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ER EOR > Regular Pulmonary--- > Flashcards

Regular Pulmonary--- Flashcards

1
Q

MCC of bronchiolitis

A

RSV

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2
Q

best predictor of dz for bronchiolitis

A

pulse ox

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3
Q

tx bronchiolitis

A

supportive
immunoprophylaxis for Pavilizumab

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4
Q

cardinal sx of acute bronchitis

A

cough

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5
Q

what is a rare sx in acute bronchitis

A

fever

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6
Q

tx bronchitis

A

supportive

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7
Q

another name for pertussis

A

whooping cough

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8
Q

different phases pertussis

A

catarrhal phase - URI sx

paroxysmal phase - severe coughing fits with high inspiratory whooping sound after cough; may have posttussive vomiting

convalescent phase – resolution of cough

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9
Q

tx pertussis

A

Macrolides
Doxy if allergy

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10
Q

where is inflammation in epiglottis

A

supraglottic structures

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11
Q

MCC epiglottitis

A

HIB

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12
Q

sx epiglottitis

A

3 D’s
drooling, dysphagia, distress

high fever
inspiratory stridor
tripoding

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13
Q

dx epiglottitis

A

lateral neck XR - thumbprint sign
laryngoscopy - definitive; cherry red epiglottis

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14
Q

tx epiglottitis

A

airway maintenance
supportive
abx - cephalosporin
can add dexamethasone for swelling

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15
Q

another name for croup

A

laryngotracheitits

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16
Q

inflammation in croup

A

subglottic region

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17
Q

MCC croup

A

parainfluenza

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18
Q

sx croup

A

seal like barking cough
inspiratory stridor
hoarseness

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19
Q

dx croup

A

frontal cervical XR - steep sign
Westley croup score - classifies severity of croup

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20
Q

tx croup

A

steroids in all stages of croup (IV or IM)
supportive
nebulizer epinephrine - for severe croup (if it doesn’t work, it’s likely bacterial tracheitis)

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21
Q

tx CAP

A

axocillin

or augmentin or cephalosporin + macrolide

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22
Q

sx pneumonia

A

sudden onset fever
productive cough + purulent sputum
pleuritic chest pain
rigors
tachycardia, tachypnea

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23
Q

PE for pneumonia

A

bronchial breath sounds
dullness to percussion
increased tactile fremitus
egophony

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24
Q

sx for PJP

A

triad - progressive DOE, fever, nonproductive cough

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25
PE for PJP
nearly all patients with have either hypoxemia at rest or with exertion
26
where in the lungs is primary TB typically located
middle portion - Ghon focus
27
where in the lungs is secondary/reactive TB typically located
apices
28
sx TB
prolonged fever cough chest pain dyspnea hemoptysis fever/chills/night sweats
29
dx TB
isolation of TB from a body secretion or fluid or tissue place in respiratory isolation
30
how many sputum specimens should bobtailed for TB
3
31
histology for TB
caseating granulomas
32
any positive PPD for TB should be followed with
CXR
33
people considered to have positive PPD test >/= 5 mm
HIV or immunosuppressed close contacts of patients with active TB CXR consistent with old/healed TB (calcified granuloma)
34
people considered to have positive PPD test >/= 10 mm
People recently arriving (< 5 years) from high-prevalence countries * People who use injection drugs Mycobacteriology laboratory workers * Residents/employees of high-risk congregate settings * Those with comorbid conditions (e.g., diabetes, severe kidney disease, Hodgkin disease, lymphoma, malnutrition) People with < 90% ideal body weight * Children < 4 years old * Infants, children, and adolescents exposed to adults in high-risk categories * Children born in high-prevalence regions of the world
35
people considered to have positive PPD test >/= 15 mm
everyone else
36
acute respiratory distress syndrome is characterized by
rapid onset of severe dyspnea refractory hypoxemia diffuse pulmonary infiltrates, leading to respiratory failure
37
when should ARDS be suspected
acute onset of progressive sx of profound dyspnea hypoxemia with increasing requirement for oxygen alveolar infiltrates on chest imaging within 6-72 hours of inciting event
38
CXR ARDS
bilateral diffuse pulmonary inflaters - classically spares the costophrenic angles
39
PCWP ARDS vs pulmonary edema
ARDS - < 18 pulmonary edema > 18
40
tx ARDS
PEEP low tidal volume ventilation - 6ml/kg supplemental oxygen
41
MCC cancer related death in US
lung CA
42
MCC lung CA
smoking smoking and asbestosis are synergistic
43
what lung CA are included in non-small cell
adenocarcinoma large cell squamous cell lepidic pattern
44
MCC cancer in smokers in nonsmokers
adenocarcinoma
45
DX adenocarcinoma of the lung
CXR - peripherally located biopsy - gland formation/glandular with mucin production
46
second MCC lung CA
squamous cell
47
characteristics of squamous cell lung CA
CCCP centrally located cavitary lesions hypercalcemia pan coast syndrome
48
dx squamous cell lung CA
perform cytology and bronchoscopy histology - keratinization by tumor cells and intracellular desmosomes - intercellular bridges
49
large cell carcinoma characteristics
large peripheral mass with prominent necrosis
50
histology large cell carcinoma
pleomorphic giant cells - sheets of round or polygonal cells with prominent nuclei
51
which lung CA is most aggressive
small cell
52
which lung CA is most likely to present with paraneoplastic syndromes
small cell
53
dx small cell lung CA
CXR - centrally located histology - sheets of small dark blue cells w rosette formation
54
transudative effusions are due to
increased hydrostatic or decreased oncotic
55
etiologies of transudative pleural effusions
HF cirrhosis nephrotic syndrome pulmonary embolism
56
etiologies of exudative pleural effusions
malignancy pneumonia/TB pulmonary embolism pnacreatitis esophageal rupture hemothorax
57
sx and PE for pleural effusion
dyspnea pleuritic chest pain cough dullness to percussion decreased fremitus decreased breath sounds
58
Dx pleural effusions
CXR - blunting of costophrenic angles lateral decubitus films - best - detect smaller effusions thoracentesis - gold standard; determine cause
59
light's criteria for pleural effusion
transudate: pleural: serum protein 0.5 pleural: serum LDH > 0.6 pleural fluid LDH > 2/3 ULN
60
types of pneumothorax
primary spontaneous - atraumatic; no underlying cause secondary spontaneous - underlying lung disease traumatic - trauma or iatrogenic tension - any type of pneumothorax where the air pressure pushes the trachea to the contralateral side
61
sx pneumothorax
sudden onset dyspnea and chest pain - pleuritic, ipsilateral, unilateral
62
PE pneumothorax
hyper resonance to percussion decreased fremitus decreased breath sounds tension - increased JVD
63
CXR pneumothorax
CXR - decreased peripheral markings; deep sulcus sign; visible visceral pleural sign
64
tx pneumothorax
small - observe large - needle or small bore catheter aspiration secondary - chest tube tension - needle aspiration --> chest tube
65
sx pulmonary embolism
triad - dyspnea, pleuritic chest pain, hemoptysis
66
what is highly suspicious for PE
normal CXR in the presence of hypoxia
67
classic findings in CXR for PE
Westermark's sign - start cut off of pulmonary vessels Hampton's hump - wedge-shaped opacification at the periphery of the lung
68
EKG pulmonary embolism
S1Q3T3 deep S in lead I isolated Q inversion in lead III isolated T inversion in lead III
69
what level for DDimer makes PE unlikely
< 500
70
dx PE
CTPA - criterion standard VQ scan - test of choice in pregnancy Duplex US
71
Tx PE
stable - anticoagulation - UFH, LMWH, fondaparinux unstable (SBP < 90 or R HF) - thrombolysis; embolectomy if thrombolysis fails
72
preferred anticoagulant in malignancy and pregnancy for PE
LMWH
73

ER EOR (28 decks)

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