Pulmonology Flashcards
Duration of chronic cough
> 8 weeks
First step in evaluation of a chronic cough
Chest xray
Most common causes of chronic cough in a non-smoker, not on ACEIs, with normal PE and CXR: (3)
- Postnasal drip
- Asthma
- GERD
Criteria for diagnosis of Bronchial Asthma on spirometry:
Low FEV1
FEV1/FVC ratio is <0.7
FEV1 is increased by >12% and 200mL post bronchodilator
FEV1 is increased by >12% and 200mL from baseline after 4 weeks on steroid trial
Best diagnostic test in COPD during acute exacerbations
ABG
Major site of increated resistance in most individuals with COPD
Small airways (<2mm)
Most important prognostic factor for COPD
Degree of airflow obstruction
When do you start supplemental O2 in COPD?
pO2 <55/ sat 88%
or pO2 <60/sat 90% if with signs of pulmonary hypertension or lung failure
PDE4 inhibitor that may be beneficial for COPD
Roflumilast
Target O2 sat in acute exacerbations of COPD:
%>=90
Bacteria commonly implicated in COPD exacerbation:
H. influenzae
M. catarrhalis
S. pneumoniae
In CAP, gross hemoptysis is suggestive of:
CA-MRSA
Chest radiograph in CAP will resolve at around:
4-12 weeks
Primary lung abscesses are usually due to:
Aspiration
Recommended treatment for primary lung abscess
Clindamycin IV or
Beta lactam with BLIC IV
Lung zones most commonly involved in primary PTB
Middle and lower lung zones
Lung zones most commonly involved in post-primary PTB
Apical and posterior segments of upper lobes
Superior segments of lower lobes
Target MAP for septic shock
65 mmHg
PaO2/FiO2 ratio idicative of ARDS
<300
These cause DIRECT lung injury which may lead to ARDS: (5)
Pneumonia Aspiration Pulmonary contusion Near-drowning Toxic inhalation
After starting controller therapy for asthma, physician should monitor response after:
2-3 months
Serum and pleural fluid protein gradient >___g/L suggests transudative pleural effusion
31 g/L
Most common cause of pleural effusion
LV failure
Pleural effusion: factors that suggest need for more invasive procedure than thoracentesis (in increasing order of importance) (5)
Loculated pleural fluid Pleural fluid pH <7.20 Pleural fluid glucose <60 mg/dL Positive gram stain or culture of pleural fluid Presence of gross puss
Initial recommended therapy for primary spontaneous pneumothorax
Simple aspiration
Most secondary pneumothorax is due to:
COPD
The major risk factor for asthma
Atopy
The characteristic physiologic abnormality in asthma
Airway hyperresponsiveness
If pleural effusion is clinically transudative but biochemically exudative, check________
Serum-pleural fluid gradient
>31 g/dL is transudative
This is the most highly significant predictor of FEV1 in COPD
Pack-years of smoking
Ventilatory failure is defined as PCO2>____mmHg
PCO2>45mmHg
Single strongest predictor of COPD exacerbations
Previous exacerbation
