COPD, interst lung ds, heart ds, SCD, emphys, PE
Loud split S2, flow murmur, S4, parasternal heave; hypoxemia on exert*

32
Q

Pulmonary hypertension / Cor pulmonale (dg, ttt)

A

Dg: CXR (larg central pulm art), ECG (RVH)
Echocard (#1) + right heart cath (defin): RV overload

ttt: O2, anticoag, vasodil, diuret (if R CHF)
Underl cause
If Pulm art HTN: prostanoids, endothelin recept antag, PDE inhib

33
Q

Pulmonary thromboembolism (RF, etiologies)

A

95% emboli from DVTs in leg
Leads to pulm infarct*, right HF, hypoxemia

Virchow triad (predisposing fact): venous stasis, endothelial injury, hypercoagulability
Other etiologies of emboli: amniotic fluid, fat, air, cholest
34
Q

Pulmonary thromboembolism (PE)

A

Sudden/subacute dyspn, pleurit chest pain, low-grade fev, cough, tachypn, tachycard, rare hemoptysis
Hx of immobil; hypoxia + hypocarbia (resp alkal)

Loud P2, prominent jugular A waves w/ right HF

35
Q

Pulmonary thromboembolism (dg)

A
  • D-dimer (#1 to r/o PE; when low suspic*)
  • CT pulm angiogram w/ IV contrast (defin!!!)
  • ABGs: resp alkal (hyperventil, PO2<80)
  • CXR: atelect, pleur effus*, Hampton hump
  • ECG: sinus tachycard, rare S1Q3T3
  • V/Q scan: just if CT scan CI (↑crea, pgnt); areas of mismatch
  • LE venous US: spec/sens for DVT not PE (just to dg DVT)
36
Q

Pulmonary thromboembolism (ttt)

A
  • Anticoag: acute (heparin bolus then infus* or LMWH subcut); chronic (3-6mo or during predispo; INR 2-3)
  • IVC filter: if anticoag CI and LE DVT dg or if recurr PE while anticoag
  • Thrombolisis: if massive PE w/ right HF + hemodyn instabil
  • DVT prophyl: immobil ptt; subcut heparin or LMWH, intermitt LE compress, early ambulat (+++)
37
Q

Lung nodules

A

Esp asympt; chronic cough, dyspn, SOB
Always ask abt smok, Hx of expo bcz ↑R cancer
Recent immigrant (TB); SW US (coccidio); Ohio river valley (histopl)

ttt: surg resect* if ↑R malign; follow-up w/ serial CXR/CT if ↓R; invasive dg procedure if size ↑

38
Q

Benign vs Malignant lung nodules

A

Benign: <35yo, nonsmok, no change, smooth margins, central/uniform/popcorn calcificat*, <2cm

Malignant: >45-50yo, smoker, new/enlarging, irreg margins, absent/irreg calcificat*, >2cm

39
Q

Lung cancer (RF, PE)

A 
#1 cause of cancer death in US
RF: tobacco (except bronchoalv carcinoma), radon, asbest
Cough, hemoptysis, dyspn, wheez, pneumonia, chest pain, ↓weight, +/- crackles/atelectasis
Horner sd (Pancoast tumor at apex); SVC sd; Hoarsness (recurr laryngeal nerv involv); Many paraneopl sds
40
Q

Lung cancer (dg, ttt)

A

Dg: CXR or CT (#1); FNA (CT-guided for periph les); bronchoscopy (for central les)
Meta esp: Liver, Adrenals, Brain, Bone

ttt: SCLC (unresectable; radiat* + chemoth; usual recurr; low survival rate)
NSCLC (surgical resect* if early; w/ radiat* or chemoth depend on stage; palliative radiat* +/or chemoth if sympt but unresect)

41
Q

Small cell lung cancer

A

Cigarette expo; Central locat*
Neuroendocrine (Kulchitsky cells); myc oncogene
Chromogranin A ⊕

Ass w/ paraneopl sd (ACTH, SIADH, Lambert-Eaton, myelitis)
Often ⊕ meta intrathor + extra thor (brain, liver, bone)

42
Q

Non-small cell lung cancer

A

Adenocarcinoma (#1 fqt)
Squamous cell carcinoma
Large cell carcinoma

Less likely to meta at early stage

43
Q

Adenocarcinoma

A

Peripheral; #1 in nonsmoker
KRAS, EGFR, ALK mutat*; ass w/ hypertroph osteoarthrop
Histo (glandular; Mucin⊕)

Bronchoalv carcinoma (subtype; adenoK in situ; CXR similar to pneumonia; excellent pg); apparent thick alv walls

44
Q

Squamous cell carcinoma

A

Central; hilar mass from bronchus
Smokers (98%)
Cavitat*; hyperCalcemia (PTHrP)
Keratin pearls, intercellular bridges

45
Q

Large cell carcinoma

A

Peripheral
Highly anaplastic, undifferentiated; poor pg
Pleomorphic giant cells; B-hCG

46
Q

Bronchial carcinoid tumor

A

Excellent pg
Sympt by mass effect; rare carcinoid sd (5-HT, flush, diarrh, wheez)
Nests of neuroendocrine cells; chromogranin A ⊕

47
Q

Pleural effusion (2 types)

A

Transudate: ↑PCWP or ↓oncotic pressure
(CHF, cirrhosis, nephrotic sc)

Exudate: ↑pleural vasc permeab
Any of Light’s criteria
(pneumonia, TB, cancer, PE, collagen vasc ds, pancreatitis, trauma)

48
Q

Pleural effusion (PE, dg, ttt)

A

Dyspn, pleur chest pain, cough, dull to percuss, ↓breath sounds, pleur frict rub

Dg: CXR (#1; sometimes lateral decub view)
Thoracocentesis: for new >1cm in decub
ttt: underl cause; if complicated effus* or empyema then chest tube drain + AB or pleurodesis

49
Q

Pneumothorax (types)

A
  • 1* spont: rupture subpleural apical bleb
  • 2* PT: 2* to COPD, trauma, inf, iatrog, ⊕P* mechan ventil

-Tens* PT: pulm/chest wall defect (1-way valve; air trap); tracheal deviat* → SVC compress* → cardiac arrest, hemod instab; !!! shock-death unless immed ttt

50
Q

Pneumothorax (PE, dg, ttt)

A

Acute unilat pleur chest pain, dyspn, tachypn, ↓/no breath sounds, hyperreson, ↓tact fremitus, JVD
Tens* PT: resp distress, hypoxia

Dg: CXR (lung retract); Tens PT clinical dg
ttt: immed for tens* PT (needle decompr then chest tube)
If small, spontan resolut*; give O2

English 2 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions