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40 Cards in this Set
- Front
- Back
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Interstitial lung disease
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– Velcro crackles, inspiratory squeaks
– reticular CXR at bases and honeycombing in advanced – give steroids |
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Sarcoidosis
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– increased Ca in serum and urine
– RA and uveitis – increased AP (liver) |
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Hypersensitivity pneumonia
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– acute (fever) and chronic (fine rales)
– CXR shows military nodular infiltrate (acute) or fibrosis of upper lobes (chronic) – give steroids |
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Asbesteosis
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– linear opacities at bases and pleural plaques
– results in more bronchogenic carcinoma than mesothelioma |
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Coal mine disease
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– small nodular opacities in upper lung
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Silicosis
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– from mines
– small nodular opacities in upper lung and eggshell calcifications – increased risk of TB |
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Berylliosis
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– high tech
– diffuse infiltrates w/ hilar adenopathy – needs chronic steroid treatment |
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Theophilline
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– decreases camp but narrow therapeutic window (cardio and neuro tox)
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Bronchiectasis CXR and CT
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– increased brohcovascular markings, tram lines, and honeycombing
– ballooned cysts at end of bronchus on lower lobes |
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COPD ABG
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– hypoxemia w/ actue respiratory acidosis (increased CO2)
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Increased A-a gradient
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– suggests v/q mismatch or diffusion impairment
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Increase O2 sats vs. help hypercapnic patients on vent
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– increase FIO2, PEEP, and I/E ratio
– increased minute vent w/ TV or RR |
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ARDS ratio and tx
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– PaO2:FiO2 < 200
– Vent w/ low TV and PEEP – goal is FiO2 < 0.6, PaO2 > 60 and sats > 90 |
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PE ABG
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– hypoxia and hypocarbia w/ respiratory alkalosis
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When do you resect lung nodules?
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– < 35 or change in size or character
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SCLC
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– central and neuroendocrine in nature
– can cause peripheral neuropathy or subacute cerebellar degeneration |
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Adenocarcinoma
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– peripheral
– can cause thrombophelbitis and nonbacterial verrucous endocarditis |
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Bronchoalveolar
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– multiple nodules and prolific sputum
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Large Cell
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– gynecomastia
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Bronchogenic carcinoma
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– most likely to do SVC syndrome
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Histo CXR
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– calcified nodes but no cavitary lesion
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Exudative effusion
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– Pleural/serum protein > 0.5
– Pleural/serum LDH > 0.6 – LDH greater than 2/3 serum ULN – pH < 7.35 |
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When do you place chest tube w/ effusion?
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– if pH < 7.2
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Pleural effusion w/ glucose < 60?
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– likely parapneumonic effusion, TB, or RA
– TB will have high adenosine deciminase |
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ASA sensitivity syndrome
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– psedo allergic
– wierd PGE/LT ratio – use LT receptor antagonist |
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Sub-Q emphysema is astmatics
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– benign, but get CXR to rule out pneumo
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Dementia w/ recurrent pneumonia
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– impaired epiglottis function
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Alveolar proteinosis
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– accumulation of material for unknown reason but its PAS + and total BAL will cure
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Aspergilloma
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– mobile cavitary mass w/ intermittent hemoptysis
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How do you treat exercise induced asthma?
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– b-agonists and mast cell stabilizers
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COPD w/ catastrophic worsening
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– suspect pneumo w/ dilated apical airspaces
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CAP inpatient and outpatent drugs (Q-bank)
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– Levo or Gent
– Azithro or doxy |
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Auto-PEEP
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– when you get hypotension w/ the ventilator
– decrease VT |
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Hypertrophic osteoarthopathy
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– chronic proliferative periostitis of long bones, clubbing, and synovitis
– seen w/ lung cancer |
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DLCO in COPD
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– decreased in emphysema
– normal in COPD |
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Massive hemoptysis Dx
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– rigid bronch so you can treat
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Legionella pneumonia
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– elderly w/ ab pain, hyponatremia, and confusion
– failed to respond to b-lactam |
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Pneumonia that doesn’t heal for 2 weeks
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– get CT then bronch to look for abscess or blockage
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Where is a post aspiration lung abscess and how do you treat it
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– posterior R upper or apical R lower
– give clinda or Amp + metro |
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Blastomycosis
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– blasts lung, skin, and bone
– Wisconsin and Ohio and Mississippi river valleys |
