Pulmonology Flashcards
describe low V:Q ratio
low ventilation with increased/normal perfusion
describe high V:Q ratio
are with decreased perfusion compared to ventilation
central chemoreceptors in the ___?
medulla
peripheral chemoreceptors in the ___ and ___
carotid and aortic bodies
volume of air in/out of lungs during normal breathing
TV
volume of air in lungs after maximal exhalation
residual volume
volume of air that can be forced out at the end of expiration
expiratory reserve volume
volume of air that can be further inhaled at the end of inhalation
inspiratory reserve volume
max volume of air that can be exhaled after max inspiration
Vital capacity (IRV + TV + ERV)
volume of air in lungs after max inspiration
total lung capacity (VC + RV)
volume of air that can be exhaled at the and of 1 sec forced expiration
FEV1
volume of air that can be expelled from max inflated lung with pt breathing as hard and fast as possible
FVC
MC causes of bronchiactasis
CF (pseudomonas)
H. influenza
MC cause of massive hemoptysis
bronchiactasis
lab study findings in pt with sarcoidosis
increased ACE
Hypercalcemia
tx of sarcoidosis
steroids
methotrexate (if steroid resistant)
hydroxychloroquin (chronic disfiguring features)
egg shell calcification at hilum
nodular opacities in upper lobes
silicosis
small upper lobe nodules
hyperinflation
caplan syndrome (pneumoconiosis + RA)
coal workers lung (black lung)
works in electronics, aerospace, ceramics or tool/dye manufacturing
berylliosis
cotton exposure
byssinosis
bronchogenic carcinoma
malignant mesothelioma os pleura
asbestosis
PNA, fever, HA in a person who has been working with birds
Psittacosis (chlamydophila psittaci)
tumor originating from the pleura
mesothelioma
acute inflammation of the costochondral, costosternal oor sternoclavicular joints that is worse with breathing, coughing and upper limb movements
costochondritis & Tietze syndrome
gold standard tx for pleural effusion
thoracentesis
chest tube if empyema + IV abx
meds used for pleurodesis
talc
doxy
bleo (toxic so not used as commonly)
pink-purple well vascularized central tumor that may secrete serotonin, ATCH, ADH, MSH
bronchial carcinoid tumors
MC ca caused by smoking and found in the periphery of lung
adenocarcinoma
centrally located lung CA associated with cavitary lesions, hypercalcemia, pancoast syndrome (
squamous cell
very aggressive form of non-small call lung CA
large cell (anaplastic)
centrally located lung CA with early metastasis
small cell
what endocrine abnormalities are common with small cell lung CA
SIADH
hyponatremia
gold standard for dx pulm htn
R sided heart catheterization
gram + cocci, mc cause of CAP with rusty sputum
strepococcus pneumoniae
gram negative rods
2nd MC cause of CAP (esp with lung dz)
haemophilus influenzae
MC cause of atypical pna, associated with bullous myringitis
mycoplasma pna
PNA + GI sxs (increased LFTs, N/V/D)
associated with contaminated water supply
tx?
legionella
levofloxacin, azithromycin
gram + cocci in clusters
Pna that usualyl occurs after viral illness
staph aureus
gram - rods
upper lobe PNA associated with ETOHics
currant felly sputum
Tx?
klebsiella
cefotaxime
organisms associated with aspiration PNA
Tx?
anaerobes
clinda, metro, amox/clav
gram - rods
immunocompromised
pseudomonas
MC cause of viral PNA in children
RSV
MC cause of viral pNA in adults
influenza
fungal/parasite pna in immunocompromised host who desats with ambulation
Tx?
pneumocystis jirovecii
Bactrim
MC cause of hospital acquired PNA
pseudomonas
PNA associated with hoarsness
tx?
chlamydial
erythromycin
CAP outpt Tx
macrolide or doxy
FQ for those with comorbidities
CAP inpt Tx
B lactam + macrolide
or FQ
CAP in ICU tx
B lactam + macrolide
or B lactam + FQ
HAP tx
antipsudomonal B lactam and AG or FQ
- vanc for MRSA
- levo or azithro for legionella
gold standard TB test
acid-fast smear + sputum cx
when is CXR used for TB
to exclude active TB and as yearly screen for Pts with known + PPD or active TB
how long is TB tx performed
6 months
TB med with orange color secretions and thrombocytopenia
rifampin
TB med associated with hepatitis and peripheral neuopathy
isoniazid give with B6
TB med associated with hepatits, hyperuriemia and photosensitive dermatologic rash
Pyrazinamide
TB med assocaited with optic neuritis and peripheral neuropathy
ethambutol
Dx and tx for pertussis
PCR of nasopharyngeal swab
Macrolide
tx for epiglottitis
maintain airway
ceftriaxone or cefotaxime
what is the cause of croup
Tx?
parainfluenza virus type 1
humidified air, dexamethasone, epinephrine (for stridor at rest)