Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
50 Cards in this Set
- Front
- Back
RLD: extrapulmonary causes
|
-muscular dystrophy
-kyphoscoliosis -obesity hyperventilation syndrome |
|
RLD: parenchymal diseases (interstitial lung disease)
|
-Ideopathic pulmonary fibrosis
-Systemic disease -hyaline membrane disease -ARDS -autoimmune disease -environmental & occupational -infections -drug induce |
|
Hyaline membrane disease: aka infant resp. distress disease
|
-primarily pre-mature infants
-inadequate surfactant - |
|
hyaline membrane disease
|
-decreased air movement heard on auscultation
-tachypnea -cyanosis |
|
Hyaline membrane disease: CXR shows:
|
-bilateral atelectasis
-hypoextension and domed diaphragm |
|
Fetal lung maturity
|
indicated by:
-lecithin/spingomyelin ratio >2 -presence of phosphatidyl glycerol |
|
Treatment of hyaline membrane disease in the premie:
|
-antenatal cortiscosteroid admin. to mother more than 24 hours prior to birth
-intratracheal exogenous surfactant Tx has a synergistic effect |
|
Adult resp. distress syndrome
|
-acute onset of resp. distress
-decreased arterial pO2 and HbO2 saturation -CXR shows diffuse pulmonary infiltrates without evidence of L heart failure |
|
Causes of ARD
|
-Infection - sepsis
-diffuse Pul. infx -gastric aspiration -O2 toxicity |
|
ARD clinical features
|
-dyspnea
-crackles, rhonchi, and or wheezes -cyanosis |
|
DX of ARD
|
-must have high suspicion of dyspnea in setting known to cause
-ABG shows acute resp. alkalosis -CXR shows bilat. infiltrates similar to tose of CHF but heart is normal size |
|
Sarcoidosis
|
systemic disease characterized by non-caseating epithelioid granulomas
|
|
Sarcoidosis
|
-decreased CD4+ lymphocytes
-increased CD4+ lymphos in bronchoalveolar lavage fluid |
|
Sarcoidosis S/S
|
-cough and dyspnea
-fatigue -arthralgias -fever (high or low) -weight loss |
|
Other manifestations of Sarcoidosis
|
Skin: erythema nodosum
Liver: granulomas Cardiac: Dysrhythmias, CHF Neurologic: HA, CN palsies, meningitis, seizures Renal: RF, hypercalcemia, |
|
Heerfords's syndrome aka Uneoparotid fever
|
triad of:
-uveitis -parotis -CN7 palsy |
|
Lofgren's syndrome
|
triad:
-erythema nodosum -hilar adenopathy |
|
DX of sarcoidosis
|
-hypergammaglobulinemia
-PFTs show decreased compliance -CXR shows b/l hilar adenopathy -Kveim test is + -Serum ACE levels are increased |
|
Treatment of Sarcoidosis
|
-steroids with held as long as poss.
|
|
Prognosis of Sarcoidosis
|
-1/3 remit spontaneously
-1/3 remain stable at some level -1/3 progress withh 10% developing severe restrictive pulmonary |
|
Pneumoconiosis
|
3 major:
-asbestos -silica -coal dust |
|
Asbestos
|
-restrictive manifestations range from pleural effusion to slowly progressing pulmonary fibrosis
-inc'd risk of lung CA and plural mesothelioma -latency from asbestos exposure to Lung CA is 20-40 years |
|
Silicosis
|
-silica exposure
-found in sand -produces lung inflammation and massive pulmonary fibrosis -CXR shows eggshell calcification of hilar nodes |
|
Coal dust
|
-black lung
-concurrent exposure to silica |
|
Emboli
|
-air embolus
amniotic fluid -fat embolus -foreign body -tumor cell embolus |
|
Risk factors for PE
|
-non-ambulatory
-recent sx -woman on oral contraceptives that smokes -obesity -CA -Hereditary ypercoagulability -dehydration |
|
Sarcoidosis
|
systemic disease characterized by non-caseating epithelioid granulomas
|
|
Sarcoidosis
|
-decreased CD4+ lymphocytes
-increased CD4+ lymphos in bronchoalveolar lavage fluid |
|
Sarcoidosis S/S
|
-cough and dyspnea
-fatigue -arthralgias -fever (high or low) -weight loss |
|
Other manifestations of Sarcoidosis
|
Skin: erythema nodosum
Liver: granulomas Cardiac: Dysrhythmias, CHF Neurologic: HA, CN palsies, meningitis, seizures Renal: RF, hypercalcemia, |
|
Heerfords's syndrome aka Uneoparotid fever
|
triad of:
-uveitis -parotis -CN7 palsy |
|
Lofgren's syndrome
|
triad:
-erythema nodosum -hilar adenopathy |
|
DX of sarcoidosis
|
-hypergammaglobulinemia
-PFTs show decreased compliance -CXR shows b/l hilar adenopathy -Kveim test is + -Serum ACE levels are increased |
|
Treatment of Sarcoidosis
|
-steroids with held as long as poss.
|
|
Prognosis of Sarcoidosis
|
-1/3 remit spontaneously
-1/3 remain stable at some level -1/3 progress withh 10% developing severe restrictive pulmonary |
|
Pneumoconiosis
|
3 major:
-asbestos -silica -coal dust |
|
Asbestos
|
-restrictive manifestations range from pleural effusion to slowly progressing pulmonary fibrosis
-inc'd risk of lung CA and plural mesothelioma -latency from asbestos exposure to Lung CA is 20-40 years |
|
Silicosis
|
-silica exposure
-found in sand -produces lung inflammation and massive pulmonary fibrosis -CXR shows eggshell calcification of hilar nodes |
|
Coal dust
|
-black lung
-concurrent exposure to silica |
|
Emboli
|
-air embolus
amniotic fluid -fat embolus -foreign body -tumor cell embolus |
|
Risk factors for PE
|
-non-ambulatory
-recent sx -woman on oral contraceptives that smokes -obesity -CA -Hereditary ypercoagulability -dehydration |
|
thromboemboli arise from:
|
-ant. and post. tibial veins
-peroneal vein NOT great or small saphenous |
|
thromboemboli propogate proximally into the:
|
-popliteal vine
-ileofemoral vein to form a proximal DVT |
|
S/S of DVT
|
(50%) have NO symptoms
-dull ache -distention -homan's sign |
|
Sx of PE
|
-dyspnea
-tachypnea -tachycardia -cough, wheezing, crackles, hemoptysis, -accentuated P2 -homan's sing |
|
Lab findings of DVT or PE
|
-CXR: can r/o other dx
-ABGs: hypoxemia, usually resp. alkalosis due to hyperventilation -ECG: sinus tach non-specific ST segment changes T wave changes |
|
ECG
|
S1Q3-T3:
-s wave in Lead I -Q wave in lead III -T wave inversion in lead III ALL abnormalities must be present at once |
|
DX of DVT:
|
-Plasma D-dimer level
-doppler -MRI with gadolinium |
|
DX of PE
|
-spiral CT
-pulmonary angiography -V/Q scan - |
|
Treatment of PE
|
Best: prevention
-heparin -coumadin |