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40 Cards in this Set

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