Pulmonology Flashcards
what is the presentation of bronchitis
cough >5 days with or without sputum production, lasting 2-3 weeks
- chest discomfort
- SOB
- +/- fever
what is the treatment of bronchitis
ABX are not recommmended due to common viral casues
what PFT volumes determine Chronic bronchitis
FEV1/FVC ratio less than 0.7
what type of lung cancer presents with a central mass
small cell
who does small cell lung cancer affect
15% of cases
99% smokers
what is the typical presentation of small cell cancer
recurrent pneumonia,
anorexia, weight loss, weakness and cough
what other conditions is small cell lung cancer associated wtih
superior vena vaca syndrom
phrenic nerve palsy
recurrent laryngeal nerve palsy
horner syndrom
malignant pleaural effusion
eaton-lambert syndrome
what is superior vena cava syndrome
obstruction of SVC by mediastianl tumor, facial fullness and facial/arm edema with dilated veins over anterior chest, arms and face. jvd
what is horner syndrome
invasion of cervical sympathetic chain by apical tumor causing unilateral facial anhidrosis, ptosis and miosis
what is the treatment of small cell lung cancer
combo chemotherapy as it does not respond to surgery
what is the most common type of non-small cell lung cancer
adenocarcionma (peripheral mass)
what are the differnt types of non-small cell lung cancer
squamous cell (central mass)
Large cell
adenocarcioma (peripheral mass)
what is the treatment options for non-small cell lung cancer
surgery
+/- chemo
what is carcinoid syndrome
flushing, diarrhea, telangectasias
what is a pancoastal tumor
shoulder pian, horners syndrome and brachial plexus compression
what is the most common etiology of community-acquired pneumonia
S. Pneumoniae
what are risk factors for community-acquired pneumonia
advanced age, alcholoism, tobacco use, and comorbid medical conditions (asthma, COPD)
what is seen on CXR with community-acquired pneumonia
pathcy airspace opacities to lobar consolidation
what are preventative measures for pneumonia
Pneumovax 23
Prevnar13
who should get prevnar13
65+ and immunocompromised
what pathogens are associated with nosocomial pneumonia
S. aureus, K. pneumoniae, E. coli and pseudomonas aeruginosa
what are the treatment options for community-acquired pneumonia
Marcrolide: clarithromycin 500mg PO BID for 5 days or azithromycin 500mg PO then 250mg PO for 4 days
what are the treatment options for inpatient (non-icu) pneumonia pts
Respiratory FQ: IV levofloxacin 750 daily or IV ciprofloxacin 400mg Q8-12hr
what are the treatment options for ICU pts with pneumonia
azithromycin or respiratory FQ + antipneumococcal beta-lactam: cefotazime, ceftriaxone or unasyn
what is the treatment of latent TB
rifamycin-based 3 or 4 month
what is treatment of active TB
4 months Rifapentine-moxifloxacin (rifapentine, moxifloacin, isoniazid and pyrazindamide)
or Quad therapre RIPE: rifampin, isoniazid, pyrazinamide, ethambutol
what are the SE of moxifloxacin
QT-prolonging agent - associated wiht cardiac arrythmias - which may be fatal
what is the side effect of Rifampin
orange body fluids, hepatitis
