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Hippos > Thoracic and Respiratory > Flashcards

Thoracic and Respiratory Flashcards

1
Q

What is the timeframe for an acute vs chronic cough?

A
  • Less than 3 weeks = acute

- More than 8 weeks = chronic

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2
Q

What, besides asthma/COPD causes wheezing? (5)

A
  • FB
  • PE
  • CHF
  • LRI
  • Allergies
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3
Q

What is singultus?

A

Hiccups

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4
Q

What are the three major causes of persistent hiccups?

A

Cancer
CNS
Metabolic

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5
Q

What are the three major causes of acute, self-limiting hiccups?

A
  • Distended stomach
  • Smoking
  • EtOH
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6
Q

What is the usual cause of death with massive hemoptysis?

A

Asphyxiation, not exsanguination

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7
Q

What is the general treatment for massive hemoptysis?

A
  • Intubation (mainstem)
  • Bad side down
  • Correct coagulopathy
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8
Q

What is the definition (in mL and in clinical terms) of frank hemoptysis?

A
  • 200 mL in 24 hours

- If spitting up whole, frank blood

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9
Q

Where is the bleeding from (which arteries) with massive hemoptysis?

A

Bronchial arteries that come directly off aorta to feed lungs

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10
Q

What is the primary cause of dyspnea/hypoxia 2/2 neuromuscular disorders?

A

Hypoventilation

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11
Q

What causes death with Guillain-barre syndrome?

A

Respiratory failure

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12
Q

How many grams of Hb are needed to be desaturated to cause central cyanosis?

A

5 grams

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13
Q

Can you have cyanosis and be profoundly anemic?

A

No

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14
Q

What two times is a tracheo-innominate fistula most likely to occur?

A

If new trach site, and if recently changed sizes/position/brand

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15
Q

Who investigates a trach bleed?

A

Surgeon in the OR where bleeding can be controlled. NOT in the ED.

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16
Q

What three techniques can be done to stop bleeding from a tracheo-innominate fistula?

A
  • Hyperinflate the trach tube
  • Lever the trach tube to apply pressure to the innominate artery
  • Digital pressure
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17
Q

What is the problem with airway management for an expanding neck hematoma? How do you manage these?

A
  • If paralyzed, strap muscles relax and may allow hematoma to move airway
  • Ketamine without paralytic, or awake intubation
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18
Q

What is the disposition for a child that you suspect has/had choking episode due to foreign body?

A

Admit for bronchoscopy

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19
Q

What is the most sensitive film for determining for a FB obstruction? What will these show if a FB is present?

A
  • Lateral decubitus views.

- If FB present dependent lung will NOT deflate as it should normally

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20
Q

What is the most common cause of isolated right and left sided pleural effusions respectively?

A 
RIght = CHF
Left = Aortic dissection or Boerhaave's
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21
Q

What are the three major risk factors for reexpansion pulmonary edema?

A
  • Large PTX
  • PTX present for long periods
  • PTX rapidly expands
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22
Q

What is the typical cause of an empyema?

A

Parapneumonic effusion from pneumonia

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23
Q

What is the role of anesthetic gases in asthma exacerbations?

A

Very potent bronchodilators

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24
Q

Do you put a chest tube into a COPD bleb?

A

No–will cause PTX, worsen breathing

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25
Q

How can you differentiate lobar collapse from PNU?

A

Lobar collapse will cause an elevated diaphragm, and appear like a well demarcated consolidation

26
Q

What is the reason to put a blue bloater on home oxygen?

A

To prevent lung scarring from chronic hypoxia

27
Q

What is ARDS? (3 elements)

A
  • PaO2 less than 60 mmHg with FiO2 over 0.5.
  • Normal heart function
  • Diffuse infiltrates on CXR
28
Q

What are the two most common causes of ARDS?

A
  • Trauma

- Sepsis

29
Q

What is the treatment for ARDS?

A

supportive with permissive hypercapnia

30
Q

What organism classically causes pneumonia in a COPD/smoker?

A

Haemophilus influenzae

31
Q

Who gets gram negative pneumonias?

A

People at risk for aspiration

32
Q

What is the classic HR finding with atypical pneumonias?

A

Relative bradycardia

33
Q

Which atypical organism can cause guillain -barre syndrome, Raynaud’s phenomenon, and/or associated with ramsay hunt syndrome?

A

Mycoplasma

34
Q

Staccato cough in a 6 week old = ?

A

Chlamydia pneumonia

35
Q

What extrapulmonary symptoms happen with legionella?

A
  • GI s/sx

- Hyponatremia

36
Q

Name the organisms and the abx for outpatient pneumonia.

A

Strep pneumo/atypicals

Macrolide

37
Q

Name the organisms and the abx for inpatient pneumonia.

A

Gram negatives

Fluoroquinolone

38
Q

Name the organisms and the abx for ICU pneumonia.

A

Pseudomonas/MRSA

Cefepime/vanco

39
Q

What is the course of disease with fungal pneumonia? Classic CXR finding?

A
  • Slowly progressive

- Bilateral infiltrates with perihilar nodes

40
Q

Where are the following fungal infections founds: coccidioidomycosis, Blastomycosis, histomycosis

A
  • Coccidioidomycosis = Southwest US
  • Blasto = southeast
  • Histo - mississippi river valley
41
Q

Pneumonia + skin lesion = what sort of organism?

A

Fungal

42
Q

Pneumonia + sheep/cow = ?

A

Q fever

43
Q

Pneumonia + parrots = ?

A

Chlamydia psittaci

44
Q

Pneumonia + mouse exposure in SW US = ?

A

Hantavirus

45
Q

Under what CD4 count can patients with AIDS get PCP pneumonia?

A

200

46
Q

Under what CD4 count can patients with AIDS get MAC pneumonia?

A

50

47
Q

Under what CD4 count can patients with AIDS get CMVpneumonia?

A

50

48
Q

Under what CD4 count can patients with AIDS get TB pneumonia?

A

over 200

49
Q

What do all patients with HIV and a CD4 count less than 200 get treated for regardless of CXR findings? Why?

A

TB

Can be asymptomatic

50
Q

What lab will be elevated with PCP pneumonia?

A

LDH

51
Q

What is the classic exam finding with PCP pneumonia? CXR appearance?

A 
Exam = desat with exertion
CXR = batwing
52
Q

Why are steroids so important to add with PCP pneumonia, and why does oxygen not improve sats well?

A

Unlike other pneumonias, the interstitium is inflamed and causes diffusion issue.

53
Q

What is the stain that classically shows PCP pneumonia?

A

silver stain

54
Q

What are the three abx used to treat PCP pneumonia?

A
  • Bactrim
  • Pentamidine
  • Dapsone
55
Q

What are the two classic side effects with pentamidine?

A
  • hypotension

- hypoglycemia

56
Q

What is the treatment for anthrax?

A

PCN or Doxycycline

57
Q

What are the skin manifestations of anthrax?

A

Necrotizing black eschar

58
Q

What animal is known to carry SARS?

A

Civet cat

59
Q

What are scrofula?

A

Lymphatic TB

60
Q

Why are pts with nephrotic syndrome and HIV more prone to PE/DVTs?

A

Lose antithrombin III and other anticoagulant proteins

Hippos (23 decks)

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