Respiratory Flashcards

1
Q

What volume should surgical intervention be considered with a Chest tube

A

When drainage exceeds 1 L

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2
Q

What would be visualized with Mallampati Airway classification III

A

-Hard palate
-soft palate–base of uvula

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3
Q

Latent TB treatment

A

Single drug therapy
Isoniazid + vitamin B6 x6 months

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4
Q

Typical Antibiotic treatment for CAP

A

Oral Amoxicillin
Azithromycin- a macrolide
-Ceftiraxone
Common pathogen is streptococcus pneumoniae

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5
Q

Complication of barotrauma encountered with Mechanical ventilation

A

Aveolar- Pleural- Fistula (APF)

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6
Q

Gold standard imaging for diagnosing Interstitial Lung Disease (ILD)

A

High resolution CT
s/s:
-worsening dry cough and fatigue
-Rales in base of lungs
-gradual increase in SOB
-Hx of smoking and lung CA

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7
Q

Characteristics of chylous effusion

A
  • milky, white appearance
    -fluid has a high triglyceride count greater than 110 mh/dl
    -elevated WBC
    -higher protein and lower LDH

Chylothorax usually occurs when the thoracic duct is damaged

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8
Q

Anticipated finding in Status asthmaticus

A

-Dehydration
-Tachycardia
- Elevated pCO2
-Spontaneous pneumothorax may occur

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9
Q

Antibiotics used for Hospital Acquired Pneumonia (HAP)

A

-vancomycin- to cover MRSA
-Piperacillin-Tazobactam (Zosyn)
- Meropenem
-Cefepime

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10
Q

Diagnostic imagining to Pulmonary hypertension

A

-Right heart catheterization
s/s
-Right axis deviation with right ventricular hypertrophy
- TTE with show severe tricuspid regurgitation

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11
Q

What reverses bronchospasm (difficulty bagging due to stridor after intubation)

A

Nebulized racemic epinephrine

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12
Q

s/s of Pulmonary edema

A
  • Dyspnea
  • Tachypnea
    -Wheezing and bilateral crackles
    -Pink frothy sputum
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13
Q

Antibiotic treatment for Legionella spp (atypical CAP)

A

Azithromycin (Zithromax -macrolide

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14
Q

Characteristics of Cor Pulmonale

A

-synonymous with right heart failure
-enlargement of the RV secondary to pulmonary disease

Right heart failure results from pulmonary disease and primary PA hypertension

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15
Q

Emperic therapy for VAP

A

Vancomycin or Linezolid - to cover MRSA
Piperacillin-Tazonactam
Levofloxacin (Levaquin)
Meropenem

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16
Q

PFT result that indicates airflow obstruction

A

A decrease in the FEV1 to FVC ratio

17
Q

PFT result that indicate Restrictive Lung disease

A

A reduction in both FEV1 with a normal FEV1/ FVC ratio

18
Q

Clinical finding seen in chronic bronchitis but not emphysema

A

Polycythemia

19
Q

Gold standard for diagnosing OSA-hypopnea syndrome

A

Overnight polysomnography with direct technician observation

20
Q

EKG findings seen on severe pulmonary hypertension

A

Tall R in V1 and deep S in V6 indicates RV hypertrophy
Right Axis deviation

21
Q

Initial management of Frail chest

A

Intubation with positive pressure ventilation

22
Q

Contraindications for a Bullectomy

A

A patient who continues to smoke
Patient with pulmonary hypertension
Patients who do not have well-defined Bullae on the chest x-ray and CT

23
Q

PCWP <18 vs PCWP> 18

A

PCWP less than 18 indicates ARDS
PCWP greater than 18 indicates pulmonary edema

24
Q

Supportive care for patients with pulmonary hypertension due to right heart failure

A

Intravenous prostanoids and platelet aggregation inhibitors ( clopdidogrel)

25
Q

PFT results to confirm COPD

A

Post-bronchodilator FEV1/FVC less than 0.7

26
Q

Lung sounds auscultated in Pulmonary embolism

A

Bilateral clear breath sounds
RV S3

27
Q

Length of treatment for Tuberculoses

A

Latent TB -6 months
Patients with HIV and/ or immune compromised- 9 months

28
Q

Mainstay treatment for Empyema

A

-culture data (both peripherally and locally) via blood
- Thoracentesis with prolonged drainage via chest tube
- systemic antibiotics (vanco and zosyn)

29
Q

What does elevated peak pressures with normal plateau pressure indicate?

A

Resistance somewhere in the circuit
ex. mucous plug, ET obstruction or kinking
Intervention: in-line suctioning

30
Q

Tension pneumothorax s/s on the ventilator

A

High peak inspiratory pressures accompanied by hemodynamic instability

Intervention: Decompressing the pleural space

31
Q

What are the chronic medical therapy shown to improve the survival rate of pt with COPD

A

Smoking cessation with correction of hypoxemia with supplemental oxygen

32
Q

Indication for tube thoracotomy

A

-Loculated pleural fluid
-pH below 7.2
-pleural glucose less than 60mg/dL
-Gm+ or culture of pleural fluid or the presence of pus

33
Q

S/S of aortic rupture

A

-Widened Mediastinum
-Rib fracture
- Tracheal deviation

34
Q

Stridor and upper airway edema post extubation treatment

A

Aerosolized racemic epinephrine
OR
Parenteral steroids
Helix