Reading...
Play button
Play button
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;
71 Cards in this Set
- Front
- Back
|
What are the extrapulmonary manifestations of cystic fibrosis?
|
The extrapulmonary manifestations of cystic fibrosis include aspermia in males, recurrent partial intestinal obstruction, pancreatic insufficiency, and cirrhosis
|
|
|
List five causes of nodular or cavitary pneumonia?
|
Cryptococcus
Norcardia Bacterial lung abcess Neoplasm Aspergillus |
|
|
What is a catamenial pneumothorax?
|
Catamenial pneumothorax is described as repeated pneumothoraces in women developing within 72 hours of beginning menses.
|
|
|
What is the triad seen in fat emboli syndrome?
|
Bergman's triad (mental status changes, dyspnea, petechiae)
|
|
|
Which type of COPD is characterized by thin patients with no signs of cor pulmonale, minimal to no cough, hyperinflated lungs with decreased vascular markings, and increased total lung capacity?
|
Pink Puffer
|
|
|
On chest radiograph, the right hemidiaphragm is usually higher than the left. What are four reasons that there would be elevation of the left hemidiaphragm?
|
Unilateral hemidiaphragmatic paralysis
Displacement secondary to intraabdominal mass or ascites Loss of volume on affected side Subpulmonic effusion |
|
|
What are the mechanisms of metabolic alkalosis?
|
Decreased potassium, decreased hydrogen ions, excess HCO3, or chloride losing diarrhea
|
|
|
What is the most common cause of pneumonia in patients on the ventilator 4 days or less?
|
More than 50% of pneumonias in this setting will be secondary to Staph aureus, Strep pneumonia, or H. influenza
|
|
|
Is there a difference in the PO2 of venous versus arterial blood?
|
The PO2 will be lower in venous blood
|
|
|
What are the 3 classifications of bronchodilators drugs used with COPD?
|
Methylxanthines (theophylline)
Beta-adrenergic agonists Anticholinergic agents (atrovent will compete with ach at its receptors) |
|
|
List five causes of nodular or cavitary pneumonia?
|
Cryptococcus
Norcardia Bacterial lung abcess Neoplasm Aspergillus |
|
|
In what percentage of people will a primary spontaneous pneumothorax recur?
|
Approximately 50% of patients will have a second episode.
|
|
|
How is the venous pH different from arterial pH?
|
The venous pH is lower than the arterial pH
|
|
|
Which focal pulmonary fibrosis occurs first in the upper lobes with enlargement of the hilar lymph nodes and is characterized by multiple egg shell calcifications?
|
Silicosis
|
|
|
What is the definition of massive hemoptysis?
|
Massive hemoptysis is defined as greater than 600 ml of blood over 48 hours or sufficient enough to impair gas exchange
|
|
|
What is the definition of chronic bronchitis?
|
Chronic bronchitis is characterized by a productive cough on most mornings for three or more consecutive months for two or more consecutive years
|
|
|
Which DVT location is associated with the highest risk of a pulmonary embolus?
|
Deep vein thrombosis above the knee have the highest incidence of resulting in a pulmonary embolus
|
|
|
What is the definition of chronic bronchitis?
|
Chronic bronchitis is defined as the presence of a productive cough that persists for at least 3 months for 2 consecutive years.
|
|
|
What are the most common causes of massive hemoptysis?
|
Tuberculous cavitation
Pulmonary mycetomas Bronchiectasis Pulmonary alveolar hemorrhage Cystic fibrosis Neoplasms |
|
|
What is the most common symptom of a pleural effusion?
|
Dyspnea
|
|
|
Is there a difference between venous PCO2 and arterial PCO2?
|
The venous PCO2 will be higher than the arterial PCO2
|
|
|
What does the term 'blue bloater' describe?
|
Chronic bronchitis - these patients have chronic cough and peripheral edema secondary to cor pulmonale. They do not appear short of breath and do not feel oxygen deprived
|
|
|
What are the classic EKG changes seen in pulmonary embolism?
|
Tachycardia and S1Q3T3
|
|
|
What are the two general mechanisms of increased shunt fraction?
|
Under ventilation
-pneumonia -pulmonary edema -respiratory distress syndrome -mucous plugging Overperfusion -loss of pulmonary vasculature -massiv |
|
|
List five indications for intubation and mechanical ventilation?
|
Inadequate oxygenation
Inadequate ventilation Airway obstruction Airway protection Increased work of breathing |
|
|
Are lung transplants being performed in patients with cystic fibrosis?
|
Lung transplants are being done in patients with cystic fibrosis who have a FEV1 of less than 30% predicted value
|
|
|
Where is the cystic fibrosis gene locus found?
|
The cystic fibrosis gene locus is found on the long arm of chromosome 7
|
|
|
What is indicated by a V/Q mismatch <1?
|
A V/Q mismatch <1 means that the blood flow to a region exceeds the amount of alveoar gas in that region
|
|
|
What is the effect of pressure supported ventilation?
|
This decreases the work of breathing and increases spontaneous ventilation in patients with respiratory failure
|
|
|
What is the most common etiology of pneumothorax related to lung disease?
|
COPD
|
|
|
What happens to the PCO2 in respiratory alkalosis?
|
The PCO2 is decreased in respiratory alkalosis
|
|
|
What is the most common cause of a chronic cough in an immunocompetent patient?
|
In immunocompetent patients, chronic cough most commonly secondary to postnasal drip syndrome
|
|
|
What is the definition of a hemothorax?
|
Hemothorax is characterized by plural fluid with a hematocrit which is more than 50% of the systemic hematocrit
|
|
|
What are the most common chest radiograph findings in patients with asbestosis?
|
Interstitial fibrosis beginning usually at bases and progressing upwards without hilar adenopathy.
|
|
|
What is the other name for Hamman-Rich syndrome?
|
Idiopathic pulmonary fibrosis
|
|
|
What is the quantity of the normal daily water lost in respiration?
|
500-700 ml
|
|
|
What is the definitive test for a pulmonary embolus?
|
A pulmonary angiogram
|
|
|
What are the initial goals when a patient presents with massive hemoptysis?
|
Stabilize the airway
Maintain oxygenation Stabilize the vital signs Establish IV access |
|
|
What type of plural effusions develop after trauma or obstruction to the thoracic duct?
|
Chylous effusions can develop in this setting and are associated with plural fluid triglycerides > 115 mg/dL
|
|
|
Which sleeping disorder results from increased weight on the chest wall and diaphragm resulting in compression of the lungs during sleep?
|
Obesity hypoventilation syndrome
|
|
|
What are the eight mechanisms of development of pleural effusions?
|
Decreased oncotic pressure
Increased hydrostatic pressure Trauma or obstruction to the thoracic duct Decreased pleural pressure (such as a ptx) Obstructed lymphatic drainage Diaphragm abnormalities Iatrogenic Mic |
|
|
What are 3 causes of respiratory acidosis?
|
Intrinsic lung disease
Chest wall disease CNS depression of the respiratory center |
|
|
What percentage of patients on ACE inhibitors develop a dry chronic cough?
|
10-15%
|
|
|
Which two ventilator settings provide end expiratory pressure exceeding ambient barometric pressure, which can result in increased end expiratory volumes and improved V/Q ratios?
|
PEEP- postitive end expiratory pressure
CPAP- continuous positive airway pressure |
|
|
What is Mendelson's syndrome?
|
Chemical pneumonitis secondary to aspiration of stomach contents
|
|
|
On chest radiograph, the right hemidiaphragm is usually higher than the left. What are four reasons that there would be elevation of the left hemidiaphragm?
|
Unilateral hemidiaphragmatic paralysis
Displacement secondary to intraabdominal mass or ascites Loss of volume on affected side Subpulmonic effusion |
|
|
Oxygen therapy should attempt to maintain PaO2 just over 60mmhg. What are the two phases of oxygen toxicity?
|
Acute exudative phase
Chronic proliferative phase |
|
|
What are two common symptoms associated with oxygen toxicity?
|
Substernal chest pain
Non-productive cough |
|
|
What is the most common complication of pneumococcal pneumonia?
|
Empyema
|
|
|
If the PaCo2 of an arterial blood gas is increased by 10, what is the effect on pH?
|
PaCo2 increased by 10 = pH decreased by 0.08
|
|
|
What happens to the PCO2 in respiratory alkalosis?
|
The PCO2 is decreased in respiratory alkalosis
|
|
|
Which organisms most commonly cause nosocomial pneumonia?
|
Gram negative organisms (Pseudomonas, Klebsiella, E. coli, Enterobacter)
|
|
|
What are the Light's criteria for exudative pleural effusions?
|
Pleural fluid protein to serum protein ratio >0.5
Pleural fluid LDH to serum LDH >0.6 Pleural fluid LDH >2/3 upper normal of serum LDH |
|
|
Which disorder is characterized by central obstructive apnea during sleep and daytime somnolence?
|
Sleep Apnea syndrome
|
|
|
What are the blood gas findings of a mixed respiratory acidosis and a metabolic alkalosis?
|
These patients will have a near normal PH with increased HCO3 concentration and an increased PCO2 concentration
|
|
|
What percentage of malignant pleural effusions are transudative?
|
Approximately 10-20%
|
|
|
List nine causes of pleural effusions?
|
Pulmonary infection
CHF SLE/Rheumatoid arthritis Pancreatitis Trauma PE Renal disease Cirrhosis Malignancy |
|
|
How often do patients with cystic fibrosis have the 508th amino acid missing in the cystic fibrosis transmembrane regulator (CFTR) protein?
|
Approximately 70% of patients with cystic fibrosis will have this Delta F508 change
|
|
|
What are three aids to spontaneous ventilation and oxygenation that can be used in the setting of respiratory failure?
|
Continuous positive airway pressure
Pressure support ventilation Helium-Oxygen mixtures |
|
|
What is the most common cause of chylothorax?
|
Mediastinal tumors, most commonly lymphoma
|
|
|
What are five findings in atelectasis?
|
fever
decreased breath sounds tachypnea tachycardia increased density on CXR |
|
|
What should be the primary goal of the history and physical in a patient with hemoptysis?
|
Rule out the GI tract and nasopharynx as the source of bleeding
Estimate the quantity of bleeding Evaluate for etiology of hemoptysis |
|
|
Which occupation related disease is associated with the cotton industry?
|
Byssinosis
|
|
|
What is the triad seen in fat emboli syndrome?
|
Bergman's triad (mental status changes, dyspnea, petechiae)
|
|
|
How do you differentiate cardiogenic pulmonary edema from non cardiogenic pulmonary edema (ARDS)?
|
With pulmonary capillary wedge pressure which reflects the left ventricular filling pressure. The PCWP is normally 6-12 mmhg. This will be increased if pulmonary edema is secondary to cardiogenic causes, but will be normal in ARDS.
|
|
|
Which ventilator setting delivers a breath when the patient initiates a breath, and has a backup mechanism that delivers a breath if the patient does not initiate a breath?
|
Assist/Control ventilation
|
|
|
Which disorder is characterized by decreased vital capacity, normal expiratory flow rate, normal maximum voluntary ventilation, decreased TLC, decreased compliance, and decreased diffusion of carbon monoxide?
|
Restrictive ventilatory defect
|
|
|
What are 3 causes of respiratory acidosis?
|
Intrinsic lung disease
Chest wall disease CNS depression of the respiratory center |
|
|
What are the common pleural fluid findings in the setting of pleural effusions secondary to rheumatoid arthritis?
|
Glucose < 30
LDH > 1000 pH <7 |
|
|
Describe the findings of Cor pulmonale?
|
These patients have cough with prominent sputum production, persistent signs of right heart failure, frequent periods of profuse oxygen desaturation, and a depressed cardiac output.
|
|
|
What are the indications for placement of a chest tube?
|
Empyema
Loculation on the chest radiograph Pleural fluid glucose less than 40-50 mg/dL Positive culture or gram stain of pleural fluid |
