Respiratory 1 Flashcards
most common symptom of acute carbon monoxide poisoning
headache
lung cancer - what should raise suspicion on a smoker or former smoker
cough
most common type of lung cancer
non-small-cell lung cancer
screen for lung cancer with CT in who
adults 50-80 years old, who have a 20 pack year smoking dx and currently smoke or have quit in the past 15 years
soft, low pitched breath sounds, heard over most of the peripheral field
vesicular breath sounds
gold standard test for asthma and COPD
pulmonary function testing
forced expiratory volume in 1 second FEV1
amount of air that a person can forcefully exhale in 1 second
forced vital capacity FVC
total amount of air that can be exhaled during the FEV1 test
Asthma is a disease characterized by
chronic airway inflammation
which meds classes can trigger asthma
4
NSAIDs
BBs
ACEI
certain eye drops
first line drugs for asthma are
inhaled corticosteroids ICSs
___ when used alone, increase the risk of death from asthma
LABAs; a combo of LABA and ICS is safer
intermittent asthma should be treated with
SABA as needed (e.g. albuterol)
asthma step 2 - add what
low dose ICS
asthma step 3 - add what
LABA with ICS; keep SABA prn
GINA 2020 rescue inhaler recs
prefer ICS-formoterol; albuterol or SABA monotherapy is discouraged, but can be used as an alternative rescue drug
intermittent asthma - night awakenings
occur 2 or more times per month
exercise induced bronchoconstriction - premediate how
5-20 mins before exercise w/ two puffs of a SABA (-buterols); effect will last up to 4 hours
maximal rate that a patient can exhale during a short maximal expiratory effort after a full inspiration
peak expiratory flow rate
PEF rate is based on
HAS - height, age, and sex
PEF rate measures
effectiveness of treatment, worsening symptoms, and exacerbations
PEF rate - patients are asked to monitor and record their PEF how often
2-4 times daily for two weeks (ideally when asthma is controlled)
asthma green zone
80-100% of personal best PEF; no wheeze or couhg; sleeps through the night; can work and play; continue daily controller meds
asthma yellow zone
50-80% of personal best PEF; mild wheeze, tight chest, cough at night
asthma red zone
<50% of personal best PEF; signifies warning or medical alert; breathing hard and fast
what is ipratropium
Atorvent; short acting antimuscarinic SAMA
chronic lung disease characterized by the permanent loss of elastic recoil of the lungs, inflammation, airflow limitation, and changes in pulmonary vasculature
COPD
most characteristic symptom of COPD
chronic and progressive dyspnea
chronic bronchitis
coughing with excessive mucus production for 3 or more months for a minimum of 2 or more consecutive years
emphysema
irreversible enlargement and alveolar damage with loss of elastic recoil resulting in chronic hyperinflation of the lungs
increased anterior-posterior diameter is to
emphysema findings
emphysema objective findings
6
- increases AP diameter
- decreased breath and heart sounds
- use of accessory muscles to breathe
- pursed lip breathing
- prolonged expiratory phase
- weight loss
