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33 Cards in this Set
- Front
- Back
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centrilobular emphysema seen in |
smokers |
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panacinar emphysema seen in |
anti trypsin deficiency |
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spirometery in COPD |
FEV1 decreased FEV1/FEV less tha 70% TLC increased RV increased |
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FEV1 in COPD |
<80% mild disease 50-80% moderate 30-50% severe >30 very severe |
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treatment for COPD (COPDERS) |
smoking cessation (prolongs survival) inhaled anticholinergic (first line) inhaled b agonist (SABA as first line and LABA) inhaled corticosteroids (fluticasone) oxygen (dec mortality) pulmonary rehab vaccination |
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treatment for COPD exacerbation |
b agonist and anticholinergics IV corticosteroids (methylprednisolone) antibiotics Oxygen (keep O2 sat at 90-93%) |
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spirometery in asthma |
decreased FEV1 decreased FEV1/FEV increase in FEV1 by 122% with albuterol |
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mild intermittent mild persistent moderate persistent severe persistent |
symptoms <2 per week symptoms not every day daily symptoms continual symptoms/frequent exacerbations |
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acute asthma treatment |
- b agonist with nebulizer - corticosteroids - IV magnesium |
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lung cancer with lowest association with smoking and most common type overall |
adenocarcinoma |
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time to consider a lung mass benign |
2 years |
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overall 5 year survival of lung cancer |
14% |
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treatment of NSCLC |
surgery only without distant metastasis radiation is an important adjunct |
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treatment for SCLC |
combo of radiation and chemotherapy |
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Light's criteria |
pleural protein/ plasma protien >0.5 pleural LDH/plasma LDH>0.6 LDH> 2/3 of serum LDH |
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primary simple pneumothorax |
high recurrence rate (50% in 2 years) |
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secondary complicated pneumothorax |
complication of underlying lung disease |
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sarcoidosis is a systemic granulomatous disease |
noncaseating granulomas |
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Symptoms of sarcoidosis AGRUELINGD |
ACE, granulomas, rheumatoid, uveitis, erythema nodosum, lymphadenopathy (bilateral hilar lymphadenopathy), idiopathic, non caseating granulomas, gammaglobulinemia, vit D increase |
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diagnose sarcoidosis |
transbronchial biopsy (must show non caseating granulomas) |
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treatment of sarcoidosis |
systemic corticosteroids most cases resolve in 2 years methotrexate for progressive disease |
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asbestosis found in |
lower lobes higher risk of bronchogenic carcinoma and malignant mesothelioma |
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silicosis |
upper lobes more common egg shell calcifications mining, stone cutting, glass manufacturing |
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hypoxemia tests |
- Aa gradient - response to supplemental oxygen - PaCO2 level |
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ventilation is monitored by PaCO2 |
change with RR or TV |
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oxygenation is monitored by O2 saturation |
change with FiO2 or PEEP |
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patients with ___ and ___ have highest risk of developing ARDS |
sepsis, septic shock |
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does ARDS improve with 100% O2? |
No- requires a high PEEP to prop open ariways with low TV Bilateral diffuse pulmonary infiltrates |
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AC ventilation |
delivers the highest level of PEEP to the lungs, risk of barotrauma patient can initiate breaths at a faster rate than backup rate all breaths are supported by ventilator |
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SIMV |
patients can breath above the mandatory rate without help of ventilator |
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CPAP |
no volume breaths are delivered but positive pressure is delievered |
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tracheostomy performed after ___ of being ventilator dependent |
2 weeks |
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Treatment of PE |
- O2 - anti coagulation immediately with LMWH - long term anticoagulation with warfarin or novel agents and continue for 3-6 months - tPA... maybe - IVC filter |
