Respiratory Flashcards
An adolescent with asthma presents for follow-up evaluation. After several changes in medications and doses, the parents report that the adolescent continues to experience difficulty with coughing, especially at night. What other condition is most likely cause of the continued cough?
GERD
A high school freshman presents complaining of shortness of breath while playing soccer. The patient has been experiencing this symptom more than 2 days per week but not daily. The patient has also been awakening at night with this symptom at least once per week. Testing indicates FEV1>80% of predicted. The nurse practitioner classifies this patient’s asthma as:
mild persistent
Which two lobes of the lung are most associated with aspiration pneumonia?
Right middle and right lower
Anticholinergic agents such as ipratropium (Atrovent) and tiotropium (Spiriva) are used in COPD primarily to:
induce bronchodilation
Patients with bullous lung disease are at risk of developing all the following except which barotrauma-related complication?
Hemothorax
An adult presents for f/u regarding asthma. He has been waking up at night twice a week and using his albuterol three days of the week. The next best prescription management would be:
low dose inhaled steroid
Although LABAs help control asthma symptoms both during the day and at night, reducing the frequency and severity of wheezing, shortness of breath, and chest tightness, they MUST be only added to an ICS due to risk of death. A low dose inhaled corticosteroid should be added next for the stepwise approach and then if needed, then a LABA can be added, but only as a combination with ICS.
Vesicular breath sounds
Soft and low pitched
Bronchial breath sounds
Louder, high-pitched, heard over the lower trachea
Bronchovesicular breath sounds
Intermediate intensity and pitch, heard mid chest
Tracheal breath sounds
Highest and loudest, heard at upper trachea and anterior neck
Respiratory failure/Severe respiratory distress symptoms
- tachypnea
- lack of wheezing
- accessory muscle use
- diaphoresis
- exhaustion
Egophony
Patient says “eeee” and while listening to the lungs you hear ‘bahhh”, means there is fluid consolidation in the lungs
Percussion tone - Hyperressonance
Excess air in the lungs
COPD
Percussion tone - Tympany
Abnormal in the chest wall, may indicate pneuthorax (sounds loud, high pitched, drum-like)
Percussion tone - dull
Solid organ, pleural effusion or tumor
Examples of ICS
Budesonide
Fluticasone
Beclomethasone
Examples of SABA
“Rescue inhaler”
- albuterol, levalbuterol
Examples of LABA
Usually prescribed in ICS/LABA combo due to increased risk of death with LABA alone.
Adavair –> fluticasone/salumetrol combo
