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27 Cards in this Set
- Front
- Back
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Indicators of Severe Asthma Attack
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Normal PCO2 levels (should be depressed from hyperventilation)
Speech diffiuclty, Diarphoresis, AMS, Cyanosis & SIlent Lungs |
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Restrictive Lung Dzs: Mechanical vs Ts:
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Increased Functional Reserve Capacity in Mechanical
Mechanical --> Ankylosing Spondylitis |
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Why is excess O2 bad for COPD:
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blunted hypoxic drive
oxygenated hemoglobin has higher CO2 affinity (Haldante effect --really?) causes pulmonary vasodilation --> increased dead space ventilation --> worsens V/P mismatch |
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O2 Therapy & COPD
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Oxygen improves COPD lifespan
INdications PaO2 <55, SaO2 <88, Hematocrit >55% even more beneficial than vaccines apparently |
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pt with cirrhosis has pleual effusion
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think hepatic hydrothorax = loss of albumin
salt restriction & diruetics --> TIPS |
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best way to follow pt with Guillian Barre
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is through serial measurements of vital capacity (as much as you can suck in to as much as you can blow out)
Tx: IVIG & Plasmapheresis CSF reveals elevated protein without elevated cellularity or change in glucose |
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progressive dyspnea, dry cough & "Velcro-like" inspiratory crackles-->
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ideiopathic pulm fibrosis
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Tx for ARDS:
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Low Tidal Volumes ~6ml/kg (so normally ~400mL) (prevents barotrauma) +
& PEEP up to 15 mmHg to keep alveoli from collapsing |
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Diagnostic Criteria: ARDs
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Acute onset, patchy bilateral arispace dz (CXR), PCWP <18, or no clinical evidence of LVEDP, PaO2/FiO2 <200
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inspiration vs expiration in those pulmonary flow graphs
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inspiration is on top expiration is on bottom
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differentiating COPD from asthma
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bronchodilator challenge increases FEV1 in asthma but not COPD
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Differentiating types of restrictive diseases
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Diffusion of CO:
Normal: chest wall weakness (neuromuscular) decreased: interstitial lung disease |
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bradycardia, AV block hypotension, diffuse wheezing
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--> beta blocker OD
Tx: glucagon |
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glucose in pleural exudate
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30-50: lots of thigns incl. malignancy, SLE TB, eosphageal rupture
<30: empyema or rhematic effusion with active WBC's |
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Hemothorax vs Pneumothorax
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Hemo: neck veins collapsed
Pneumo: neck veins engorged |
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Signs of consolidation:
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E-->A, Prominent expiration, dullness to percussion, often crackles
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Aspirin Exacerbated Respiratory Dz:
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asthma, chronic rhinosinusitis c nasal polyps, bronchospasm or nasal congestion following aspirin or NSAIDs; surgery is palliative, but avoid aspirin and NSAIDs
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increase in PCO2 + decrease in PO2
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= alveolar hypoventilation
NB most other things which cause a decrease in PO2 would cause an increase in PCo2 from hyperventilation |
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PAO2 =
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(FiO2 x (Patm - PH2O)) - (PaCO2/R)
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Cancer inside the Nose
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Nasopharyngeal Carcinoma
Extremely linked to EBV usually metastatic at presentation |
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recurrent URI, persistent nasal discharge, & bilateral nasal polyps
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--> CF
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Pt has subcutaneous emphysema
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-->knee jerk CXR for Pneumothorax
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Pt with COPD treated for pneumonia now has Headaches, insomnia, nausea, vomiting and arrhtymia
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Erythromycin or Ciprofloxacin --> altered theophylline metzm --> Theophyllin toxicity
Theophyllin Toxicity: CNS, GI, Cardiac toxicities |
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Pulmonary Renal Sros:
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Goodpasture - circulating anti-glomerular BM abs Tx with Plasmapheresis
Wegeners' Polyarteritis Nodosum Idiopathic rapidly proegressive glomerulonephritis SLE |
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COPD + infeciosu exacerbation
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Even receives corticosteroids as a 2 week taper.
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list the light criteria for exudate vs transudate
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fluid protein/serum protein ratio >0.5, fluid LDH/serum LDH >0.6, pleural fluid LHD greater than 2/3 ULN of the serum LDH
if exudate: complivated vs uncomplciated complicated: positve gram stain, positive cx, pH <7,2, glucose <60, & requires chest tube drainage, more likely to progress to empyema/be unresponvie to abx always drain if pH <7.2 OR glucose <60 = diagnostic for empyema. |
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high mixed venous o2 saturation with shock
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spetic shock (hyperdynamic circulation, inability of
ts to access o2, inproper distribuption of Cardiac Output) |
