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105 Cards in this Set
- Front
- Back
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1st step in asthma Tx
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remove offending agent
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bronchiectatic lung bugs
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h.influenzae, s.aureus, pseudomonas
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most common cause of hemoptysis
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TB
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hemoptysis, sinusitis, glomerulonephritis
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Wegener's granulomatosis
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dyspnea, hemoptysis, acute renal failure
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Goodpasture's
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S1-Q3-T3
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classic PE finding on EKG
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crunching sound occurring w/heartbeat
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Hamman's sign (pneumomediastinum)
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most common Sx of lung CA
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chronic cough
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lung CA not linked to smoking
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bronchoalveolar CA
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small cell lung CA Tx
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chemotherapy (rapid mitotic rate)
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small cell paraneoplastic syndrome
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SIADH, Eaton-Lambert, ectopic ACTH
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squamous cell paraneoplastic syndrome
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PTH
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non-small cell CA Tx
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surgery (local), chemo (mets)
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primary spontaneous pneumothorax etiology
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male smokers, tall for wt
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expiratory/inspiratory chest film more sensitive for pneumothorax
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expiratory!
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chronic cough
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>3 wks
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V/Q mismatch responds to...
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supplemental oxygen
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CO poisoning does/doesn't cause cyanosis
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does not
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hypoventilation scenarios
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apnea, Guillan Barre, MG, ALS
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most important determinant of oxygen delivery to tissues
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Hb
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light's criteria for exudate
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pleural:serum protein >0.5
pleural:serum LDH > 0.6 pleural LDH > 2/3 nl |
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transudate etiologies
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CHF, cirrhosis, nephrosis
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exudate etiologies
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tumor, trauma, infection
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low glucose in pleural fluid
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RA, empyema, tumor, TB
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high amylase in pleural fluid
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renal failure, esophageal rupture, tumor, pancreatitis
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pneumonia that looks worse than it is
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mycoplasma pneumoniae
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currant jelly sputum
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Klebsiella
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post-influenza pneumonia bug
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pneumococcus
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bulging fissure bug
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klebsiella
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high serum LDH bug
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PCP
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small gram (-) rods + halo
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h.flu
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adequate sputum sample
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<10 epithelial cells, >25 leukocytes hpf
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community-acquired pneumonia Tx
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macrolide
2nd/3rd-gen ceph (high risk) |
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pneumonia bugs causing bradycardia
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legionella, salmonella, chlamydia psittaci
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indication for steroid Tx for PCP
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A-a > 35
PaO2 < 75 |
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leading cause of death worldwide
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TB
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pregnant women & TB Tx
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wait until after delivery (unless high risk)
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status epilepticus + TB
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INH toxicity
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TB drug discoloring contact lens
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rifampin
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optic neuritis TB med
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ethambutol
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pink puffers
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emphysema
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blue bloaters
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chronic bronchitis
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only Tx for COPD to extend life
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supplemental oxygen
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asthmatic in respiratory distress w/nl ABGs
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impending respiratory failure; need to intubate
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cough 1st work-up step
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CXR
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pertussis immunity lasts...
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12 yrs
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massive hemoptysis
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bleeding > 600 ml in 48 hrs
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DVT dx gold standard
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angiography
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ischemic bowel dz dx gold standard
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angiography
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sudden onset severe SOB + pleuritic CP
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primary spontaneous pneumothorax
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pneumomediastinum
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alveolus/bronchus/trachea rupture
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mediastinitis tx
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high-dose penicillin, cipro, doxy
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horner's syndrome
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enopthalmos, ptosis, miosis, ipsilateral anhydrosis
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byssinosis
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cotton dust exposure
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farmer's lung IgX
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IgG
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facial swelling, dyspnea, cough, headaches, epistaxis, syncope
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SVC syndrome
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ARDS Tx
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oxygen does not work
mechanical ventilation w/PEEP |
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ARDS Dx
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1.PaO2/FiO2 < 200
2.B/L fluffy infiltrates 3.no CHF |
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dilation of medium-sized airways
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bronchiectasis
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hemopytsis Tx
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1.supplemental oxygen
2.bleeding side down 3.suppress cough (codeine) |
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pulmonary fibrosis
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V/Q mismatch
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improper oxygen utilization
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diptheria toxin, cyanide
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"cherry red" discoloration of lips & nails
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CO poisoning
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egophony
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1.consolidation
2.compressed lung above pleural effusion |
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parapneumonic effusion
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WBC>10,000 high PMNs
always exudates |
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pleural effusion WBC > 100,000
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empyema
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chest wall disorders
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restrictive lung disease
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HIV + diffuse B/L infiltrates
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PCP
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community acquired (atypical)
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1.chlamydia pneumonia
2.legionella pneumophila 3.mycoplasma pneumonia |
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hospital acquired
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1.pseudomonas
2.staph aureus 3.enteric |
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community acquired (typical)
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1.strep pneumoniae
2.h.flu |
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rusty sputum
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pneumococcus
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HIV, CD4 < 500
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TB
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HIV, CD4 < 200
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PCP, histo, crypto
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HIV, CD < 50
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MAC, CMV
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loeffler's pneumonia
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idiopathic eosinophilic pneumonia
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most TB infected people
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disease free
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anergy test
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1.mumps
2.candida |
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INH toxicity antidote
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pyridoxine
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pts taking INH need to check ? every month
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LFTs (hepatitis risk)
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centrilobular emphysema
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respiratory bronchioles
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panlobular/panacinar emphysema
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alpha-1-trypsin deficiency
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distal acinar emphysema
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spontaneous pneumothorax
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alpha-1-antitrypsin deficiency inheritance
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autosomal recessive
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hyperinflated lungs, flattened diaphragm
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emphysema
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MAT, R-strain
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emphysema
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emphysema / chronic bronchitis:
wt loss / CO2 retention |
emphysema - wt loss
chronic bronchitis - CO2 retention |
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severe asthma = wheezing yes/no?
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no wheezing (severe asthma)
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MDI / nebulizer reach smallest airways better?
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MDIs deliver smaller particles
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temporary hyperK+ Tx
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beta-2 agonists
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permissive hypercapnia
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allow pt to have high CO2 while intubated to increase expiratory phase & prevent breath stacking
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dries up bronchial secretions
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ipratropium
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obstructive sleep apnea
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>=5 episodes
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farmer's lung Tx
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steroids
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>15mm induration (TB test)
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everyone (+)
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>10mm induration (TB test)
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(+) if high-risk pop'n
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anterior mediastinum massees
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1.thymoma
2.teratoma 3.thyroid 4.terrible lymphoma |
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pleurodesis
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artifical obliteration of pleural space
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lung CA more common in women
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bronchoalveolar
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sympathetic nerve paralysis
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Horner's syndrome
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injured CN8, 1st & 2nd thoracic nerves & ribs, shoulder pain radiating to arm
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pancoast's syndrome
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lung CA responding to radiotherapy
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small cell
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immunocompromised, chronic steroid use
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1.TB
2.nocardia |
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always requires chest tube
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1.empyema
2.+ cultures 3.loculated effusion |
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preventive asthma meds
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1.leukotriene modifiers
2.mast cell stabilizers (cromyln) |
