Respiratory

Question 1

Name characteristics of EXUDATIVE pleural effusions.

Answer 1

Pleural fluid protein: serum protein ratio > 0.5

Pleural fluid LDH: serum LDH > 0.6

Pleural fluid LDH > 2/3 the upper limit of normal serum LDH

Fluid cytology is needed to determine malignancy.

Question 2

Name characteristics of TRANSUDATIVE effusion.

Answer 2

Pleural fluid glucose = serum glucose

pH: 7.40 - 7.55

WBCs: < 1000 /mcL

Question 3

Name characteristics of CHYLOUS effusion

Answer 3

milky
white appearance
fluid has a high triglyceride count

Question 4

What antibiotics are used for the tx of HAP?

Answer 4

Vancomycin for MRSA coverage

Zosyn

Question 5

What is the GOLD standard for the initial diagnosis of ILD?

Answer 5

high resolution CT

Question 6

What abx is used to tx CAP?

Answer 6

Amoxicillin and Azithromycin (Macrolide)

Question 7

What diagnostic study will further characterize pneumonia?

Answer 7

CT scan of the chest w/out contrast

Question 8

What are the characteristics of Cor Pulmonale?

Answer 8

common in pt’s with COPD

synonymous w/ RVHF

RVHF results from pulmonary disease and primary PA HTN

No degeneration of the myocardium in Cor Pulmonale

Not associated with pulmonary edema

Question 9

What is the characteristics of chronic bronchitis?

Answer 9

Excessive secretion of bronchial mucus
Manifested by + cough for 3 months or more
At least 2 consecutive years

Question 10

What is the characteristics of emphysema?

Answer 10

Permanent enlargement of the alveoli

Question 11

What are the s/sx of chronic bronchitis?

Answer 11

Intermittent mild to moderate dypsnea
Onset of sx after age 35
Copious sputum production - PURULENT
Stocky, obese body habitus
Chest A-P diameter - NL
percussion NL
CXR - hyperinflation
Increase HCT

Question 12

What are the s/sx of emphysema?

Answer 12

Progressive, constant dyspnea
Onset of sx after age 50
Clear mild sputum
Thin, wasted body habitus
Chest A-P diameter - INCREASED
percussion HYPERRESONANT
NL HCT
Total lung capacity is INCREASED

Question 13

What is the lab/dx of COPD?

Answer 13

low flattened diaphragm by CXR secondary to air trapping
decrease BS w/ auscultation
FEV1 airflow reduced
TLC, FRC, RV may be increased

Question 14

Name the out-pt management of asthma/COPD

Answer 14

discontinuation of smoking
avoidance of irritants or allergens
postural drainage may clear excess secretions
inhaled ipratropium bromide or sympathomimetics: MAINSTAY of therapy
Inhaled titropium bromide (Spiriva) promotes bronchodilation

Question 15

What is the PORT score?

Answer 15

Pneumonia Severity Index (PSI)/Patient outcomes research team (PORT) score