Respiratory Flashcards
What is the presentation of tension pneumo
compression of mediastinum, absent breath stounds, hypotension
Presentation of GPA?
upper airway - bloody discharge, sinusitis, oral ulcers
lower airway - dyspnea, cough, hemoptysis
renal: hematuria, renal insufficiency,
What are the treatment modalities available for asthsma?
mild intermittent - SABA PRN mild persistent: SABA + ICS moderate persistent: SABA + ICS + LABA Severe: SABA + medium ICS + LABA controller - theophylline = leukotriene antagonist, can be used fluticasone - persistent
What are the causes of hilar lymphadenopathy?
CLL, lymphoma, sarcoidosis, mets, granulomatous infection
What are the causes of pulmonary hypertension?
Cardiac - congenital heart disease, acquired heart disease
Pulmonary - COPD, restrictive lung disease
Pulmonary vascular - chronic PE, vasculitis, primary pulmonary hypertension
What masses can be found in the anterior mediastinum?
thymoma, thymus lymphoma, teratomas, thyroid masses
What are the possibilities for posterior mediastinum masses?
Nerve - schwannoma, neurofibromas,
Bone - primary bone tumor ( osteosarcoma, myeloma, osteomyelitis)
What are the possibilities for a middle mediastinum mass?
Aorta- Aortic dissection, aortic aneurysm, esophagus - esophageal alchalasia, adenocarcinoma, cyst,
Heart - cysts
What is the most common pneumonia in post flu patients?
Staph
What lab finding is an indication of a worsening asthma attack?
Normal PCO2
What is the treatment protocol for COPD?
Bronchodilators (albuterol, ipatroprium = anti muscarininc)
Oxygen
Systemic steroids
Antibiotics (cover moxella, h flu and strep pneumo)
For persistent COPD - advisor (LABA + ICS)
Possibly NSAIDs
Run through the whole differential for pulmonary massess
See rads lecture Neoplasm - carcinoma, hamartoma, carcinoid, lymphoma, met Infection - TB, histo, coccidio, abscess Infarct Trauma - hematoma Other: Wegener's, rheumatoid, BOOP,
Run through differential for multiple pulmonary nodules
Mets -
Infection - Septic emboli, Miliary TB, fungal, invasive aspergillus
Inflammatory - AVM, Wegener’s, Rh nodules
Run through differential for chest wall lesions, pleural lesions, apical
Chest wall - abscess, hematoma, hamartoma, fibroma, lipoma, lymphoma
Pleural - fibroma, lipoma, loculated effusion, lymphoma, mets, mesothelioma,
Apical - TB, Abscess, pancoast tumor, TB mimics, PNA
What are the different causes of pulmonary effusions?
Unilateral - cirrhosis, PE, empyema, TB, mesothelioma, PNA, Dressler’s syndrome
Bilateral - CHF, nephrotic syndrome, mixed connective tissue disease, malnutrition, hypothyroid, viruses
Both - ascites, pancreatitis, trauma, pericarditis, chylous
What are the criteria for diagnosis of asthma?
airflow obstruction partially reversible with inhaled SABA as shown by
An increase in FEV1 of 12% from baseline, an increase of 10% points from baseline or increase of PEF of greater than 20% from baseline
What are the treatment options available for empyema?
streptokinase early - can help bust, but not if thick
antibiotics - helpful early
can do second chest tube if not too complex
otherwise, surgery
Describe the gram negative bacilli that can cause PNA
e coli, klebsiella, pseudomonas, proteus, enterobacter,
How does klebsiella mediated PNA often present?
currant jelly-like sputum with tissue necrosis, early abscess formation, often happens in alcoholics
produces mucoid colonies
A patient comes in with a complicated PNA. Treatment?
antibiotics +corticosteroids - minimizes pulmonary complications from inflammatory effects of dead organisms in tissue
What is peak airway pressure? What is plateau pressure?
peak = resistive + plateau plateau = elastic + PEEP
A patient presents with low grade fevers, lytic bone lesions, skin involvement from the Mississipi river valley. This is.. (and what is the treatment?)
blastomyces - treatment is amphotericin B
What are Light’s criteria?
fluid/serum protein > 0.5, fluid/serum LDH > 0.6,
What is the cause of transudative vs. exudative effusions?
exudative - infection, malignancy, autoimmune, PE
