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42 Cards in this Set
- Front
- Back
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most important agent of neonatal pneumonia?
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group B Streptococcus (coagulase negative) - EARLY onset of pneumonia
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has early (within hrs after birth) and late (typically after 7 days) onset
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neonatal pneumonia
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Early onset of pneumonia agent
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group B Strep (coagulase negative)
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Late (typically after 7 days) onset of pneumonia agent
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oxacillin-resistant coagulase-negative Staphylococcus
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early stages of inflammation
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dilation of blood vessels, brings max amount of bld. Increase permeability (due to histamine, etc)
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pavementing
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white bld cells marginate and adhere to capillary wall
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diapedesis
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white bld cells after they adhere to capillary wall permeate through separated endothelial cells and into the tissue
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inflammatory infiltrate at different stages. composition?
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early stage - PMNs, shortly after Macrophages/monocytes. So, important to know if we are looking at content within hours or a day later.
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chronic inflammation?
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plasma cells and lymphocytes
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in chronic brochiectasis what bld vessel is often eroded?
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bronchial artery (supplies lung parenchyma)
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frank bld hemoptysis in pnt with bonchiectasis management
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occlusion (embolization) of bronchial artery
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in pregnant pnt uterus displaces diaphragm cephalad. anything a DO can do?
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myofacial diaphragm technique to increase diaphragmatic motion and improve breathing
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opioids classification
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antitussive, antidiarrheal, analgesic
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cystic fibrosis (CF). what type of dx is it?
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restrictive due to scarring (secondary to chronic infections)
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restrictive type of disease. how does it affect lung?
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decreased total lung capacity and vital capacity
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FEV1/TLC ratio decrease is characteristic of what type of dx?
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obstructive pulmonary dx (eg. COPD) when elevated intrathoracic pressure with forced exhalation leads to collapse of floppy airways
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in what type of dx the residual volume is elevated?
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obstructive (not restrictive) as air gets trapped behind collapsed airways
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cystic fibrosis (CF). what type of dx is it?
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restrictive due to scarring (secondary to chronic infections)
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restrictive type of disease. how does it affect lung?
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decreased total lung capacity and vital capacity
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FEV1/TLC ratio decrease is characteristic of what type of dx?
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obstructive pulmonary dx (eg. COPD) when elevated intrathoracic pressure with forced exhalation leads to collapse of floppy airways
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in what type of dx the residual volume is elevated?
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obstructive (not restrictive) as air gets trapped behind collapsed airways
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in addition to increased residual volume pnts with obstructive pulm dx show an increased RV/TLC ratio (not seen in restrictive dx)
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nota bene (RV is up more than TLC which is up as well)
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what peculiar side effect does rifampin have?
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its metabolite has orange color. thus, urine, tears, other secretions will turn orange
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in inhalation dysfunction use counterstrain point on/at_______
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midaxillary line at the level of the same rib (dysfunctional rib)
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only midaxillary or rib angles for ____ ribs
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inhaled and exhaled (correspondingly)
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asthma is more sever in pediatric pnts b/c their airways are of a smaller caliber. As pnt grows older, the caliber increases and less attacks will be seen
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nota bene. intrinsic and extrinsic triggers of asthma are just as likely to trigger a rxn in pnt of any age.
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at level T2-7 symp innervn of lungs
C3-5 phrenic n T1-5 heart T6-10 upper GI T10-L1 kidney |
nota bene ("KNOW your shit") in latin
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what is a hallmark of obstructive pulm dx? (loss of airway elasticity->collapse of small airways, trapping air, the amount of air to expire decreases (continued in answer)
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decreased FEV1/FVC (forced vital capacity) ratio
(trapped air increases residual volume and decreases forced vital capacity) FEV1 and FVC both decrease, yet there is still a decreased ratio |
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residual volume is increased in obstructive dx (air trapped) and decreased in restrictive (due to increased elastic recoil b/c of fibrosis)
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increased residual vol/total lung capacity (obstructive pattern)
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decreased total lung capacity?
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restrictive dx
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normal or increased total lung capacity?
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obstructive dx
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What technique is used to free restrictions of cranial sutures?
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V-spread technique
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septal hyphae with 45 degree branching?
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Aspergillus (in immunosuppresed)
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in neutropenic (few PMNs) pnt what ubiquitous 'sun og a gun' will get the pnt's lungs?
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Aspergillus
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small oval yeast with neck budding?
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histoplasmosis
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Amphotericin works how?
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binds to ergosterol in fungal membrane
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obesity related hypoventilation is called?
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Pickwickian syndrome (many DM pnts are obese too, but have to look at blood gas panel to exclude DM)
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how does it all come together in the lungs in Pickwickian syndrome?
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alveolar hypoxia induces vasoconstriction on the pulmonary vascular bed, causing high pulm resistance and hypertension. Thus R ventricular hypertrophy develops
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if aerosol beta2 agonists are being overused by an asthma patient, what would be expected as a side effect?
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paradoxic bronchoconstriction, b/c beta2 receptors are now being downregulated by the body in response to overstimulation. (tachicardia and inability to sleep -other SE)
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how is TB transmitted?
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aerosalized transmission (not through direct contact with bodily fluids)
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what is the drug of choice recommended for prophylaxis of Tuberculosis?
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isoniazid (if not tolerated rifampin is an alternative for monotherapy)
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what are some of the polytherapy Rx for TB?
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streptomycin, ethambutol, pyrazinamid
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