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AGACNP Cert > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What stage of COPD is a patient with an FEV1 85% predicted value?

A

GOLD 1 — FEV1 ≥ 80% predicted value

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2
Q

What stage of COPD is a patient with an FEV1 60% predicted value?

A

GOLD 2 — FEV1 50-79% predicted value

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3
Q

What stage of COPD is a patient with an FEV1 40% predicted value?

A

GOLD 3 — FEV1 30-49% predicted value

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4
Q

What stage of COPD is a patient with an FEV1 20% predicted value?

A

GOLD 4 — FEV1 <30% predicted value

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5
Q

What are criteria for COPD category A?

A

Category A — no or 1 moderate exacerbation that does not require hospitalization per year, mMRC 0-1, CAT <10

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6
Q

What are criteria for COPD category B?

A

Category B — no or 1 moderate exacerbation that does not require hospitalization per year, mMRC ≥2, CAT ≥10

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7
Q

What are criteria for COPD category E?

A

Category E — ≥ 2 moderate exacerbations or ≥ 1 leading to hospitalization per year

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8
Q

What is the treatment for COPD patients in category B or E?

A

LABA + LAMA

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9
Q

What is the initial treatment for TB?

A

Initial treatment includes rifampin, isoniazid, pyrazinamide, and ethambutol, if the isolate proves to be fully susceptible to isoniazid and rifampin then the fourth drug can be discontinued

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10
Q

How long does treatment for TB last in a patient without HIV?

A

Triple therapy should be continued for two months followed by an additional four months of isoniazid and rifampin for a total of 6 months

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11
Q

How long does treatment for TB last in a patient with HIV?

A

patients with HIV should be treated for nine months

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12
Q

What drug regimen is indicated for patients with a positive PPD without evidence of infection?

A

isoniazid should be taken for six months

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13
Q

What would be considered a positive PPD in a patient with HIV?

A

5 mm

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14
Q

What would be considered a positive PPD in a patient who is an inmate?

A

10 mm

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15
Q

What would be considered a positive PPD in a patient who is not in a high-risk group?

A

15 mm

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16
Q

Where should treatment take place for a patient with pneumonia and a PORT score of 60?

A

≤ 70 — outpatient

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17
Q

Where should treatment take place for a patient with pneumonia and a PORT score of 80?

A

71-90 — brief admission

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18
Q

Where should treatment take place for a patient with pneumonia and a PORT score of 100?

A

91-130 — inpatient

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19
Q

Where should treatment take place for a patient with pneumonia and a PORT score of 130?

A

> 130 — ICU

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20
Q

What are the criteria for CURB-65?

A

Confusion, BUN >19, Respiratory Rate ≥ 30, BP <90/60, & Age ≥ 65

21
Q

Where should treatment take place for a patient with pneumonia and a CURB-65 score of 1?

A

0-1 — outpatient

22
Q

Where should treatment take place for a patient with pneumonia and a CURB-65 score of 2?

A

2 — brief hospital admission

23
Q

Where should treatment take place for a patient with pneumonia and a CURB-65 score of 3?

A

≥ 3 hospital admission with consideration for ICU

24
Q

What antibiotics are indicated for outpatient treatment of low-severity CAP?

A

amoxicillin, doxycycline, or azithromycin

25
Q

What antibiotics are indicated for outpatient treatment of moderate to high-severity CAP?

A

augmentin or cephalosporin PLUS doxycycline or azithromycin OR mono therapy with levofloxacin

26
Q

What antibiotics are indicated for inpatient treatment of nonsevere CAP?

A

ceftriaxone plus azithromycin OR monotherapy with levofloxacin +/- vancomycin or linezolid if MRSA is suspected

27
Q

What antibiotics are indicated for inpatient treatment of nonsevere CAP?

A

ceftriaxone plus azithromycin OR monotherapy with levofloxacin +/- vancomycin or linezolid if MRSA is suspected

28
Q

What antibiotics are indicated for inpatient treatment of severe CAP?

A

ceftriaxone plus azithromycin OR if pseudomonas suspected then cefepime, zosyn, or merrem PLUS levofloxacin +/- vancomycin or linezolid if MRSA is suspected

29
Q

What antibiotics are indicated for inpatient treatment of HAP with low risk mortality?

A

zosyn, cefepime, merrem, aztreonam, or levofloxacin PLUS vancomycin or linezolid

30
Q

What antibiotics are indicated for inpatient treatment of HAP with high risk mortality?

A

zosyn, cefepime, merrem, aztreonam, PLUS levofloxacin or gentamicin PLUS vancomycin or linezolid

31
Q

What antibiotics are indicated for inpatient treatment of HAP with high risk mortality?

A

zosyn, cefepime, merrem, aztreonam, PLUS levofloxacin or gentamicin PLUS vancomycin or linezolid

32
Q

What antibiotics are indicated for inpatient treatment of VAP?

A

zosyn, cefepime, merrem, aztreonam, PLUS levofloxacin or gentamicin or polymixin PLUS vancomycin or linezolid

33
Q

What is the mechanism of action for SABAs?


A

Beta2-agonists relax airway smooth muscle by stimulating beta2-adrenergic receptors, which increases cyclic AMP and antagonizes mechanisms of bronchoconstriction

34
Q

What is a normal SvO2?

A

60-80

35
Q

What is a normal minute ventilation?

A

6-8L/min

36
Q

What is the normal tidal volume on a ventilation?

A

Vt 6-8 ml/kg ideal body weight

37
Q

What p/f ratio is consistent with mild lung injury in ARDS?

A

p/f <300 mild lung injury

38
Q

What p/f ratio is consistent with moderate lung injury in ARDS?

A

p/f <200 moderate lung injury

39
Q

What p/f ratio is consistent with severe lung injury in ARDS?

A

p/f <100 severe lung injury

40
Q

What should the set tidal volume be on the ventilator for a patient with ARDS?

A

Vt 4-6 ml/kg ideal body weight

41
Q

Pleural fluid analysis shows pleural fluid protein to serum protein ratio < 0.5, pleural fluid LDH to serum LDH ratio < 0.6, and pleural fluid LDH < 2/3 the upper limit of normal serum LDH. This is consistent with what type of effusion?

A

Transudative

42
Q

Pleural fluid analysis shows pleural fluid protein to serum protein ratio > 0.5, pleural fluid LDH to serum LDH ratio > 0.6, and pleural fluid LDH > 2/3 the upper limit of normal serum LDH. This is consistent with what type of effusion?

A

Exudative

43
Q

Pulus paradoxus can be present in which conditions?


A

cardiac tamponade, tension pneumothorax, acute asthma exacerbation, acute COPD exacerbation, and obstructive sleep apnea

44
Q

What is the first step in the asthmatic treatment ladder?

A

SABA PRN

45
Q

What is the second step in the asthmatic treatment ladder?

A

Low-dose ICS

46
Q

What is the third step in the asthmatic treatment ladder?

A

low-dose ICS + LABA

47
Q

What is the fourth step in the asthmatic treatment ladder?

A

medium dose ICS + LABA

48
Q

Dysphasia, drooling, and expiratory stridor are concerning for what condition?

A

Epiglottitis

AGACNP Cert (12 decks)

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