TB, PE, Sleep Apnea DSA Flashcards
necrotizing granulomatous disease with ziehl-neelsen staining
mycobacterium tuberculosis
TB
primary TB
Dx - tuberculin skin test
-fever, SOB, non-prod cough, erythema nodosum
CXR opacities in midlung with hilar lymphadenopathy
ghon complex
primary TB
-small calcified scar in midlung fields and associated hilar node
ranke complex
late fibrocalcific lesions of lung and hilar node
progressive primary TB
failure to develop immunity
-children, elderly, immunocompromised
reactivation TB
pulmonary, pleural, miliary, meningitis, pericarditis, lymphadenitis, peritonitis, GI, renal, vertebral osteomyelitis
miliary TB
small dots everywhere
latent TB diagnosis
PPD induration based on patient risk
interferon gamma release assay IRGA
active TB diagnosis
acid fast sputum smear and culture
latent TB infection Tx
INH for 6-9 months
active TB infection Tx
INH, rifampin, ethambutol, pyrazinamide for 2 months
followed by INH/rifampin for 18 weeks
pulmonary embolism
obstruction of pulmonary a by material traveled to lung
DVT, fat, amniotic fluid
venous thromboembolism
3rd most common cause of CV death after MI and stroke
risk fx for venous thromboembolism
age, obesity, cancer, surgery, immobile
virchows triad
hypercoag
factor V mutation
protein C
protein S
antithrombin III
dyspnea, tachypnea, hypoxemia, pleuritic chest pain, cough, anxiety, syncope, split second heart sound, leg swelling
PE
D-dimer
PE test
CT pulmonary angiography
for PE
V/Q scan
inhale xenon or technetium
IV technetium albumin
results - high, intermediate, or low probability
for pt allergic to contrast or during pregnancy
ultrasound of lower extremities
for DVT
PE EKG
S1Q3T3 pattern, RBB, limited sensitivity
more commonly - sinus tachycardia
Tx for PE
anticoag - heparin, low MW heparin, warfarmin, rivaroxaban
if severe - thrombolytics
cyclic obstruction of upper airways during sleep with disturbed sleep
-daytime sleepy and loud snoring
sleep apnea
obstructive apnea
absent airflow for at least 10 seconds with continued vent effort
hypopnea
partial obstruction
dx of sleep apnea
polysomnohraphy
-EEG, EKG, resp effort, O2 levels, electro-oculography
tx for sleep apnea
CPAP
O2
weight loss
tracheostomy
prognosis of sleep apnea
increased risk of long term mortality in middle aged men
high risk - with HTN association
