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43 Cards in this Set
- Front
- Back
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What is the best way to determine the severity of a pt's asthma attack? |
Peak expiratory flow rate. -Will be <75% predicted for age range. <40% predicted is ER worthy. |
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Described the statistics for bronchodilator response. |
->12% improvement in FEV1% ->12% improvement in FVC ->30% improvement in FEV25-75% |
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What can you expect to see on an ABG of an asthma pt and why? |
Respiratory Alkalosis. -This is because CO2 is acidic. During an asthma attack, the pt is blowing off more CO2 (hyperventilation) |
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If someone is allergic to albuterol, what can you use instead? Describe the MOA the SE's, and CI. |
-If allergic to albuterol, use ipatropium (Atrovent) -MOA: Activates the sympathetic nervous system to counteract the parasympathetic nervous system (which causes bronchoconstriction). -SE's: Inc thirst, urinary retention, blurred vision -CI's: glaucoma or BPH |
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What is Duoneb? |
-Also known as Combovent -Albuterol & ipatropium -Used for COPD and asthma exacerbations immediate relief |
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What is dangerous about theophylline? |
-Theophylline has a narrow TI - can cause arrhythmias and seizures -Higher dose is needed in those that are smokers |
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What are the S&S of sarcoidosis? |
Pulm: Dry cough, dyspnea, CP Skin: lupus pernio, erythema nodosum Eyes: Uveitis, conjunctivitis Other: CN 7 palsies |
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How can you dx sarcoidosis? |
Bx: Non-caseating granulomas CXR: hilar/ paratracheal LAD, ground glass opacities, reticular opacities Labs: Inc. ACE, hypercaliuria/ hypercalcemia, cutaneous anergy |
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What disease is honeycombing found in? |
Seen in CXR of idiopathic pulmonary fibrosis |
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How do you tx idiopathic pulmonary fibrosis? |
Lung transplant only cure |
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What is pneumoconiosis? |
-Occupational lung disorder caused by chronic inhalation of irritant -Irritant = fibrosis = restrictive dz |
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What are the CXR manifestations of pneumoconiosis? |
-Multiple, small nodular opacities mostly in the upper lobes -Egg shell calcifications -Hilar LAD |
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What is mesothelioma? |
A type of CA usually caused by occupational exposure. Will occur on any pleural surfaces - MC is the lung. 80% due to chronic asbestos exposure. |
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How do you dx mesothelioma? |
Pleural biopsy via VATS |
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What is transudative fluid? |
-Extravascular fluid with low protein |
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What is the MC cause of transudative pleural effusion? |
CHF |
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What is exudative fluid? |
Occurs when inflammatory processes change vascular permeability = usually infectious |
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What is a companion line? |
A faint line that usually runs parallel to the ribs in pt's with pneumothorax |
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What are possible SE's to isonazid? |
-Peripheral neuropathy (prevent w/ B6) -Hepatitis (esp after 35+ y/o) |
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What are SE's to rifampin? CI? |
-SE: yellow colored secretions, thrombocytopenia -CI: NNRTI tx |
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What are the SE's of pyrazinamide? CI? |
-SE's: hepatitis, hyperuricemia, photosensitivity rash -CI: caution in gout pt's |
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What are the SE's of Ethambutol? |
-Optic neuritis/ vision cx's -Peripheral neuropathy |
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What is the MC cause of bronchiolitis? |
RSV |
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What is bronchiolitis obliterans? |
Chronic inflammation of the bronchioles usually caused by lung transplant rejection of occupational exposure |
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What are the two MC complications of bronchiolitis? |
-OM caused by s. pneumo -Asthma later on in life |
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What can you give to at risks groups to prevent RSV bronchiolitis? |
Palivizumab |
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What is the MC cause of bronchitis? |
Adenovirus |
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What is the MC cause of croup? |
Parainfluenza virus |
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What are the S&S of croup? |
-Barking/ seal cough -Stridor -Dyspnea -Hoarsenesss |
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How do you tx croup? |
-Humidified mist -Steroids -Nebulized epi if severe |
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What is the MC cause of epiglottitis? |
H. Flu type B (HIB) |
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What are the S&S of epiglottitis? |
-3 D's: Dysphagia, drooling, dyspnea -Tripod position -Odynophagia |
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How do you dx epiglottitis? |
-Lateral C-spine: Thumb print sign -Laryngoscopy = G.S. |
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How do you tx epiglottitis? |
-Dexamethasone steroids -2nd/3rd generation cephalosporin & ampicillin/ PCN for Staph coverage |
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What is the MC cause of whooping cough (pertussis) |
Bordetella pertussis |
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How do you dx whooping cough? |
-Can do nasal swab if w/in 3 wks of sx onset -CBC: severe lymphocytosis |
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How do you tx whooping cough? |
Supportive, abx show no effect on duration |
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How do you prophylax for whooping cough? |
-Erythromycin/ azithromycin |
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What is the MC complication of whooping cough? |
Pneumonia |
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What are the RF for infant respiratory distress syndrome? |
-Caucasian -Male -Premature -Multiple births -Perinatal infections -Maternal DM |
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What will a CXR of infant respiratory distress syndrome show? |
-Reticular, ground glass opacities -Air bronchograms |
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How do you tx infant respiratory distress syndrome? |
-If premature delivery is expected, tx with steroids -Can give exogenous surfactant post-delivery. |
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An asymptomatic 70 year old male presents to the clinic for pre-operative evaluation. Chest x-ray reveals a two centimeter solitary lung nodule. Which of following is the most likely diagnosis? |
Granuloma - Over 70% of benign solitary nodules are granulomas |
