Pulmonary Flashcards
Clinical Presentation of Asthma?
- Wheezing
- Episodic Coughing
- Intermittent Dyspnea
Diagnostic criteria for Asthma?
Reduced FEV1 to FVC ratio on Spirometry
Complications of Asthma Exaberation?
- Severe Hypoxema
- Hypercapnia
- Respiratory acidosis
Treatment for Acute Asthma Exaberation?
- Supplemental Oxygen
- Inhaled Albuterol
- Systemic Corticosteriods
- Ipratropium/Magnesium Sulfate
Maintenance Treatment for Intermittent Asthma?
Intermittent Asthma= 2 episodes a wk, 2 night episodes a month, FEV1= 80%
- Treat with Inhaled B2-agonists (albuterol)
Maintenance Treatment for Mild Persistent Asthma?
Mild Persistent = 2+ episodes a wk (not daily), 3-4 night episodes a month, FEV1= 80%
- Treat with Inhaled Albuterol + Low dose corticosteriod
Maintenance Treatment for Moderate Persistent Asthma?
Moderate Persistent = Daily symptoms, Night episodes 1x a week, FEV1= 60-80%
- Treat with Low/med dose corticosteriods, Long acting inhaled B2 agonists, Quick acting inhaled B2 agonists
Maintenance Treatment for Severe Persistent Asthma?
Severe Persistent Asthma = Symptoms throughout the day, Night symptoms multiple times a week, FEV1= < 60%
- Treat with Med/High dose corticosteriods, Long acting inhaled B2 agonists, Quick acting inhaled B2 agonists
Treatment for Asthma-exaberated Respiratory disease?
- Montelukast
- Zafirlukast
Clinical Presentation of COPD?
- “Barrel chest” (increased AP diameter)
- Diminished breath sounds
- Hyperresonance on percussion
- Prolonged expiration with “pursed lips” breathing
Diagnostic Criteria for COPD?
Pulmonary Function Tests results of:
- Decreased FEV1
- Decreased FEV1/FVC ratio
- Decreased VC
- Normal DLCO in chronic bronchitis vs decreased DLCO in emphysema
- Increased TLC, RV, FRC (from trapped air)
Chest X-Ray findings in COPD?
- Flattening of the diaphram
- Hyperlucent lungs
- Elongated, tubular shaped Heart (severe)
Complications of COPD?
- Respiratory Acidosis
- Cor pulmonale
- Spontaneous Pneuothorax
Treatment of COPD symptoms?
- Inhaled and Long Acting B2- agonists
- Inhaled anti-cholinergics (Ipratropium)
- Corticosteriods (Severe only)
Indications for supplemental oxygen in COPD?
- PaO2 < 55 mmhg
- SpO2 < 88 mmhg
or presence of Cor-pulmonale or Erythrocytosis
Treatment for Acute COPD exaberations?
- Supplemental oxygen titratedto goal(SpO2) of 88 to 92%
- Inhaled bronchodilators(e.g.albuterol,ipratropium)
- Intravenous glucocorticoids
- Antibiotics
Clinical Presentation of Lung Cancer?
- Cough
- Dyspnea
- Wheezing
- Hemoptysis
- Fatigue
- Weight loss
- Paraneoplastic syndromes
Initial test for suspected Lung Cancer?
Chest CT
Definitive Diagnostic test for Lung Cancer?
Biopsy (Endobronchial ultrasound guided biopsy)
Complications of Lung Cancer?
- Metastatic Disease
- Mass effects
- Paraneoplastic Syndrome
- Pleural Effusion
Clinical Presentation of Superior Vena Cava Syndrome and most common cause?
- Facial fullness
- Edema of neck, arms, head
- JVD
Associated with small cell lung cancer
Types of Mass effects as a result of Lung Cancer?
- Superior Vena Cava Syndrome
- Horner’s Syndrome
- Pancoast Tumor
Common sites of metastasis in Lung Cancer?
- Brain
- Bone
- Adrenal Glands
- Liver
Lung Cancer that is commonly found centrally near the hilum and how to treat it?
Small Cell Lung Cancer, Treat with Chemotherapy and Radiation