Respiratory Flashcards
What is bronchiolitis obliterans?
Infection of the bronchioles leading to fibrotic damage of the lumen
Hemoptysis related diseases
Lung cancer
Bronchiectasis
TB
Urinary antigen detection for what causes of pneumonia ?
Legionella
Strep pneumoniae
Criteria for hospitalization for CAP
RR> 28/min
Systolic bp < 60mmHg or SaO2 <90%
CAP for previously healthy and no risk factors
Macrolide (azithromycin, clarithromycin, erythromycin)
Doxycycline
CAP with comorbidities antibiotics
Fluroquinolones (-floxacin)
Beta-lactam + macrolide or amoxicillin + calvulanic acid
CAP ICU antibiotics
B-lactam + azithromycin or quinolone
If p. Aureginosa, use piperacillin+tazobactam, imipenem/meropenem + Ciprofloxacin
If MRSA then vancomycin or linezolid
Diagnostic criteria for ARDS
PaO2/FiO2 < 200
Acute onset
Bilateral infiltrate
HIV patient is most likely to develop TB I’m what part of the lungs ?
Lower lobes
When to suspect TB
Cough > 3 months Fever > 1 month Bloody sputum Night sweats Weight loss High risk patient
gold standard for TB diagnosis
Culture
but need 4-8 weeks on solid medium and 2 weeks on liquid medium
Not only TB can form granulomas. What else can?
Foreign bodies Fat necrosis Fungal Sarcoidosis Crohn's
Initial event in all interstitial lung diseases
ALVEOLITIS - the presence of immune cells within alveolar walls which secrete cytokines causing inflammation. Damage mediated by ROS and proteases.
remember ILD is RESTRICTIVE disease
Pathogenesis of ILD
Fibroblasts migrate across damaged alveolar wall into alveolar space. Fibrin is then organized, collagenized, and covered by alveolar epithelium.
Fibrosis pulls down on bronchiolar space causing dilation
final stage called HONEY COMB LUNG
Pulmonary function test pattern for RESTRICTIVE diseases
DECREASE: lung vol, compliance, diffusing capacity, FVC, FEV1, TLC, DLco
BUT
NORMAL FEV1/FVC ratio
