Pulmonary Part 2 Flashcards
How much pulmonary vascular most be occluded during a PE to by symptomatic
20-30%
Most PEs come from
a large proximal vein in the proximal leg
What are Risk Factors for PE
Age >50 Bed Rest >48hrs Splinting or ortho immobilization Sx Trauma Malignancy Pregnancy
What criteria is used to score likelihood of PE
Well’s Criteria
What does the Well’s Criteria include?
SXS DVT PE #1 ddx HR>100 Immob 3 day or Sx past 4 weeks Previous PE or DVT Hemoptysis Malignancy w/tx within 6m
Hallmark signs to PE
Dyspnea unexplained by auscultatory findings EKG findings -only 15% S1Q3T3-pathognomic -MC is sinus tacchy -common is RAD CXR
Typical Vital Signs of PE include
NO predictable alteration tachycardia, tachypnea, hypoxia ~S3 or S2 split ~rales (wheezes and others decrease likelihood)
rust colored sputum with patchy infiltrate. What is the causative organism
Strep pneumonia
“currant jelly” sputum and CXR with upper lop infiltrate
Klebsiella
Purulent gram + cocci in clusters from sputum culture, CXR showing patchy multi lobar infiltrate
+/- empyema
causative organism
Staph aureus
CXR showing cavitary legions in hilar regions during PNA. Most likely causative organism
Klebsiella
Tx bullous myringitis with
A Macrolide
-Azithromycin
Pt with complaints of cough, fatigue, fever, and sputum production. ENT exam shows nodular structure on ear drum. Most likely causative organism is
Mycoplasm
Poorer prognosis for PNA
Multilobar involvement Leukopenia Bacteremia Jaundice Splenectomized pts - Sickle Cell pts CHF COPD Alcoholism Diabetes
Consider pseudomonas in what types of patients
Cystic fibrosis, hospitalized, central venous catheters, burn wounds, bronchiectasis, and HIV
