Pulmonary HY Flashcards
How is a COPD exacerbation managed (4)?
First Bronchodilators (DuoNeb: Albuterol + Ipratropium)
Next → Prednisone
Start → Non-Invasive Positive Pressure Ventilation NIPPV (C-Pap or BI- Pap)
If still hypoxic → INTUBATE
Upon discharge give 3-5d of oral steroids
(Don’t give Antibiotics if NO signs of Infection: Fever & leukocytosis) Azithromycin + CTX
intervention most likely to improve 5 year survival in COPD pts
Smoking Cessation
Home Oxygen improves survival if Oxygen saturation on room air is lower than ___ %
or rest pO2 is less than ___
89%
or rest pO2 is less than 56
Pulmonary vasoconstriction occurs due to ___.
It can help reduce ventilation-perfusion mismatching within the lung
alveolar hypoxia
Dysphagia (coughing when eating), dysarthria (slurred speech), and tongue atrophy with fasciculations
± Diaphragmatic weakness (expansion of the abdomen on expiration) and elevation of the diaphragm on CXR.
Diagnosis?
amyotrophic lateral sclerosis (ALS)
causes Restrictive lung disease
Takes care of goats, sheep, and cats
(Farm animals)
has dyspnea
dx/bug/tx?
Interstitial PNA
Coxiella Burnetii
Doxycycline
Researcher that works with wild rabbits has dyspnea
dx/tx?
Tularemia
GENTAMICIN (Aminoglycoside)
Cleans chicken/bird coops has dyspnea
dx/tx?
Histoplasmosis
Itraconazole
–
(KT, Indiana, Illinoi, Chicago, CAVES)
Recent trip to New Mexico (Southwestern US)
(AZ, CA, TX)
has dyspnea
dx/bug/tx?
Interstitial PNA
Cocci
Itraconazole
Young person (<40) with T of 100.4
a non-productive cough for days
CXR: pulmonary interstitial infiltrates
Dx/Tx?
Mycoplasma (walking pNA)
Tx: Macrolides
HIV with lobar consolidation: Bug/Drug?
HIV with interstitial infiltrates: Bug/Drug?
Strept. Pneumo (CTX)
Pneumocystis Jirovecii (TMP-SMX)
Outbreak in the water system causing
atypical PNA (non-productive, dry cough + crackles)
dx/tx?
Legionella
FQ
Macrolides
Aspiration PNA
s/t ANEROBES
Bacteroides, fusobacterium, or prevotella
Treatment?
Clindamycin
(anerobic coverage)
