Pulmonary Clinical Medicine IV: Pneumothorax, TB, and Sarcoidosis Flashcards
What is pneumothorax defined as?
Acute onset of unilateral chest pain and dyspnea
How is a pneumothorax diagnosied?
Presence of pleural air on CXR
Which category of pneumothorax occurs in the absence of an underlying lung disease?
It is thought to occur from?
1) Primary spontaneous pneumothorax
2) Rupture of subpleural apical blebs in response to high negative intrapleural pressures
Which category of pneumothorax is a complication of preexisting pulmonary disease?
Secondary spontaneous pneumothorax
Which category of pneumothorax usually occurs in the setting of penetrating trauma, lung infection, cardiopulmonary resuscitation, or positive-pressure mechanical ventilation?
Tension pneumothorax
What should be suspected in the presence of marked tachycardia, hypotension, and mediastinal or tracheal shift?
Tension pneumothorax
What can be performed for a spontaneous primary pneumothorax that is large or progressive?
Aspiration drainage of pleural air with a small-bore catheter
Patients with should receive chest tube placements with what kind of Pneumothoraces?
Secondary Pneumothorax
Large Pneumothorax
Tension Pneumothorax
Pneumothorax with mechanical ventilation
What are the sx of Pulmonary Tuberculosis?
How is it diagnosed on CXR?
1) Fatigue
2) Fever
3) Weight Loss
4) Night Sweats
5) Productive Cough
Apical pulmonary opacities
Which phase of TB is clinically and radiographically silent?
Primary phase
Individuals with what type of tuberculosis infection do not have active disease and cannot transmit the organism to others?
Latent tuberculosis infection
What can cause increased risk of reactivation of TB?
1) Gastrectomy
2) Silicosis
3) DM
4) Immunocompromised
What are the risk factor for drug resistance strains of TB?
1) Immigration from countries with a high prevalence of drug-resistant tuberculosis
2) Close and prolonged contact with individuals with drug-resistant tuberculosis
3) Unsuccessful previous therapy
4) Nonadherence to treatment
Definitive diagnosis of TB depends on?
Sputum culture positive for M tuberculosis
What is encountered on imaging for TB in elderly patients?
Lower lobe infiltrates with or without pleural effusion
When is a miliary pattern (diffuse small nodular densities) of TB seen on imaging?
With hematologic or lymphatic dissemination of the organism
Immunocompromised especially late stage HIV TB infected patients will show what?
Lower Lung zone, diffuse, or miliary infiltrates
Pleural effusions
Hilar/Mediastinal LN involvement
A positive tuberculin skin test reactions with indurations greater than or equal to 5mm is shown in which groups of patients?
HIV patients
Recent contact with infectious TB pt
Person with fibrotic change on CXR suggestive of prior TB
Organ Transplant patients
A positive TB skin test with induration size greater than or equal to 10 mm is seen in which groups of people?
Recent immigrants from high prevalence countries
IV drug abuser
Mycobacterial laboratory personel
Children exposed to adults at high risk
What points to diagnosis of pulmonary sarcoidosis in a biopsy specimen?
(Highlighted in his slides)
Noncaseating granuloma
What population is most at risk for sarcoidosis?
Black female
