respiratory 2 Flashcards
Anticoagulation regimen in pregnant woman if VTE diagnosed?
LMWH from diagnosis till 6 weeks post-partum and switch to warfarin
- withhold LMWH 24 hours prior to neuroaxial anesthesia
- withhold LMWH 4 hours prior to epidural catheter to minimize epidural hematoma
Leukotriene modifiers use in?
Aspirin sensitivity asthma
Eosinophilic asthma
-blocks Th2 response
Mepolizumab use for?
Eosinophilic asthma
-doesn’t modify FEV1
Lebrikiizumab used for?
Th2 asthma
Dupilumab (IL4) used for ?
Steroid dependent asthma
ABPA is what type of hypersensitivity?
Type 4 - Th2 mediated
Omalizumab used for?
IgE mediated asthma/ Refractory AGBA
Most effective drug for nicotine dependence?
Varenicline (Champix)
-Nicotine partial agonist/competitive antagonist ( blocks pleasurable sensation)
Bupropion side effects?
Weight gain
Lower seizure threshold
Increase suicide ideation
Lung volume reduction surgery indications?
FEV1 > 20%
DLCO > 20%
Large upper lobe bullae
Lung transplant indications?
FEV1 < 20 - 25%
PCO2 > 55 mmhg + pO2 < 55 mmHg
Bilateral lungs - Age < 60
Lungs + heart - Age < 55
Theophylline mechanism of action?
Inhibit phosphodiesterase - activate cAMP = bronchodilatation
Desquamative interstitial pneumonitis (DIP) - what changes?
Langerhans histiocytosis = thin walled cysts in upper lobe
Drug induced pulmonary fibrosis
Commonest drug?
MTX clues?
Nitrofurantoin clues?
Commonest drug = Amiodarone
MTX =Eosinophilia and diffuse ground glass changes
Nitrofurantoin = HF
Radiation pneumonitis clues?
~6 weeks after treatment = hazy opacities and ground glass changes
Silicosis strongly a/w what?
Changes on imaging?
TB
‘Egg shell’ appearance = mediastinal + hilar LN
Lofgren syndrome?
Lofgren has painful joints and bull-eye skin
Arthralgia
Erythema nodosum
Hilar lymphadenopathy
Heerfordt syndrome?
Heerfordt is Hot Red Eyes Frog
Fever
Enlarge parotids
Uveitis
Treatment of bronchiectasis?
Prophylactic = Azithromycin MR-pseudomonas = B-lactam + Aminoglycoside Immunodeficiency = IVIG Haemoptysis = Bronchial artery embolization
CFTR function?
CFTR is found on what chromosome?
traffics Chloride out of cell
Chromosome 7
Cystic fibrosis
pathogens caused in adults?
pathogens caused in elderly?
Adults = Non-TB MAC + Burkholderia Elderly = Pseudomonas
ABPA affects any age
Cystic fibrosis - monitor what component of lung function test?
FEV1
Bronchiolitis obliterans a/w condition?
Inhalation injury
Drugs - gold
Nasal brushings to exclude what?
Hemophilia
Diffuse lung alveolar hemorrhage
why azithromycin/macrolide effective in pseudomonas?
inhibit quorum sensing signals
pseudomonas use sensing signals to attract more pseudomonas = build biofilm
Homozygous D508 use what?
Heterozygous D508 use what?
Homozygous = Ivacaftor + Lumacaftor
Heterozygous = Iva + Teza + Elexa
Apnea/Hyponea index calculation?
Apnea episodes/ Hours of sleep
Gold standard test for narcolepsy?
Mean sleep latency test
Narcolepsy = MSLT = 0 - 5 minutes test + repeated rapid REM onset
Medications for narcolepsy;
Narcolepsy alone?
Cataplexy?
narcolepsy = modafinil
Cataplexy = SSRI
Group 1 pHTN pathophysiology?
Increase endothelin, decrease NO + prostacyclin
Surrogate marker for PCWP for left heart disease?
LV end diastolic pressure
