Brainscape's Knowledge GenomeTM

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


See full index

AGNP AANC Boards > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

s/s PE

A

sudden onset of SOB and cough. + productive ( pink) sputum, tachy, impending doom. Most common cause is a DVT emboli

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

what type of reaction is a anaphalxisis

A

type 1 igE-mediated

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

how many lobes does the L and R lung have

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

What does the normal resp drive respond too?

A

changes in the aterial C02 ( hypercapnia)

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

Norm base/lower lung sounds

A

vesicular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

norm bronchi/upper airways sounds

A

bronchial or bronchovesciular

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

normal sound with percussion?

A

reasonance

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

When you hear dull percussion on lungs?

A

lobar pnuemonia , blood fluid, tumor

over ribs/bone, liver and heart

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

when do you hear hyperreasonace/tympany?

A

“too much air in heart” = emphysema

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

Do upper or lower lobes have more fremitus?

A

upper have more vibration

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

Increased fremitus on one lower lobe indicates what?

A

lobar pnuemonia

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

decreased fremitus indicates?

A

emphysema/copd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is egophony?

A

when pt says “ee” but it sounds like ‘aa”, if that is true = positive = lobar pnuemonia over affected lobe ( consolidation)

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

What is the diagnostic test for COPD

A

PFT’s with a FEV1/FVC ration

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

what will a CXR look like with a pt with COPD?

A

hyperinflation/hyperexpansion with increased chest size and flattened diaphram

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

What is COPD? what is the #1 risk factor?

A

irreversible loss of elastic recoil of the lungs and aveolar damage

smoking

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

what is chronic bronchitis?

A

chronic cough w/ increased mucus on most days for at least 3 months per year for at least two consecutive years.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is emphysema? on physcial exam?

A

increased AP diameter, decreased breath and heart sounds , expiratory phase prolonged, pursed lip breathing

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

what would you see on PE for emphysema?

  • percussion
  • fremitus
  • egophony
A

Hyperresonance
decreased tactile fremitus
decreased egophony

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

What would you see on spirometry for dx of COPD?

A

FEV 1 <80%

O2 < 92%

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

examples of ICS:

A

Fluticansone, budesonide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

examples of SABA

A

Albuterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

examples of SAMA

A

short-acting anticholingeric atrovent (iprtropium)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

examples of LABA

A

formeterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

examples of LAMA

A

tiotropium / sprivia

26
Q

GOLD A and B are based on two things?

A

exacerabation in the last 12 months and hospitalization

27
Q

other options for COPD

A

Oxygen only 2-3 liters - dont go above 92%
pulmonary rehab
flu and pnuemococcal vaccine

28
Q

what pathogen is responsible for a secondary bacterial infection ? s/s ? tx?

A

H. influenza pneumonia
acute onset fever, + purulent sputum, wheezing

Bactrim, doxy or ceftin BID for 10 days

29
Q

who should get the pnuemonia vaccine? which one?

A

anyone over 65
get PCV 13 then a year later PPSV23

if you give it prior to 65 you want to give again in 5 years

30
Q

who is considered high risk for getting pnuemonia

A

no spleen / damaged spleen, scc, HIV/AIDS, chronic heart or lung dx, chemo, people on steroids, cochlear inplant , renal failure

31
Q

CAP s/s and PE

A

acute onset fever/chills, w/ productive cough and pluertic chest pain

cough productive of yellow, green - rusty colored phelgm

rusty/blood tinged sputum = strep. pneumoniae

PE if consolidation present:

  • positve tactile fremitus, egophany and whispered petroliguy
  • dullness on precussion
32
Q

what is the gold standard for dx the CAP

A

Chest xray showing infiltrates or lobar consolidation w/ CLINICIAL SYMPTOMS

you should repeat CXR after tx expecially w/ high risk pt

33
Q

What labs would see on CAP

A

increased WBC
elevated nuetrophils > 70 %
shift to the left
increase in bands if bacterial

34
Q

What is the CURB65 criteria

A

indicates if out pt tx or inpatient tx is needed to tx CAP
A score GREATER than 1 = inpt tx

Confusion
Urea (BUN >19 )
Resp rate >30/min
BP <60 or <90
Age 65 or older
35
Q

What are the top two pathogens for CAP

A

Strep. pnuemoniae ( alcoholics

H. influenza ( more common in copd and smokers

36
Q

CAP pathogen in young adults?

A

mycoplasma pnumoniae

37
Q

TX for CAP out pt? comormidities or not

A

No commormidities : Macrolides Azithromycin x 5 days
Doxy if allergic to macrolides

Comordities ( renal, lung, heart , asplenia, DM, Alcoholics)
Fluoroquinolones : Moxifloxacin QD 5-7 days, Levofloxacin 750 mg X 5 days

38
Q

Adverse effects of Fluoroquinolones? Name 3

A

Hypo/hyperglycemia, QTc prolongation, confusion, achiles tendon rupture, nueropathy, AKI

Cipro, anything ending in floxin, levaquin)

39
Q

What type of bacteria causes Atypical Pnuemonia? TX

A

Mycoplasma pnuemoniae and Chlamydia

TX: doxycline

40
Q

Viral URI

A

acute onset of sneezing, runny nose, sore throat, nasal congestion

resololves on own

can use dextromethropan for cough
pseaudophedrine for nasal congeston
guiafenesin ( mucoltic )

41
Q

ACEI / ARB cough

A

new cough, dry

stop ACE and try ARB if not better switch classes

42
Q

Acute Bronchitis s/s, organism, tx

A

Recent history of a cold but longer duration x 2 weeks
may have chest wall pain

organisms ( viruses and chlamydia )

TX: no antibiotics

  • antitissuves ( honey, dextromethorpan, tessalon) - cough
  • Wheezes - albuterol
  • mucolytic - increased fluids and guiafenesin
43
Q

What is asthma?

A

chronic airway inflammation results in hyperresponsive airways and bronco-contriction ( which is reversible)

44
Q

presentation of asthma and PE

A

history of a “bad cold” or acute bronchitis, increase use of inhaler, w/ no relief. Complains of chest tightness especially at night

PE: inspiritory and expiriotry wheezes or heard to hear lung sounds

45
Q

what is the rescue drug for asthma ?

A

SABA PRN - albuterol to treat wheezing

46
Q

what are asthma controller agents?

A

Inhaled corticosteriod ( ICS) flovent 2 puff BID * first line*

can also use

  • singulair
  • LABA ( advair diskus) which is a combo of a LABA and ICS
47
Q

What concerns to we have with theophylline ?

A

Blood levels and drug interactions

48
Q

safety concerns with ICS

A

osteoporosis, cateracts, gluacoma

thrush ( rinse mouth with water after use)

49
Q

safety concerns with LABA

A

increase risk of death and pneumonia

50
Q

safety concerns with albuterol

A

arrythmias, MI, angina

51
Q

What are the variables that are used to figure out someones PEF ( volume lung can hold)

A

H eight
A ge
G ender / sex

52
Q

Step 1 asthma ( called, symptoms, nighttime awakenings, PEF)

A

intermittent
( everything less than two) (symptoms less than 2 week, using SABA less than 2 x month
N : < 2 a month
>80 PEF

53
Q

Step 2 asthma ( called, symptoms, nighttime awakenings, PEF)

A

mild persistent
> two days a week, > SABA use 2 days a week ( not daily)
N: 3/4 a month
> or equal to 80%

54
Q

Step 3 asthma ( called, symptoms, nighttime awakenings, PEF)

A

MODERATE persistent ***
Daily attacks, SABA use daily
N : > night a week ( but not daily)
60-80 percent

55
Q

Step 4 asthma ( called, symptoms, nighttime awakenings, PEF)

A

Severe Persistent
daily attacks markedly imparied function and activity
N: nightly
<60 %

56
Q

What type of asthmatics should use an ICS

A

all BUT step one ( intermittent)

all should be using albulterol

57
Q

What is the tx for Exerisce-Induced bronchospams?

A

pre-tx before excerise : 5-15 min with SABA

Education: use a mask/scarf for cold-induced EIB. Warm up period encouraged

58
Q

Emergency care for asthma

A
  1. assess severity ( check PEF, s/s, resp distress, check o2
  2. tx with continuous SABA with inhaled ipratripium
  3. monitor response
  4. if PEF is less than 50 % of expected or <91 % send to ED`
59
Q

What does it mean if you cant hear lung sounds in an asthmatic

A

severe bronchoconstriction

60
Q

What is a PFT

A

pulmonary function test : measure of severity of obstructive and restrictive pulmonary dysfunction

61
Q

what are examples of obstructuve diseases

A

reduction in airflow rates

COPD, Asthma

62
Q

what are examples of restrictive diseases

A

reduction in lung volumes

pulmonary fibrosis, plerual dx, diaphram obstuction

AGNP AANC Boards (27 decks)

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