Respiratory

Question 1

CAP Outpatient Tx (w and w/o co-morbidities)

Answer 1

w/o: high dose amox OR doxy OR macrolide

w/: augmentin OR 3rd gen cephalosporin (gram pos) + macrolide OR doxy (atypicals)

Question 2

Vent Strategy for Pulmonary Contusion

Answer 2

low tidal volumes

Question 3

Vent Strategy for COPD or Asthma

Answer 3

permissive hypercapnea

low RR and lower I:E ratio to dec air trapping

Plateau press < 30

Question 4

How do you manage asymptomatic drowning patient?

Answer 4

Obs x 6 hours

D/c if no hypoxia, normal CXR and remain asymptomatic

Question 5

What is normal pulmonary artery pressure?

Answer 5

25 mmHg or less

Question 6

How do you define massive hemoptysis?

Answer 6

> 50 cc in single cough OR > 600 cc in 24 hrs (TRANSFUSE)

Question 7

What is the #1 cause of Boerhaaave’s?

Answer 7

Iatrogenic - endoscopy

Question 8

Boerhaave’s CXR Findings

Answer 8

Air in mediastinum (double line around heart)

LEFT pleural effusion

Question 9

Where is the usual location of Boerhaave’s tear?

Answer 9

LEFT posterolateral wall (leads to left effusion)

Question 10

How do you treat tension pneumomediastinum?

Answer 10

sub-xiphoid incision to release air OR straight to operating room

Question 11

What pathogens are responsible for tracheitis in tracheostomy patient?

Answer 11

Staph, pseudomonas, Candida

Question 12

Tracheo-innonimate Artery Fistula

Answer 12

Life-threatening bleed 1-3 weeks after surgery

Mgt

• Hemostasis with digital pressure OR hyperinflation of tube cuff
• Call ENT
• Suction
• May need to re-intubate