pulmonary infections & PFTs Flashcards

1
Q

what is the “common cold”?

A

URI : often from rhinovirus or other virus

symptoms: clear to purulent nasal discharge, sore throat, cough, no fever or eosinophilia

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2
Q

when does the “common cold” often resolve? stages of symptoms resolving?

A

most symptoms in 4-10 days, pulmonary symptoms (cough) lasting longer, up to 3 months (post-viral cough syndrome)

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3
Q

what is important to distinguish with a cough?

A

source: upper (drainage from sinus/throat) or lower (lung infection) ?

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4
Q

txt for common cold

A

humidifier, hydrate, mabye: decongestants/anti-histamines, cough suppressants

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5
Q

define bronchitis

A

cough caused by any kind of lung infection (usually viral)- not in lung tissue but in bronchi (tubes from trachea into lung)

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6
Q

what is the most common cause of hemoptysis?

A

bronchitis

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7
Q

when would you use abx for bronchitis?

A

if it is AECB (acute exacerbated chronic bronchitis)

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8
Q

what is…. usually follows viral bronchitis, no-longer infectious but inflamed, reactive lungs, lasting 6+ wks.

A

post-viral cough syndrome

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9
Q

txt for postviral cough syndrome

A

“tincture of time”

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10
Q

obstruction will likely cause ___ expiration

A

prolonged

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11
Q

wheezing occurs during _____ unless…

A

expiration (narrowed airways), unless very severe- then will occur in inspirations as well

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12
Q

sounds like asthma in a kid too young to have it (<2yo) …

A

RSV bronchiolitis

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13
Q

what is the “cough of 100 days”

A

pertussis in adults .. usually no “whooping” sound

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14
Q

preventions and txt for pertussis

A

prevention- Dtap and Tdap vaccines

txt: macrolide abx (“-mycin”)
- txt early but expect it to linger

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15
Q

paroxysmal (sudden) cough with post-tussive emesis

A

pertussis/ whooping cough

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16
Q

influenza is caused by …

A

influenza virus - type A & B (rarely C)

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17
Q

hallmark symptoms of influenza

A

HA, myalgia, fever, malaise

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18
Q

Dx of the flu is based on …

A

clinical criteria

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19
Q

CDC reccomends ___ not be used for the flu b/c or _____. instead only Rx ____

A

amantidine and rimantidine (anti-virals) b/c of resistance

Rx: neuraminidase inhib (tamiflu or relenza) - decrease severity and duration

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20
Q

anti-virals for the flu have little efficacy after ____

A

48 hours

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21
Q

what is the presentation of pneumonia? Dx?

A

flu symptoms with purulent, chunky cough

chest Xray to Dx (fluid in alveoli)

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22
Q

who gets anti-virals for flu?

A

everyone whose not young and healthy

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23
Q

whats significant about the 2009 H1N1 swine flu?

A

hit young people because old people (born before 1957) already had it and had immunity

24
Q

____ has led to the nomenclature of H#N# for flu

A

antigenic shift (H and N each refer to different antigenic molecules on the surface of the virus)

25
Q

______ can make vaccines less effective, while ____ pandemic viruses arise from _______

A

yearly antigenic drift

antigenic shift

26
Q

antigenic drift vs shift

A

drift: changes of existing Hs and Ns
shift: surface H and N proteins are not Modified by replaced

27
Q

flu history: pandemics

A

1918 spanish flu, 1957 asian flu, 1958 hong kong flu

28
Q

is the next flu pandemic coming?

A

variants are ALWAYs on the horizon and can cause a pandemic

29
Q

____ viruses on humans are very lethal. why?

A

avian : virus binds (sialic acid binding specifically) in lower respiratory area- lungs hit hard

30
Q

what is the definition of disability?

A

for PFTs: objective measure of how bad a disease is

31
Q

PFTs are measured in …

A

vol/time (liters/sec)

32
Q

PFT: obstructive defect is defined by …

A

capacity is normal but it takes longer to get there- airways are narrowed. shifts graph left

33
Q

PFT: restrictive defect is defined by …

A

decreased total lung capacity- lungs overexpanded so you cant get air in. shifts graph right (small, normal shape)

34
Q

FEV1 low, FVC normal, ratio (FEV1/FVC) dec.

A

obstructive disease

35
Q

FEV1 low, ratio (FEV1/FVC) normal or high

A

restrictive disease

36
Q

% predicted value -what is it used for and what are the three levels?

A

obstructive disease: determines severity
FEV1 as percent predicted value (for avg healthy person)
<50% severe
50-70% moderate
>70% mild

37
Q

4 components of PFT testing

A

Static lung volumes
Flow rates
Bronchodilator reversibility
Bronchial challenges (e.g. cold air, occupational chemicals)

38
Q

tidal volume

A

about 500 mL, is the amount of air inspired during normal, relaxed breathing

39
Q

inspiratory reserve volume (IRV)

A

about 3,100 mL, is the additional air that can be forcibly inhaled after the inspiration of a normal tidal volume.

40
Q

expiratory reserve volume (ERV)

A

about 1,200 mL, is the additional air that can be forcibly exhaled after the expiration of a normal tidal volume.

41
Q

reisdual volume

A

about 1,200 mL, is the volume of air still remaining in the lungs after the expiratory reserve volume is exhaled.

42
Q

vital capacity

A

is the total amount of air that can be expired after fully inhaling

43
Q

functional residual capacity (FRV)

A

is the amount of air remaining in the lungs after a normal expiration

44
Q

forced vital capacity (FVC)

A

Maximum amount of air that can be rapidly and forcefully exhaled from the lungs after full inspiration

45
Q

normal spirogram shows…

A

graph: expired vol. vs time
95% VC exhaled in 1st 3 seconds
-FEV1, FEF, FVC

46
Q

total volume most humans can hold

A

about 7L

47
Q

FEV1

A

forced capacity that comes out in the first second

48
Q

FEF 25-75

A

where 25% and 75% of FVC are on curve. (slope of line between these points) indicator of what medium sized airways are doing - assesses small airway disease

49
Q

___ is reduced in both obstructive and restrictive diseases, its the ___ that differentiates them

A

FEV1, ratio with FVC

50
Q

PFTs are ___ dependent

A

operator

51
Q

the most basic and useful lung function test

A

FEV1 - shows if theres obstruction and quantifies severity

52
Q

bronchial provocation

A

In asthma the demonstration of bronchial hyperresponsiveness to one of several constrictors challenges can be useful in establishing a diagnosis

53
Q

obstructive lung disease : what is decreased?

A

decreased: flow rates, volume, elastic recoil pressure (emphysema)
The flow volume loop acquires a scooped-out appearance
-narrow airways and parenchymal lung changes

54
Q

restrictive lung disease : what is decreased? what does the graph look like?

A

decreased: Peak flow, Total exhaled volume
Flow-volume curve is vertically compressed
No scooped-out appearance.
Expiratory limb of the flow-volume loop is steep

55
Q

etiology of restrictive vs obstructive lung disease

A

obstructive: asthma and COPD (exhaling disorder)
restrictive: pulmonary fibrosis, neuromusc disorders, chest wall disorders ,etc. (inhaling disorder)

56
Q

common symptoms for both obstructive and restrictive lung disease (4)

A

SOB, tachypnea, cough, anxiety

57
Q

those who apparently change position when trying to breath better likely have ____

A

restrictive disease