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respiratory Flashcards

1
Q

58 yo. M presents to ED with complaints of dry cough. CXR revealed generalized inflamed film throughout. What is the most likely diagnosis?

A

pneumonitis

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2
Q

Drug known to prevent nosocomial PNA?

A

sulcarafate (Carafate)

Mucosal Protective Agent

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3
Q

Initial finding associated with pulmonary embolism?

A

respiratory alkalosis

- s/t ↑ RR = blowing off CO2

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4
Q

Diagnostic of pulmonary HTN?

A

2D echo

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5
Q

Your patient is intubated on the following settings: SIMV/FiO2 .6/PEEP 5. You notice shunting. What should your next action be?

A

Increase PEEP from 5 to 10 to recruit alveoli and increase surface area to improve oxygenation

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6
Q

32 yo. M with PMH significant for mitral valve replacement now complains of wheezing during physical activity 2-3 times/week. What should you do next?

A

Send patient for PFT.

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7
Q

What is the pathology of asthma?

A

↑ response/hyperresponse of trachea, bronchi to stimuli

  • acute inflammation
  • widespread airway narrowing
  • smooth muscle hypertrophy
  • viscid mucus plugging up airways
  • mucosal edema, hyperemia, mucus gland hypertrophy
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8
Q

asthma: hallmark s/s - top 3 + 7 more

A
  • difficulty speaking in sentences
  • pulsus paradoxus gt 12 mmHg (none in COPD!)
  • hyperresonance

respiratory distress @ rest, RR 28+, cough, use of accessory muscles, chest tightness, diaphoresis, HR 110+

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9
Q

PFT value suggestive of obstructive disease?

A

↓ FEV 1

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10
Q

Which acid-base imbalance is associated with asthma?

A

Respiratory Alkalosis w mild hypoxemia

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11
Q

asthma PFT values at which hospitalization is recommended x4

A

FEV 1 lt 30% predicted
– OR –
doesn’t increase to at least 40% predicted after 1 hr tx

PEAK FLOW lt 60 L/min initially
– OR –
doesn’t increase to gt 50% predicted after 1 hr tx

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12
Q

ominous findings assoc w asthma exacerbation

  • signs x5
  • lab x 1
A

fatigue, absent breath sounds, paradoxical chest/abd movement, inability to retain recumbency, cyanosis

  • hypercapnea: pCO2 45+ = EMERGENCY
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13
Q
  • Daily maintenance drug for outpatient asthma mgmt: MOA & name
A

MOA: inhaled corticosteroid

budesonide (Pulmicort)

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14
Q

SE associated with inhaled corticosteroids used daily as maintenance drug for asthma? x3 + 1 pt education

A

candidal infection of the oropharynx
dry mouth
sore throat
- educate patient to rinse mouth

Ex: budesonide (Pulmicort)

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15
Q

asthma: outpatient mgmt x 6 meds (class & name) + indications

A
  1. SABA - albuterol/Proventil: sx relief, breakthrough, or pre exercise
  2. inhaled corticosteroid - budesonide/Pulmicort: daily maintenance, ↑ if persistent sx
  3. LABA - salmeterol/Serevent: for persistent sx
  4. theophylline or antimediators: for persistent sx
  5. inhaled anticholinergic - ipratropium bromide/Atrovent: add if necessary (secretions)
  6. anti-leukotrienes - montelukast/Singulair: chronic asthma maintenance (stabilization)
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16
Q

If asthma sx persist, what pharm interventions are indicated? x4

A

↑ inhaled corticosteroids
add LABA (salmeterol/Serevent)
add theophylline or antimediators

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17
Q

indications for ipratroprium bromide (Atrovent) & MOA

A

secretion management in asthma

MOA: inhaled anticholinergic

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18
Q

What drug + MOA is indicated in the chronic management of asthma?

A

montelukast (Singulair)
MOA: anti-leukotriene

think: stabilization

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19
Q

Which drugs x2 have BBW: “Do not take during acute asthma exacerbation?”

A

LABA

anti-leukotrienes

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20
Q

asthma: inpatient mgmt

A
  • O2 (2 - 3L/min)
  • mild to mod: ABG not necessary if SaO2 90+
  • severe: initial ABG
  • hydration (PO or IVF)
  • inhalation sympathomimetics (alupent, proventil, ventolin)
  • corticosteroids if no response to sympathomimetics (methylprednisolone)
  • parenteral sympathomimetics in pts unable to cooperate (aqueous epinephrine)
  • anticholinergic (atrovent MDI)
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21
Q

Status asthmaticus is…

A

severe, acute asthma that is unremitting, poorly responsive, and life threatening.

note: clinical findings NOT reliable indicators of severity

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22
Q

status asthmaticus: gold standard interventions x4

A

IV D5 1/2NS
Intubation (pt looks bad)
Continuous pulse ox
ABG q 10-20 min

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23
Q

Monitor pulse ox and ABGs in status asthmaticus how often?

A

Continuous pulse ox

ABG q 10-20 min

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24
Q

chronic bronchitis is…

A
  • excessive secretion of bronchial mucus

- productive cough 3+ mo over 2+ consecutive yrs

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25
Q

emphysema is…

A

abnormal, permanent alveoli enlargement

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26
Q

ABG assoc w chronic bronchitis + why.

A

hypercapnia + hypoxemia

- air trapped in alveoli, over time chemoreceptors reset to accommodate high CO2 levels

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27
Q

CXR findings associated with COPD

A

hyperinflation: low, flattened diaphragm

bulla, blebs

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28
Q

COPD: outpt mgmt x4

A
  • smoking cessation
  • avoid irritants/allergens
  • postural drainage: clear excess secretions
  • inhaled: ipratroprium bromide (Atrovent) or sympathomimetics – MAINSTAY
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29
Q

58 yo M w PMH COPD; home O2 2L NC coughing up purulent/ thick/ yellow mucous. Management plan?

A 
O2 NC 2-4 L min or 24-28% venti mask
Start antibiotics - 7-10days
Ampicillin or amoxicillin 500 mg QID PO for 7-10days
Doxycyline 100 mg BID 
Bactrim DS 1 tablet BID
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30
Q

Most common clinical presentation of TB?

A

Pulmonary disease.

TB is systemic and often asymptomatic.

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31
Q

TB: classic s/s x4

A
  • MAJORITY ARE ASYMPTOMATIC*
  • weight loss
  • low grade fever
  • night sweats
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32
Q

True or False: A positive PPD is diagnostic for active TB dx?

A

False. Positive PPD shows exposure; not active disease.

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33
Q

What are the drugs + doses in initial TB treatment?

A

R I P E

Rifampin 600 mg
Isoniazid 300 mg
Pyrazinamide 1.5 - 2.0 g
Ethambutol 15 mg/kg

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34
Q

TB tx: dosages x3 steps

A

R I P E

DAILY FOR 2 MO: Isoniazid 300 mg + Rifampin 600 mg + pyrazinamide 1.5-2.0 gm (can include E here)

THEN, DAILY 4 MO: R & I

DROP E: if tb fully susceptible to R & I

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35
Q

TB + HIV: tx duration

A

9 mo - 1 year

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36
Q

TB: monitoring protocol for newly dx x3 steps

A

FIRST SIX WEEKS AFTER INITIATION OF TX: weekly sputum smears & cultures

THEN MONTHLY until neg cx documented

IF SX CONTINUE OR + CX AFTER 3 MO: suspect drug resistance

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37
Q

TB: baseline labs ordered with initiation of treatment? What happens to those with normal baseline?

A

LFT
CBC
serum creat

If normal labs @ baseline, monthly labs not required - but monitor for sx drug toxicity.

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38
Q

TB: ethambutol considerations x2

A

visual acuity changes, red-green color blindness

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39
Q

+PPD is an indication for which drug & dosage?

A

INH - 6 mo

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40
Q

pneumonia is…

A

inflammation of LOWER respiratory tract

- r/t infection via aspiration, inhalation, hematogenous dissemination

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41
Q

most common causative agent of CAP

A

Strep. pneumoniae

gram + !

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42
Q

pneumonia: gold standard for dx

A

CXR: infiltrates

Blood cultures x 3

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43
Q

CAP: mgmt for under 65 x4

A

MACROLIDE - 1 of the following:

  • azithromycin (Zithromax)
  • clarithromycin (Biaxin)
  • erythromycin

OR

TETRACYCLINE: doxy

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44
Q

CAP: mgmt 65+ or comorbs x4

A

FLUOROQUINOLONE

  • levofloxacin (Levaquin)
  • ciprofloxacin (Cipro)
  • moxifloxacin (Avelox)
  • gemifloxacin (Factive)
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45
Q

pneumonia: inpt ICU mgmt (rx only) x3

A

BETA LACTAM
- ceftriaxone (Rocephin)

p l u s

FLUOROQUINOLONE 
//or// 
- azithromycin (Zithromax): resistance likely, avoid
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46
Q

Pseudomonas pneumonia: inpt ICU mgmt (rx only) x5

A

antipneumococcal/antipseudomonal beta lactam

  • piperacillin-tazobactam (Zosyn)
  • cefepime (Maxipime)
  • meropenem (Merrem)

PLUS
- ciprofloxacin (Cipro)
//or//
- levofloxacin (Levaquin)

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47
Q

community acquired MRSA pneumonia: rx x2

A

vancomycin
//or//
linezolid

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48
Q

What consult is necessary when ordering Linezolid?

A

ID

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49
Q

HAP: definition + most common causative organisms

A

pneumonia that occurs 48 hrs + after admission & not incubating @ admission (VAP, HCAP)

Staphylococcus aureus
Streptococcus pneumoniae
Haemophilius influenzae

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50
Q

VAP: definition + most common causative organism

A

Pseudomonas

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51
Q

pneumothorax pathophys

A

gas enters pleural space
↑ pleural pressure = collapsed lung
impairs respiration

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52
Q

pneumothorax: hallmark s/s x3

A

hyper-resonance affected side (d/t air trapping)
diminished BS & diminished fremitus affected side
mediastinal shift toward unaffected (tension pneumo)

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53
Q

gold standard for pneumothorax dx

A

CXR

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54
Q

When does pneumothorax require intervention?

A

when larger than 20% – pt will become symptomatic

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55
Q

Intervention for non-emergency pneumothorax?

A

chest tube @ 4th - 5th ICS MAL

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56
Q

STAT intervention for tension pneumothorax?

A

needle thoracostomy @ 2nd ICS MCL

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57
Q

leading cause of inpatient hospital death

A

pulmonary embolism

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58
Q

pulmonary embolism: risk factors x6

A 
immobility
venous stasis
hypercoagulable states
endothelial damage
recent surgery of a long-bone
PO contraceptives
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59
Q

pulmonary embolism: s/s x7

A 
acute/abrupt --
dyspnea, tachycardia * most common
hypotension
chest pain (retrosternal or lateral/pleuritic)
hemoptysis, low grade fever, cyanosis
60
Q

pulmonary embolism: associated ABG x2

A

HYPOXEMIA
- SaO2 lt 90%, PaO2 lt 80 mmHg

HYPOCAPNIA
- pCO2 lt 35 mmHg r/t reflexive hyperventilation

61
Q

pulmonary embolism: diagnostics x 6

A

DIAGNOSIS BASED ON CLINICAL SUSPICION (HX KEY!)

VQ scan
ABG
Spiral CT 
D-dimer
Pulmonary angiography
62
Q

pulmonary embolism: medical mgmt

A

O2
intubation
IVF (for hypotension, ↓ CO)

Heparin 80 u/kg bolus

  • then, Heparin 18 u/kg/hr // PTT 1.5 - 2x normal
  • simultaneous Coumadin // INR 2-3

if hemodynamic compromise/shock: fibrinolytics, but first PT/PTT must be less than 2x normal

63
Q

Goal INR for Coumadin tx for pulmonary embolism?

A

INR 2-3

64
Q

Goal PTT for Heparin tx for PE?

A

PTT 1.5 - 2x normal

Normal: PTT 60-90 seconds

65
Q

ARDS pathophysiology

A

acute lung injury r/t wide variety of insults;

transudative fluid build up in alveoli r/t systemic inflammatory process
- impairs ventilation and perfusion.

66
Q

ARDS: s/s x6

A

ACUTE
severe dyspnea, respiratory distress
cyanosis, tachycardia
rales, wheezes

67
Q

ARDS: hallmark features x2

A

REFRACTORY HYPOXEMIA

CXR - whited out w diffuse bilateral infiltrates

68
Q

ARDS: mgmt x4

A
  • mechanical ventilation
  • low TV: 5 - 7 or 6 - 8 ml/kg IBW
  • ↑ PEEP: 10 cm H2O
  • peak inspiratory flow 1 - 1.2L prn
69
Q

PaO2/FiO2 indicative of ARDS?

A

P/F less than 200 = shunting

- responsive to PEEP

70
Q

What’s the difference between Assist Control and Spontaneous Intermittent Mandatory Ventilation?

A

AC: preset TV & RR. Pt can breathe over set RR but gets preset TV.

SIMV: preset TV & RR, but pt can breathe over vent rate at whatever TV they pull.

71
Q

Continuous Positive Airway Pressure (CPAP) is…

A

spontaneous breathing at greater pressure than atmospheric

72
Q

Pressure Support is…

A

unassisted inspiratory support but preset airway pressure delivered with each breath

@ end of inspiration! (PEEP is end of expiration)

73
Q

What is PEEP + associated AE x2

A

maintains intrathoracic airway pressure above atmospheric throughout expiration
- recruits alveoli, ↑ ventilation & perfusion

AE: barotrauma, ↓ CO

74
Q

True of False: after ventilator TV has been established it is appropriate to change when patient’s status changes.

A

FALSE. Once a TV is set do NOT change it!

75
Q

What are the mechanical ventilation settings indicated for a patient that has acutely decompensated?

A

AC / FiO2 1.0 / RR 12 / TV 450
No PEEP
No Pressure Support

76
Q

What parameters need to be met in order to wean from mechanical ventilation? x6

A 
FiO2 0.4 + SaO2 gt 92%
SIMV: RR over vent rate
HDS (?)
Consult pulm/RT
Cough & gag reflex
77
Q

pleural effusion: gold standard for diagnosis

A

CXR: blunted costophrenic angles (shark fins)
lower than normal PaO2 r/t hypoxemia
PaCO2 r/t alveolar ventilation

78
Q

Pulsus paradoxus is seen in COPD: true or false?

A

FALSE. It is seen in asthma (greater than 12)

79
Q

pulsus paradoxus

A

exaggerated drop of SBP 10+ during inspiration

- along w ↓ pulse wave amplitude

80
Q

asthma: diagnostics test x4 and values x5

A

CBC + PFT + ABG + CXR

slight ↑ WBC + eosinophilia

PFTs: abnormalities typical of OBSTRUCTIVE dysfxn (FEV1 lt 30% / peak flow lt 60 L/min)

general improvement in FVC or FEV1 ~15% //OR// FEF 25-75 of 25% after inhaled bronchodilator

initially RESPIRATORY ALKALOSIS + mild hypoxemia

CXR unnecessary to r/o ddx, MAY show hyperinflation

81
Q

FEF 25-75

A

the avg forced expiratory flow during middle (25 - 75%) portion of FVC

it’s a PFT

82
Q

LABA BBWs

A

↑ association of asthma-related deaths d/t misuse

SABA is for rescue, NOT LABA

83
Q

Which drug class indicated for asthma rescue therapy + example?

A

SABA: albuterol (Proventil)

84
Q

SABA & LABA stand for…

+ example of each

A 
short-acting beta-2 adrenergic agonist
- albuterol (Proventil)
& 
long-acting beta-2 adrenergic agonist
- salmeterol (Serevent)
85
Q

SABA achieves what in asthma & COPD?

A

bronchodilation

86
Q

asthma inpt mgmt: inhalation sympathomimetics + dosages x3

A

alupent (0.3 cc in 5% sol) in 2.2 mL NS q 30 - 60min

proventil, ventolin 0.3 cc in 3 mL NS q 30 - 60 min

87
Q

asthma inpt mgmt: when to check ABG?

A

severe attack only, not necessarily for mild to moderate

88
Q

asthma inpt mgmt: corticosteroid for pt who do not respond to sympathomimetics dosage x1

A

methylprednisolone 60 - 125 mg IV x1

- then 20 mg IV q 4 - 6 hr until attack broken

89
Q

in-patient suffering from asthma attack does not respond to proventil - what is your next step?

A

administer corticosteroid: methylprednisolone 60 - 125 mg IV x1
- then 20 mg IV q 4 - 6 hr until attack broken

90
Q

asthma inpt mgmt: parenteral sympathomimetic & indication x1

A

aqueous epinephrine 1:1000 0.1 - 0.5 mL SQ q 30 - 90 min

- may repeat x4

91
Q

in-patient with asthma attack is fatigued and unable to take inhaled meds - what is your next step?

A

parenteral sympathomimetic: aqueous epinephrine 1:1000 0.1 - 0.5 mL SQ q 30 - 90 min
- may repeat x4

92
Q

asthma inpt mgmt: anticholinergic example + dosage x1

A

ipratropium bromide (Atrovent) MDI 2 - 6 puffs q 4 - 6 hrs

93
Q

status asthmaticus mgmt: 4 gold standard + 4 more

A 
GOLD STANDARD: 
IV D5 1/2NS
Intubation (pt looks bad)
Continuous pulse ox
ABG q 10-20 min

+

  • O2
  • methylprednisolone 60 - 125mg OR hydrocortisone 300 mg IV STAT
  • inhalation/parenteral sympathomimetics
  • consider atrovent
94
Q

Your status asthmaticus pt’s SaO2 begins to drop - what is your priority order?

A

ABG - monitor q 10 - 20 minutes

95
Q

chronic bronchitis: s/s x5

A 
intermittent mild - mod dyspnea
sputum: copious, purulent
percussion: normal
chest AP diameter: normal
stocky, obese habitus
96
Q

COPD is…

A

chronic bronchitis + emphysema

- pts usually have features of both -

97
Q

chronic bronchitis: typical pt profile x4

A
  • 35+ @ sx onset
  • stocky, obese
  • chest AP diameter normal

BLUE BLOATERS

98
Q

emphysema: typical pt profile x4

A
  • 50+ @ sx onset
  • thin, wasted
  • chest AP diameter increased

PINK PUFFERS

99
Q

emphysema: s/s x5

A 
progressive, constant dyspnea
sputum: mild, clear
percussion: normal
chest AP diameter: increased
thin, wasted habitus
100
Q

COPD: dyspnea in chronic bronchitis vs emphysema

A

chronic bronchitis: mild - moderate & intermittent

emphysema: progressive & constant

101
Q

bula & blebs on CXR indicative of (COPD)?

A

chronic bronchitis

102
Q

hematocrit in COPD

A
  • often ↑ if PaO2 less than 55 mmHg or nocturnal desaturation
  • most common in chronic bronchitis (but seen w emphysema)
  • evaluate for hypoxemia @ rest, exertion, sleep
103
Q

COPD: expected PFT *

A
  • FEV 1 * + other EXPIRATORY airflow measures REDUCED *

TLC, FRC, RV /may/ be increased

104
Q

COPD: diagnostics x3

A

PFT: ↓ FEV1/expiratory airflow + ↑ TLC, FRC, RV (maybe)
ABG: ↑ PaCO2, HCO3
CXR: low, flattened diaphragm

105
Q

COPD: expected ABG

A

↑ PaCO2 & HCO3

106
Q

mainstays of COPD mgmt (outpt)

A

inhaled –
ipratroprium bromide (Atrovent)
or
sympathomimetics

107
Q

COPD: inpt mgmt

A
  • O2 1 - 2L/min NC or venti @ 24-28%
  • pharm progression as for inpt asthma
  • purulent sputum = abx 7 - 10 days (ampicillin, amoxicillin, doxy, bactrim)
108
Q

inpt COPD + purulent sputum = x3 meds

A 
ampicillin or amoxicillin 500 mg QID
OR
doxy 100 mg BID
OR
bactrim 1T BID
109
Q

TB: s&s 4x classic + 3 more

A
  • MAJORITY ARE ASYMPTOMATIC*
  • weight loss
  • low grade fever
  • night sweats

fatigue, anorexia, dry cough progressing to productive and sometimes blood-tinged

110
Q

night sweats: 4 top ddx

A

TB
menopause
AIDS
endocarditis

111
Q

TB diagnostics*

A

*culture: M. tuberculosis x3 = definitive dx
* CXR: small, homogenous infiltrate in upper lobes (honeycomb)
AFB smears: presumptive evidence of active TB
PPD: shows exposure (NOT DIAGNOSTIC FOR ACTIVE DISEASE)

112
Q

TB: definitive diagnosis

A

culture of M. tuberculosis x3

113
Q

TB: stereotypical CXR presentation

A

small, homogenous infiltrate in upper lobes (honeycomb)

114
Q

TB: mgmt x3

A
  • notify health department of all cases

- hospitalization not required; consider if non-compliant or likely to expose others (place in negative pressure room)

115
Q

TB: hospitalization guidelines

A

not required; consider if non-compliant or likely to expose others
- place in negative pressure room

116
Q

TB: why are baseline LFTs important to establish with initiation of treatment?

A

INH is extremely hepatotoxic

117
Q

Which TB drug is associated with red-green colorblindness?

A

Ethambutol

118
Q

+ PPD: 3 levels

A

HIGH / 5mm: HIV+, case contacts, CXR typical for TB

MODERATE / 10mm: high risk groups - health care, prison, immigrants (high prev area), IVDU, CKD, DM, immune suppression

LOW / 15mm: all others (joe schmoe)

119
Q

pneumonia: s/s

A

lung consolidation on PE, increased fremitus
purulent sputum
fever, chills, malaise

120
Q

pneumonia: diagnostics x5

A 
CBC: ↑ WBC (low in immunocompromised & elderly)
CXR: infiltrates
sputum cx, gram stain
ABG: if resp failure suspected
consider blood cx: x3
121
Q

HCAP: definition x4 + common organisms (likely x2 + less x3)

A
  • hospitalized in acute care hospital 2+ days w/in 90 days of infection
  • resided in nursing home or LTCF
  • rec’d recent IV abx, chemo, wound care w/in past 30 days of infection
  • attended hospital or HD clinic

more similar to HAP than CAP

  • likely: Staph aureus, Pseudomonas
  • less: Strep pneumo, H flu, MRSA
122
Q

pneumothorax: s/s - hallmark x3 + general x4

A

hyper-resonance affected side (d/t air trapping)
diminished BS & diminished fremitus affected side
mediastinal shift toward unaffected (tension pneumo)

chest pain, dyspnea, cough, hypotension

123
Q

when is pulmonary angiography appropriate in PE?

A

when clinical data + VQ scan contradictory
OR
pt @ significant risk d/t anticoagulants have high probability VQ scan

124
Q

what is the key to diagnosis of pulmonary embolism?

A

clinical suspicion - history is crucial

125
Q

SVO2 normal vs in ARDS

A

normal: 60 - 80

in ARDS: higher (not using O2 received)

126
Q

types of pleural effusions & appearance x4

A

transudate: clear
exudate: creamy (protein/LDH)
empyema: pus
hemorrhagic: blood

127
Q

pleural effusion: exudate only lab features x3

A

1+ of these characteristics of the pleural fluid:

  • protein : serum ratio gt 0.5
  • LDH : serum ratio gt 0.6
  • LDH gt 2/3 upper limit of normal
128
Q

what happens with increased tidal volume

A

increased alveolar ventilation

129
Q

FVC

A

forced vital capacity

- volume of gas forcefully expelled from lungs after maximal inspiration

130
Q

FEV1

A

forced expiratory volume

- volume of gas expelled in first second of FVC maneuver

131
Q

FEV 25-75

A

forced expiratory volume

- maximal mid-expiratory airflow rate

132
Q

PEFR

A

peak expiratory flow rate

- maximal airflow rate achieved in FVC maneuver

133
Q

TLC

A

total lung capacity

- volume of gas in lungs after maximal inspiration

134
Q

FRC

A

functional residual capacity

135
Q

RV

A

residual volume

- volume of gas remaining in lungs after maximal expiration

136
Q

PFTs: obstructive vs restrictive diseases

A

obstructive: reduced airflow rates
- FVC, FEV1, PEFR

restrictive: reduced volumes
- TLC, FRC, RV

137
Q

PFTs: airflow rates x4

A

FVC
FEV1
FEV 25-75
PEFR

138
Q

PFTs: volumes x3

A

FRC
TLC
RV

139
Q

FVC vs FRC

A

forced vital capacity vs functional residual capacity
FVC: airflow
FRC: volume

140
Q

What happens to TLC and VC in older adults?

A

total lung capacity constant

↓ vital capacity bc ↑ residual volume

141
Q

What happens to AP diameter in older adults?

A

↑

142
Q

What happens re: thoracic percussion in older adults?

A

hyper resonance

143
Q

physiologic reasons pneumonia is more serious in older adults x5

A

alveoli collapse more easily
↓ cilia, cough reflex, response to hypoxia/hypercapnia
↑ mucus-producing cells

144
Q

most common causative agents of pneumonia in older adults x4

A

Strep pneumo, staph aureus

& gram negs: H flu, Moraxella catarrhalis, Klebsiella

145
Q

typical aspiration pneumonia CXR

A

localized to right middle lobe

146
Q

what pulmonary dysfunction is PEEP responsive?

A

shunting

147
Q

what’s the difference between pressure support and PEEP?

A

pressure support is at the end of inspiration

PEEP is at the end of expiration

0 BOARDS (14 decks)

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