Pulmonary Obstructive, Pleural, Restrictive, Circulation Flashcards
3 components of asthma
airflow obstruction
airway hyperactivity
chronic airway inflammation
Dx asthma
FEV1/FVC
19yo girl with asthma at PCP. Reports that she needs to use her albuterol inhaler atleast 2 days a week and approx. 5 times at night throughout the month
management?
add low dose ICS
ie beclamethasone, fluticasone
CF genetics
autosomal recessive dis of chloride channels
dx CF
pilocarpine iontophoresis sweat test (2 on different days)
Pt with PMH of cirrhosis and chronic kidney disease presents with SOB and cough. On exam you note decreased breath sounds, dullness to percussion, and decreased tactile fremitus. CXR shows blunting of costophrenic angle
dx
Likely pleural effusion that is transudative in nature
thoracotomy vs thoracostomy
thoraCOSTOMY is smaller and done 1st
thoraCOTOMY is larger incision and only indicated after 2nd re-occurrence of pneumothorax, or to gain access to chest organs
exudative vs transdative effusions
exudative= more protein, inflammation
infection, CA, uremia, rheumatoid, drug rxn, postCABG
transudative= less protein, acellular infiltrates
CHF, PE, nephrotic, cirrhosis, peritoneal dis, atelectasis
Initial test for PE
and “gold standard” to dx PE
Helical CT pulm angiography 1st
angiogram is gold standard (usually not necessary)
MCC Cor Pulmonale
Pulmonary Hypertension
Definition of ARDS
respiratory failure not fully explained by HR or volume overload
Restrictive airway diseases
P: pleural- effusion, mass
A: alveolar- edema, infiltrates
I: interstitial- fibrous, sarcoid
N: neurmuscuar- ALS, MG, GBS, diaphragm paralysis
T: thoracic cage abnl- obesity, kyphoscoliois
Obstructive airway diseases
asthma (reversible) bronchiectasis chronic bronchitis CF ephysema
decreased DLco seen in
emphysema
fibrosis
pulm vascular disease
*anemia (decreased RBCs)
FVC low
FEV1% 78 (nl)
restrictive
