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UW3 (2020) > UW3 (12 Pulm) > Flashcards

UW3 (12 Pulm) Flashcards

1
Q

Asthma diagnostic testing

  • PFT results? Test & result?
  • Active symptom
  • Inactive symptom
A

Active
FEV1 ↓ / FEV1 / FVC ↓
1) Bronchodilator
2) FEV1 ↑ > 15%

Inactive
PFT = n
1) Methacholine
2) FEV1 ↓ > 20%

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2
Q

Post Op Hypoxemia

Diagnosis?

1) Immediate / Stridor
2) Immediate / R↓ / Tv↓
3) Early / Wheeze
4) 1-5d / Fever / WBC ↑
5) 2-5d / Cough ↓
6) > 3d / Chest pain / HR ↑

A

1) Airway obst/edema
2) Residual anesthesia
3) Bronchospacm
4) Pneumonia
5) Atelectasis
6) PE

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3
Q

Pneumonia (recurrent / persistent)

Diagnostic? 2

A

1) CT – r/o neoplasm & obstruction

2) Flexible bronchoscopy

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4
Q

Inspiratory stridor
Barking cough
Hoarseness

  • Diagnosis?
  • Treatment? 3
A

Croup

1) Humidifier
2) Steroids
3) Epinephrine neb

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5
Q

Chronic cough

Diagnosis?

1) SOB + Stridor
2) Hoarseness
3) Rhinorrhea / Cobblestone @ oropharynx
4) Reflex w/ meals
5) Chest tightness / Triggers

A

1) TracheoMalacia
2) Laryngeal Nodule
3) Post nasal drip
4) GERD
5) Asthma

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6
Q

Solid Pulmonary Nodule

  • Diagnostic criteria? 4
  • Malignancy factor?
  • Diagnostic? 3
  • Management?
A
  • No Lymphadenopathy
  • Round opacity
  • < 3cm
  • Surrounded by Pul parenchyma
Malignancy factor
•	Size > 2cm
•	Old age
•	Female
•	Smoker
•	FH lung cancer
•	Upper lobe nodule
•	Spiculation
  • XR chest
  • Compare with prior image
  • CT if worsening
  • Nodule < 0.6cm = no FU
  • Nodule > 0.8cm + Malignancy = Biopsy, Surgical excision, VATS, PET
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7
Q

Post Op pulmonary complication risk? 4

A
  • COPD
  • Smoking
  • Sleep Apnea
  • HF
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8
Q

Cystic Fibrosis

Diagnostic criteria?

A

Sweat chloride test ⊕x2

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9
Q

Test for each disease

1) SCID (infectious diarrhea)
2) CGD = Bacterial & fungal infection @ skin / resp
3) CVID = Recurrent infection, bronchiectasis, constipation

A

1) Adenosine Deaminase ↓
2) DihydroRhodamine 123
3) Ig

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10
Q

Ventilator Pneumonia

Management? 2

A

1) Respiratory culture

2) Empiric therapy

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11
Q

Asthma exacerbation (treatment)

  • PEP/FEV1 > 40%? 3
  • PEP/FEV1 < 40%? 2
  • Severe? 3
A
  • PEP/FEV1 > 40%
  • SABA x3
  • Steroids PO
  • O2
  • PEP/FEV1 < 40% (add)
  • Iptratropium inh
  • Steroid IV
  • Severe (add)
  • MgSo4
  • Terbutaline / Epinephrine
  • Intubation / Vent
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12
Q

Asthma

  • Treatment response indication & FU
  • Good?
  • Incomplete?
  • Severe?
A
  • PEF > 70 > 1h + No distress
  • Stop SABA & Steroid PO
  • PEF 40-70 / Persistent symptom
  • Admit
  • PEF < 40 / pCO2 > 42 / Worsening
  • ICU = Intubation / Vent
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13
Q

Transient Tachypnea NewBorn

  • XR chest findings?
  • Treatment?
  • Course?
A
  • Hyperinflation / Flat diaphgram
  • Mild cardiomegaly
  • Vascular markings
  • Fluid @ fissure
  • Pleural effusion

• Support / O2

  • Resolve < 72h
  • No long term complication
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14
Q

COPD

Poor prognosis?

A

• FEV1 < 40%

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15
Q

Post Op Atelectasis

  • X-ray finding?
  • Treatment? 3
A

• XR chest: Linear opacity @ L+R lung base

  • CPAP
  • Chest PT
  • Suction
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16
Q

Bronchiolitis

  • Precaution?
  • Support care? 3
A
  • Contact
  • Droplet
  • IVF
  • Nasal bulb suction
  • Humidifiers
17
Q

Lung Cancer

Screening indication? 3

A

• LD CT chest

  • Age 55-80
  • 30+ ppy
  • Current smoker / Quit < 15y
18
Q

Allergic BronchoPulmonary Aspergillosis

  • Lab results? 4
  • XR chest findings?
  • CT findings?
  • Treatment? 3
A
  • Aspergillous IgE + IgG
  • IgE ↑ > 417
  • Eosinophilia > 500
  • Aspergillous skin test ⊕
  • Bronchiectasis
  • Bronchial wall thickening

• Central bronchiectasis

1) Steroid
2) Itraconazole
3) Voriconazole

19
Q

COPD

Antibiotic indication

A
  • (2+/3)
  • Sputum purulence ↑
  • Sputum volume ↑
  • Dyspnea
  • Mech Vent
20
Q

PE

1) EKG finding?
2) PE finding?

A

1) New RBBB

2) Tricuspid regurgitation

21
Q

Organ donor preservation method? 2

A
  • IVF

* Desmopressin

22
Q

OSA (children)

  • Cause?
  • Management?
A
  • Hypertrophy @ adenoid / Tonsil

* Tonsillectomy / Adenoidectomy

23
Q

Pulmonary Contusion

  • Complication? 2
  • XR chest finding?
  • Admission criteria? & management?
A
  • Respiratory distress
  • Hypoxemia
  • Irregular & local opacification
  • Admission @ symptoms
  • Monitor 24-48h
  • Pain control
  • Chest PT & suction
  • O2 / Vent
24
Q

Post Extubation Stridor (prevention)

A

Steroids before extubation

25
Q

Breathing pause

Diagnosis

1) Pause 5-10 sec?
2) Pause > 20s

A

1) Periodic breathing

2) Apnea of prematurity

26
Q

Acute Bronchitis

Management? 5

A

1) XR if pneumonia symptom
2) NSAID / Acetaminophen
3) Bronchodilator
4) No antibiotics
5) If chronic (cough > 3m in 2y) do PFT

27
Q

Pulmonary Embolism

Mortality association? 7

A
  • sBP < 90
  • HR > 110
  • R > 30
  • T < 86 ℉
  • O2 sat < 90% AMS
  • Confusion
  • Age > 80
28
Q

PE management

1) Anticoag
2) IVC
3) Thrombolytic
4) Embolectomy

A

1) Everyone / Unless CI to anticoag
2) Contraindication to ant-coag
3) ↑ mortality / Bleed risk ↓ / BP < 90
4) Shock
Imminent death
Failed thrombolytic

29
Q

tPA @ Pulmonary Embolism

  • Indications? 4
  • Contraindication? 4
A
  • Unstable
  • RV dysfunction
  • Large clot
  • R dardiac thrombous
  • IC neoplasm
  • Prior hemorrhage
  • Active bleed
  • Recent head trauma
30
Q

Pulmonary Nodule

Benign indication?

A 
Calcification
•	Popcorn
•	Concentric
•	Laminated
•	Central
•	Diffuse
•	Homogeneous

UW3 (2020) (19 decks)

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