Pulmonology Flashcards
What is included with PFTs?
Spirometry(FEV1 & FVC), lung volume, DLCO - diffusion capacity
FEV1/FVC, TLC & DLco with: Asthma
FEV1/FVC: normal/low
TLC: normal
DLco: normal/high
FEV1/FVC, TLC & DLco with: COPD
FEV1/FVC: low
TLC: high/normal
DLco: low
FEV1/FVC, TLC & DLco with: Fibrotic Disease
FEV1/FVC: normal/low
TLC: low
DLco: low
FEV1/FVC, TLC & DLco with: Extrathoracic Restriction(aka fat ass)
FEV1/FVC: normal
TLC: low
DLco: normal
Patients with OSA have a 2-3x increased risk of —.
MVA
T/F intranasal steroids can block growth of nasal polyps and may cause regression.
TRUE!
When classifying Asthma when does it go from intermittent to persistent?
intermittent <2d/week. Once >2d/week then its mild persistent(not daily)
When classifying asthma when does it become moderate persistent?
daily symptoms & at least once a week at night but not nightly
When classifying asthma when does it become severe persistent?
symptoms multiple times throughout the day, nighttime symptoms weekly & often every night.
Criteria for chronic bronchitis
chronic cough with phlegm for >3m for 2 consecutive years
Stage 1 COPD has an FEV1…
FEV1 >80%
Stage 2 COPD has an FEV1…
FEV1 50-79%
Stage 3 COPD has an FEV1…
FEV1 30-49%
Stage 4 COPD has an FEV1…
FEV1 <30%
FEV1/FVC in COPD?
FEV1/FVC <70%
Interstitial Lung Disease includes…
Idiopathic pulmonary fibrosis, sarcoidosis, etc
Pleural-to-Serum Protein Ratio, Pleural to serum LDH & pleural to fluid LDH in transudative pleural effusions
Pleural-to-Serum Protein Ratio: < 0.5
Pleural to serum LDH: < 0.6
pleural to fluid LDH: < 200
Pleural-to-Serum Protein Ratio, Pleural to serum LDH & pleural to fluid LDH in exudative pleural effusions
Pleural-to-Serum Protein Ratio: > 0.5
Pleural to serum LDH: >0.6
pleural to fluid LDH: >200
In order to tap pleural effusion must be greater than —.
> 1 cm on decubitus film
Pneumothorax that is —- of hemithorax & stable may be treated with supportive care only.
<15%
Pneumothorax that is —- of hemithorax will require drainage and placement of chest tube.
> 30%
Pulmonary Hypertension is defined as pulmonary artery mean pressure of —- with exercise.
> 25-30 mmHg
Common causes of pulmonary hypertension
OSA, Parenchymal lung disease, congenital heart disease, advanced liver disease, HIV, chronic thromboembolic disease, drug use
Physical exam findings in pulmonary hypertension
dyspnea, splitting of S2 with Loud P2, polycythemia due to chronic hypoxia
Besides treating the underlying cause of pulmonary artery hypertension what medications can be used for treatment?
IV infusion of prostacyclin for severe cases. PDE5 inhibitors(sildenafil, tadalafil, cardenafil)
What size lung nodule do you need to get a PET scan & bx? f/u CT interval?
> 8 mm. f/u CT at 3m, 9m & 24m
What size lung nodule do you not need any further imaging? what if they are high risk for cancer?
<4mm. If high risk then repeat in 1 year, if no growth then you dont need any further w/u
Sarcodosis vs Scleroderma sx?
- Sarcoidosis:GRUELING-CC Granulomas, rheumatoid arthritis, uveitis, erythema do some, lymphadenitis, interstitial fibrosis, negative PPD, gamma globe anemia, increase calcium, cardiac problems
- Scleroderma - systemic sclerosis/collagen deposits(anti scl-70(diffuse) & anti-centromere ab(CREST)) = CREST: Calcinosis, Raynaud phenomenon, Esophageal dysmotility, Sclerodactyly & Telangiectasias
Significantly reversible FEV1 of —- after inhaling a SABA is diagnostic of Asthma.
Increase by 12% and 200mL
First line treatment for allergic rhinitis and an individual that has asthma
Flonase nasal spray. Over-the-counter antihistamine in LT modulators are second line
