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Fun Med > Pulmonology > Flashcards

Pulmonology Flashcards

1
Q

A cough lasting more than 5 days and up to 3-4 weeks. Viral

A

Acute bronchitis

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2
Q

Infection that leads to inflammation of the trachea, bronchi, and bronchioles.

A

Acute bronchitis

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3
Q

How does one get rid of acute bronchitis?

A

Usually resolves itself.

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4
Q

______ and________work together to remove inhaled particles from the lung.

A

Cough. Mucociliary apparatus.

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5
Q

Risk factors for acute bronchitis

A

exposure to another person with acute bronchitis.

Smoking

Second hand smoke

> 2 yrs. Children 9-15

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6
Q

Sx acute bronchitis

A

Cough (may or may not be productive). Fever. Fatigue. Chest pain w. deep breathing. URI sx.

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7
Q

Exam findings for acute bronchitis.

A

Wheezing.

Rhonchi

Fever

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8
Q

Do you give antibiotics for acute bronchitis?

A

No-VIRAL!

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9
Q

Tx. acute bronchitis

A

Supportive.

Cool mist humidifier

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10
Q

Acute bronchitis most frequently found in________

A

children

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11
Q

Acute bronchiolitis is most commonly caused by what virus?

A

respiratory synctial virus

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12
Q

Edema and accumulated cellular debris cause what?

A

Obstruction of the airway

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13
Q

Acute bronchiolitis occurs most often in _____ and _______.

A

Infants (most common in first 2 years of life). Peak age-6 mo

Young children

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14
Q

Leading cause of infant hospitalization?

A

Acute bronchiolitis

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15
Q

Is there a vaccine for RSV?

A

No, monthly shots of the prophylactic monoclonal antibody Palivizumab used seasonally. -for high risk children.

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16
Q

Risk factors for acute bronchiolitis

A

Smoking exposure. Age <3 mo.

Crowded living.

Low socioeconomic group

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17
Q

Sx. acute bronchiolitis

A

Nasal flaring.

Wheezing.

Tachypnea.

Fine rales.

Tacycardia

Fever

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18
Q

Diagnostic tests for acute bronchiolitis?

A

RSV rapid viral antigen testing!

CXR-may show lobar consolidation from a secondary infection. May show signs of hyperinflaction with scattered areas of consolidation.

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19
Q

Tx for acute bronchiolitis

A

Supportive care.

Bronchodilators

Nebulized hypertonic saline.

Nasal and oral suctioning.

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20
Q

A broad spectrum antiviral agent used in severe cases of RSV.

A

Nebulized Ribavarin

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21
Q

Severe______can result in pulsus paradoxus secondary to upper airway obstruction

A

Croup

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22
Q

_______is a viral respiratory infection caused by Parainfluenza virus that involves a seal-like barking cough.

A

Croup

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23
Q

A “steeple” sign on a frontal chest X-ray is seen in______

A

croup

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24
Q

Narrowing of upper trachea and subglottis leads to characteristic _____sign on x-ray in patients with croup.

A

Steeple sign

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25
Q

Croup is also known as ______

A

acute laryngotracheobronchitis

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26
Q

______of upper trachea and subglottis leads to characteristic steeple sign on x-ray in patients with croup.

A

Narrowing

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27
Q

Inspiratory is a classical sign of croup.

A

stridor

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28
Q

Viral infection of the larynx and trachea.

A

Croup

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29
Q

Tx for most pt’s of Croup

A

Cool humidied air.

Dexamethasone IM (single dose)

single dose of nebulized racemic epinephrine.

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30
Q

Viral shedding in influenza continues for _________

A

5-10 days.

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31
Q

Most common type of influenza virus

A

A

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32
Q

Influenza viruses are part of the family of viruses.

A

orthomyxoviridae

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33
Q

The incubation period for influenza.

A

1-4 days

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34
Q

Diagnostic test to determine IF someone has influenza.

A

Rapid Influenza Diagnostic Test

35
Q

Diagnostic test to determine WHICH strain of influenza a patient has.

A

Reverse transcription-polymerase chain reaction

36
Q

Prescription antiviral meds for influenza.

A

Neuraminidase inhibitors (Oseltamivir, zanamivir, Peramivir). Must be given with 24-48 hrs of onset.

37
Q

Reye syndrome

A

Associated w/aspirin use in the management of viral infections. Young children. Rapidly progressive hepatic failure and encephalopathy!

38
Q

Sx Flu

A

Sudden fever. Fatigue. Myalgias. Sore throad. Runny nose. Watery/red eyes. GI sx associated with influenza B

39
Q

Bacterial infection that affects airways lined with ciliated epithelium

A

Whooping cough

40
Q

Pertussis is most commin in____________infants and adults.

A

Unimmuized

41
Q

Most common cause of pertussis is_________.

A

Bordetella pertussis

42
Q

What is the treatment of choice for all patients of pertussis?

A

Azithromycin

43
Q

Diagnosis tool for pertussis that can be done in the office?

A

PCR assay

44
Q

Criterion standard for diagnosing pertussis.

A

Nasopharyngeal swab for culture of B. pertussis.

45
Q

What would you see on a CBC for pertussis?

A

Leukocytosis with absolute lymphocytosis

46
Q

What phase of pertussis involves posttussive vomiting and turning red w. coughing and paroxysms of intense coughing lasting up to several minutes-followed by a whoop.

A

Paroxysmal phase.

47
Q

TB is caused by what bacteria

A

Myobacterium tuberculosis

48
Q

Myobacterium tuberculosis is a slow-growing ________

A

obligate aerobe

49
Q

Granuloma with central caseastion necrosis

A

Tb lesion

50
Q

First Step Diagnostic test for TB

A

Mantoux tuberculin skin test with purified protein derivative

51
Q

A more specific test for TB

A

Interferon-gamma release assay

52
Q

What might you see on a CXR of TB?

A

Caseating granuloma in the apical lung.

Miliary ganulomas.

Calcified granuloma + associated lymph node+GHON Complex

53
Q

Tx of Active Tb for HIV negative patients

A

2 mo daily isoniazid, rifampin, pyrazinamide, and ethambutol

54
Q

When can you release an isolated TB patient?

A

When there are no longer tubercle bacilli found on sputum on three consecutive smears taken on separate days

55
Q

Exam of TB

A

Cervical lymphadenopathy and apical rales

56
Q

Sx Tb

A

Malaise. Fever. Night sweats. Weight loss. Productive cough. Blood-streaked sputum

57
Q

Ghon complex

A

calcified focus of infection and associated lympgh node

58
Q

Abnormal accumulation of fluid in the pleural space.

A

Pleural effusion

59
Q

First questions you should ask when you suspect a pleural effusion.

A

What kind of fluid?

How/why did it get where it is?

60
Q

Clear fluid pushed in tho space from inc. pressure.

A

Transudate

61
Q

“Thick gross” caused from increased capillary permeability.

A

Exudate

62
Q

Emphysema

A

Plus

63
Q

Main cause of trasudates

A

Heart failure

64
Q

Main cause of exudate

A

Pneumonia and Cancer

65
Q

Etiology of exudative pleural effusions.

A

40-80% malignant. Lung and Breast cancer.

66
Q

Sx of Pleural effusion.

A

Dyspnea. Cough. Chest Pain.

*CXR!

67
Q

Exam findings on pleural effusion (the big 3).

A

Dullness to percussion.

Pleural friction rub.

Egophony

68
Q

Normal capillaries

A

Pleural transudates

69
Q

Leaky capillaries

A

Pleural exudate-HIGH pleural fluid levels compared to serum

70
Q

Lights criteria.

A

1) pleural fluid protein/ serum protein >.5
2) pleural LDH/serum LDH >.6
3) plural fluid LDH > 2/3s upper limit of normal serum LD

71
Q

Lab findings for hemorrhagic pleural effusion.

A

Blood + pleural fluid. 10k-100k red cells/mcL create grossly bloody pleural effusion

72
Q

Protein in pleural effusion means_____

A

TB

73
Q

Low glucose in pleural effusion means_______.

A

Empyema (bacteria is eating up glucose)

74
Q

High LDH in pleural effusion means________

A

Rheumatoid. Inflammatory marker

75
Q

High WBC in pleural effusion means _________

A

Malignancy, infection or pulmonary infarction

76
Q

<7.3 pH in pleural effusion suggests______?

A

Need for drainage of pleural space (TOO ACIDIC!) often esophageal rupture.

77
Q

Amylase in pleural effusion analysis suggests_____?

A

Pancreatitis, pancreatic tumor, adenocarcinoma

78
Q

What should you always do when there is a new pleural effusion?

A

Thoracentesis!

*observation appropriate in some situations.

79
Q

Transudative Tx.

A

Treat the underlying cause!

80
Q

To or Malignant Pleural effusion.

A

Chemotherapy or radiation therapy-treats symptoms!

Therapeutic throacentesis

81
Q

Does uncomplicated parapneumonic effusion need drainage?

A

No!

82
Q

Tx for empyema.

A

Gross infection- +Gram stain. Empyema should always be drained!

83
Q

Complicated parapneumonic effusion tax!

A

Large, inflammatory, low glucose level, low pH, loculation. TUBE THORACOSTOMY! VERY SICK!

84
Q

Tx hemothorax

A

Small-observe

THORACOSTOMY tube:

  • drain existing blood and clot
  • quantify amount of bleeding
  • reduce risk of fibrothorax
  • permit apposition of the pleural surfaces in an attempt to reduce hemorrhage.

THORACOTOMY (open surgery)-to control hemorrhage

Fun Med (5 decks)

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