Step 2 Dit: Resp (Combined)

Front 1

vasodilating effects:
Hydralazine

Back 1

arterial

Front 2

vasodilating effects:
NGN

Back 2

venous

Front 3

vasodilating effects:
DHP CCB's

Back 3

venous & arterial

Front 4

vasodilating effects:
Nitroprusside

Back 4

venous & arterial

Front 5

Rx for cluster headache

Back 5

100% O2

Triptans

Ergotamines

Front 6

Rx for iron overdose

Back 6

deferoxamine

Front 7

what is pulsus paradoxus & what pathologic process is it a/w

Back 7

fall in systolic BP of >10mmHg with inspiration

cardiac tamponade
hyperinflation d/o's (e.g. COPD, asthma)

Front 8

what pathologies are a/w muffled "hot potato" voice

Back 8

epiglottitis

peritonsillar abscess

Front 9

signs of peritonsillar abscess

Back 9

deviated uvula

trismus (i.e. "lockjaw")

muffled "hot potatoe" voice

drooling

Front 10

Tx for peritonsillar abscess

Back 10

Needle aspiration or I&D

pain meds

antibiotics (e.g. augmentin, clindamycin)

Front 11

what is a normal Aa gradient

Back 11

5-15 mmHg

Front 12

what are some causes of high Aa gradient

Back 12

PE
Pulm Edema
R to L shunt
ARDS

Front 13

what are the feared complications of untreated streptococcal pharyngitis

Back 13

rheumatic heart disease
PSGN

Front 14

what is time frame for bacterial sinusitis to be "chronic" & Rx for chronic bacterial sinusitis

Back 14

> 3 months of sx's

oral steroids
oral antibiotics x 3-6 weeks (augmentin or clindamycin)
intranasal saline irrigation
intranasal steroids indefinitely

Front 15

next step in nasal polyps that are refractory to steroids

Back 15

surgical debulking

Front 16

what are some complications of sinusitis

Back 16

meningitis
abscess
orbital infections
osteomyelitis

Front 17

classic presentation of allergic fungal rhinosinusitis

Back 17

chronic rhinosinusitis

Front 18

pathology of allergic fungal rhinosinusitis

Back 18

sinuses opacified with thick "allergic mucin" that is colonized with fungus

Front 19

what is the typical time frame after which acute bacterial sinusitis is the cause of purulent nasal discharge

Back 19

7+ days

(FYI: less than 7 days is viral)

Front 20

helpful sx to differentiate common cold from the flu

Back 20

myalgias = flu

Front 21

what is complication of mis-diagnosing CMV-Mono for Strep throat

Back 21

Amoxicillin (i.e. tx for strep throat) + CMV-mono -->

HEAD-TO-TOE RASH -->

often leads to subsequently 2nd mis-diagnosis of allergy to amoxicillin

Front 22

reversal agent for heparin

Back 22

protamine sulfate

Front 23

antihypertensive contraindicated in:
COPD

Back 23

nonselective B-blockers

Front 24

antihypertensive contraindicated in:
bilateral renal stenosis

Back 24

ACEIs/ARBs

Front 25

antihypertensive contraindicated in:
pregnancy

Back 25

ACEIs/ARBS

(FYI: allowed = hydralazine, methyldopa, labetalol, & nifidepine)

Front 26

antihypertensive contraindicated in:
advanced renal failure

Back 26

ACEIs/ARBS
K sparing

Front 27

antihypertensive contraindicated in:
gout

Back 27

diuretics (thiazides/loops)

Front 28

what is the MCC of HTN in women

Back 28

OCPs

Front 29

MCC of pneumonia in:
new born

Back 29

GBS
Listeria
chlamydia

Front 30

Rx for pneumo in:
newborn

Back 30

ampicillin (listeria coverage) & gentamycin

+/- vancomycin (if MRSA)

erythromycin (for chlamydia)

Front 31

MCC of pneumonia in:
1-4 months

Back 31

RSV
chlamydia
parainfluenza
Bordetella
Strep Pneumo
S. Aureus

Front 32

Rx for pneumo in:
1-4m

Back 32

macrolides
+/- cefotaxime

Front 33

MCC of pneumonia in:
4m-4y

Back 33

RSV (or other viruses*)
Strep pneumo
H flu
mycoplasma
S. Aureus

*rhinovirus, influenza, parainfluenza, adenovirus, coronavirus

Front 34

Rx for the MCC of pneumo in:
4m-4y

Back 34

amoxicillin (PO) / ampicillin IV

Front 35

MCC of pneumonia in:
5-15y

Back 35

S pneumo
mycoplasma
chlamydia
other viruses*

*rhinovirus, influenza, parainfluenza, adenovirus, coronavirus

Front 36

Rx for pneumo in:
5-15y

Back 36

1) amoxicillin + clarithromycin (or erythromycin)

2) azithromycin

3) amoxicillin + doxycycline

Front 37

what are indications for pneumococcal vaccine

Back 37

65+ Y/O

SERIOUS LONG-TERM HEALTH PROBLEMS:
CSF leaks
heart disease
lung disease [not asthma]
cirrhosis
alcoholism
diabetes
sickle cell disease

IMMUNOCOMPROMISED:
long-term steroids/immunosuppressant use
HIV/AIDS
lymphoma, leukemia, Hodgkin's, MM, & other CA's
cancer tx (xrays or drugs)
bone-marrow/organ transplant
kidney failure/nephrotic syndrome
damaged/absent spleen

SMOKERS B/W 19-54 Y/O

Front 38

organism causing pneumonia:
gram + cocci in clusters

Back 38

s aureus

Front 39

organism causing pneumonia:
gram + cocci in pairs

Back 39

strep pneumo

Front 40

organism causing pneumonia:
gram - rods in 80 yo

Back 40

e coli

Front 41

organism causing pneumonia:
gram + cocci in neonate

Back 41

GBS

Front 42

organism causing pneumonia:
gram - rods in neonate

Back 42

e coli

Front 43

organism a.w:
atypical pneumonia in young adults

Back 43

mycoplasma

Front 44

organism a.w:
atypical pneumonia in elderly and very young

Back 44

chlamydia

Front 45

organism a.w:
MC pneumonia in children (infants to 5 yo)

Back 45

RSV

Front 46

organism a.w:
MCC of pneumonia in neonates

Back 46

GBS

Front 47

CF pt has incr'd risk of pneumonia from which organism

Back 47

Pseudomonas aeruginosa

Front 48

What are the antipsduomonal B-lactams

Back 48

4TH GEN PCN:
cefepime

3RD GEN CEPH'S:
piperacillin-tazobactam

PENICILLINASE/B-LACTAMASE INHIBITORS:
imipenem/cilistatin
meropenem
aztreonam

Front 49

what are the antipseudomonal quinolones

Back 49

ciprofloxacin

levofloxacin

Front 50

rx regimen for pseudomonas pneumonia

Back 50

2 WEEKS OF 1 OF THE FOLLOWING:

1) ANTIPSEUDOMONAL B-LACTAM + antipseudomonal quinolone

2) ANTIPSEUDOMONAL B-LACTAM + antipseudomonal quinolone + AMG

3) ANTIPSEUDOMONAL B-LACTAM + azithromycin + AMG

Front 51

South American immigrant has cardiomegaly & achalasia. What is organism likely responsible for this pt's disease

Back 51

Trypanosoma Cruzi (dx = Chagas Ds)

Front 52

what findings can be indicative of PCP

Back 52

CXR: diffuse, B/L, interstitial infiltrates (MC finding)
CD4 < 200
LDH > 220

Front 53

what is BCG

Back 53

BCG = Bacille Calmette-Guerin

live strain of Mycobacterium Bovis used to vaccinate against TB

Front 54

under what circumstances could a px PPD be negative despite prior BCG vaccine

Back 54

given before 1 y/o

BCG was < 1 month before PPD screen

BCG was given > 10 years ago

Front 55

which pt populations is PPD considered positive at 5 mm

Back 55

HIGH RISK:
HIV+
close contacts
CXR suggests TB

Front 56

which pt populations is PPD considered positive at 10 mm

Back 56

MODERATE RISK:
homeless
immigrants (from endemic regions)
IVDA's
health care workers
chronically ill
recently incarcerated

Front 57

which pt populations is PPD considered positive at 15 mm

Back 57

ALWAYS CONSIDERED POSITIVE (any pt population)

Front 58

infectious agent a/w:
MCC of pneumonia in immunocompromised

Back 58

PCP

Front 59

infectious agent a/w:
MCC of atypical pneumonia

Back 59

mycoplasma
legionella
chlamydia

Front 60

infectious agent a/w:
currant jelly sputum

Back 60

klebsiella

Front 61

infectious agent a/w:
interstitial pneumonia in bird handlers

Back 61

chlamydophila psittaci

Front 62

infectious agent a/w:
h/o exposure to bats & bat droppings

Back 62

histoplasma

Front 63

infectious agent a/w:
recently visited southern California, New Mexico, or west Texas

Back 63

coccidiodomycosis

Front 64

infectious agent a/w:
pneumonia in alcoholics

Back 64

S. Pneumo

klebsiella

Front 65

infectious agent a/w:
q fever

Back 65

coxiella burnetti

Front 66

infectious agent a/w:
pneumonia in air conditioners

Back 66

legionella

Front 67

infectious agent a/w:
MCC of pneumonia in children 1 y/o and younger

Back 67

RSV

Front 68

infectious agent a/w:
MCC of pneumonia in neonate (i.e. birth - 28 days)

Back 68

GBS

E coli

Front 69

infectious agent a/w:
MCC of pneumonia in young adults (including college students, military recruits, & prison inmates)

Back 69

mycoplasma

Front 70

infectious agent a/w:
pneumonia in px with other health problems

Back 70

klebsiella

Front 71

infectious agent a/w:
MCC of viral pneumonia

Back 71

RSV

influenza

Front 72

infectious agent a/w:
causes woolsorter's disease

Back 72

bacillus anthracis

Front 73

infectious agent a/w:
COPD exacerbation

Back 73

Haemophilus Influenza

Front 74

infectious agent a/w:
pneumonia in ventilator px

Back 74

pseudomonas

Front 75

infectious agent a/w:
pneumonia in CF px

Back 75

pseudomonas

Front 76

infectious agent a/w:
pontiac fever

Back 76

legionella

Front 77

differential diagnosis of ground glass opacities (i.e. diffuse hazy infiltrates) on CXR

Back 77

interstitial pneumonia
PCP pneumonia
pulmonary edema
pulmonary hemorrhage
hypersensitivity pneumonitis

Front 78

what heart sounds are considered benign when there is no evidence of disease

Back 78

split S1
split S2 on inspiration
S3 in patient younger than 40
quiet systolic murmur

Front 79

Dx:
a young woman presents with amenorrhea, bradycardia, and abnormal body image

Back 79

anorexia nervosa

Front 80

Dx:
px presents with intermittent tachycardia, wild fluid fluctuations in blood pressure, headache, diaphoresis and panick attacks

Back 80

pheochromocytoma

Front 81

Sx criteria & management for mild intermittent asthma

Back 81

SX CRITERIA:
sx's 1-2 x/wk
nighttime sx's 1-2 x/month

ACUTE TX:
short-acting B2-agonist (i.e. albuterol)
IV corticosteroids (for persistent sx's)

LONG-TERM CONTROL:
albuterol, prn

Front 82

Sx criteria & management for mild persistent asthma

Back 82

SX CRITERIA:
sx's 3-6 x/wk
nighttime sx's 3-4 x/month

ACUTE TX:
short-acting B2-agonist (i.e. albuterol)
IV corticosteroids (for persistent sx's)

LONG-TERM CONTROL:
albuterol, prn
inhaled glucocorticoid
+/- leukotriene inhibitor (e.g. cromolyn)

Front 83

Sx criteria & management for moderate persistent asthma

Back 83

SX CRITERIA:
sx's daily
nighttime sx's > 1 x/wk
daily bronchidilator use
sx's interfere with activity

ACUTE TX:
short-acting B2-agonist (i.e. albuterol)
IV corticosteroids (for persistent sx's)

LONG-TERM CONTROL:
albuterol, prn
inhaled glucocorticoid
+/- long acting B-agonist, theophylline

Front 84

Sx criteria & management for severe persistent asthma

Back 84

SX CRITERIA:
sx's with minimal activity
awake multiple times/night
require multiple medications on daily basis

ACUTE TX:
short-acting B2-agonist (i.e. albuterol)
IV corticosteroids (for persistent sx's)

LONG-TERM CONTROL:
albuterol, prn
inhaled glucocorticoid
long-acting B-agonist
Oral steroid
+/- theophylline

Front 85

what PCWP distinguishes ARDS from cardiogenic pulmonary edema

Back 85

PCWP < 18 = ARDS
PCWP >18 = cardiogenic

Front 86

characteristics of ARDS

Back 86

acute onset resp distress

PaO2:FiO2 ratio < 200
(i.e. PaO2 > 42)

Bilateral pulmonary infiltrates
(consistent with pulmonary edema)

no evidence of cardiogenic origin
(BNP < 100, nl echo, PCWP = 18)

Front 87

what is the hallmark of COPD

Back 87

FEV1/FVC < 80

Front 88

COPD staging criteria & management:
Stage 0

Back 88

stage 0 criteria: normal spirometery in smokers or those with sx's (e.g. chronic cough)

stage 0 tx: (0) RF reduction + annual Flu/Pneumo vaccine

Front 89

COPD staging criteria & management:
Stage 1

Back 89

MILD:
FEV1/FVC < 70% and FEV1 < 80%

MANAGEMENT:
(0) (0) RF reduction + annual Flu/Pneumo vaccine
(1) short-acting bronchodilator, prn (e.g. albuterol, atrovent)

Front 90

COPD staging criteria & management:
Stage 2

Back 90

MODERATE:
FEV1/FVC 50-80%

MANAGEMENT:
(0) RF reduction + annual Flu/Pneumo vaccine
(1) short-acting bronchodilator, prn (e.g. albuterol, atrovent)
(2) long-acting bronchodilator:
B2-agonist (e.g. salmeterol)
anticholinergic (e.g. Ipratropium/Spiriva)

Front 91

COPD staging criteria & management:
Stage 3

Back 91

SEVERE:
FEV1/FVC 30-50%

MANAGEMENT:
(0) RF reduction + annual Flu/Pneumo vaccine
(1) short-acting bronchodilator, prn (e.g. albuterol, atrovent)
(2) long-acting bronchodilator:
B2-agonist (e.g. salmeterol)
anticholinergic (e.g. Ipratropium/Spiriva)inhaled (3) steroids

Front 92

COPD staging criteria & management:
Stage 4

Back 92

VERY SEVERE:
FEV1/FVC < 30%
(or < 50% with chronic respiratory failure)

MANAGEMENT:
(0) RF reduction + annual Flu/Pneumo vaccine
(1) short-acting bronchodilator, prn (e.g. albuterol, atrovent)
(2) long-acting bronchodilator:
B2-agonist (e.g. salmeterol)
anticholinergic (e.g. Ipratropium/Spiriva)
(3) inhaled steroids
(4) +/- theophylline + home O2 (if criteria met)

Front 93

what Rx is proven to decrease morbidity and mortality in COPD pt

Back 93

supplemental O2

Front 94

at what point do px with chronic COPD qualify for home O2

Back 94

Pulse Ox < 88%
Pulm HTN
Peripheral edema
polycythemia

Front 95

What is the "goal" pulse-ox level in COPD pts on home-O2

Back 95

90% -- any higher & may suppress respiratory drive!

Front 96

Rx for COPD pt chronically has FEV1/FVC of 40%

Back 96

Dx; Stage 3 COPD

MANAGEMENT:
(0) RF reduction + annual Flu/Pneumo vaccine
(1) short-acting bronchodilator, prn (e.g. albuterol, atrovent)
(2) long-acting bronchodilator:
B2-agonist (e.g. salmeterol)
anticholinergic (e.g. Ipratropium/Spiriva)inhaled (3) steroids

Front 97

tx for endocarditis

Back 97

long-term IV antibiotics (e.g. vancomycin)

Front 98

heart defect a/w:
chromosome 22q11 deletion

Back 98

22q11 deletion = DiGeorge Syndrome

ASSOC'D WITH:
tetralogy of fallot
truncus arteriosus

Front 99

heart defect a/w:
down syndrome

Back 99

endocardial cushion defect

Front 100

heart defect a/w:
congenital rubella

Back 100

PDA

Front 101

heart defect a/w:
turner

Back 101

coarctation of aorta

Front 102

heart defect a/w:
marfan

Back 102

aortic regurg

Front 103

Rx for cardiogenic shock

Back 103

dobutamine

Front 104

rx for CHF + cardiogenic shock

Back 104

"LMNOP"

Loops
Morphine
Nitrates
O2 supplementation
Positioning/Pressors (e.g. Dobutamine)

Front 105

next step in a positive PPD

Back 105

CXR

Front 106

what is the next step in a px with a solitary pulmonary nodule

Back 106

compare to previous x ray

CT (determine location, progression, & size)

Front 107

lung cancer a/w:
increased ACTH

Back 107

small cell

Front 108

lung cancer a/w:
increased PTHrp

Back 108

squamous cell

Front 109

lung cancer a/w:
increased ADH

Back 109

small cell

Front 110

lung cancer a/w:
antibodies to presynaptic Ca2+ channels

Back 110

small cell

Front 111

initial Rx for localized non small cell lung cancer

Back 111

surgical resection

Front 112

classic radiologic finding in ideopathic pulmonary fibrosis

Back 112

normal 10%

reticular pattern

nodular pattern

honey combing (with possible bronchiectasis)

Front 113

Rx for idiopathic pulmonary fibrosis

Back 113

steroids
immunosuppressives
azathioprine
cyclophosphamide
N-acetylcysteine (helps with mucous plugging)

Front 114

pneumoconiosis a/w:
progressive fibrosis

Back 114

coal miner's

silicosis

Front 115

pneumoconiosis a/w:
increased risk for TB

Back 115

silicosis

Front 116

pneumoconiosis a/w:
electronics and cancer risk

Back 116

berryliosis

Front 117

pneumoconiosis a/w:
mesothelioma

Back 117

asbestosis

Front 118

indication for surgical repair in aortic aneurysm

Back 118

Males: > 5.5 cm; Females > 5.0 cm

symptomatic/ruptured

rapidly growing (> 0.5 cm / 6 months)

Front 119

next step in a child with severe asthma exacerbation and persistantly low oxygen saturation despite medication

Back 119

nasal canula/mask ==> intubate

Front 120

Indications for intubation in asthmatic children

Back 120

unable to speak (due to work of breathing)

unable to maintain SaO2, despite O2 supplementation

AMS

Front 121

next step for a brain tumor that is identified in CT or MRI

Back 121

MCC = Metastasis ==> look for source:

bone scan
CT - chest/abdomen, pelvis

Front 122

classic sign of PE on CXR

Back 122

hamptom's hump
(wedge shaped opacification at distal lung field)

Front 123

MC EKG finding in PE

Back 123

sinus tachycardia

Front 124

what is a classic but rare EKG finding in PE

Back 124

S1Q3T3:

S1 - wide S in lead I
Q3 - large Q in lead III
T3 - inverted T in lead III

Front 125

next step in a px suspected to have pulm HTN because of symptoms of JVD, loud S2, dyspnea and fatigue

Back 125

echocardiogram
(noninvasive measure of pulmonary artery pressure)

Front 126

former smoker with chronic COPD & chronic CHF presents with SOB & hypoxemia;

what CXR findings are indicative of pulm edema

Back 126

diffuse interstitial fluid

cephalization of the vessels

kerby B lines

Front 127

imaging studies most helpful in diagnosing PE

Back 127

spiral CT with IV contrast

V/Q perfusion scan

pulmonary angiography

Front 128

contraindicaitons for contrast CT (including "spiral CT")

Back 128

Pt on metformin (incr'd risk of lactic acidosis)

Renal disease/RF

Front 129

Tx for pulmonary HTN

Back 129

O2

vasodilators

anticoagulants

diuretics

Front 130

vasodilators used in the Rx for Pulm HTN

Back 130

VASODILATORS
prostanoids
endothelial receptor antagonist (e.g. bosentan)
cGMP PDE-I's (e.g. sildenafil)
DHP CCB's (e.g. nifedipine)

Front 131

Ws of post op fever

Back 131

WIND: pneumonia (day 3)
WATER: UTI (days 3-5)
WOUND: infection at surgical site (days 5-8)
WALK: DVT
WONDER DRUGS: drug-induced
"WEIN" = VEIN: thrombophlebitis & sinusitis

Front 132

lung cancer a/w hypercalcemia

Back 132

squamous cell

Front 133

when might a pt have cushings triad
what are the sx's

Back 133

DX: incr'd ICP

CUSHING'S TRIAD:
HTN
bradycardia
abnormal respirations

Front 134

what is the next step in a px with cushings triad

Back 134

raise head of bed

hyperventilate

mannitol

neurosurg consult

Front 135

what study shows if pleural effusion if loculated or free flowing

Back 135

upright chest xray then lateral decubitus

Front 136

px in respiratory distress, CXR shows pleural effusion, what is the next step

Back 136

chest tube

Front 137

what causes transudate pleural effusion

Back 137

CHF
cirrhosis
nephrotic syndrome

Front 138

what are some causes of exudative pleural effusion

Back 138

Infection

Neoplasm

Vasculitis

Front 139

what size of a pneumothorax requires chest tube placement

Back 139

> 15%

Front 140

what are the locations for immediate needle decompression for tension pneumothorax

Back 140

5th ICS midaxillary line

3rd ICS midclavicular line

Front 141

usual time frame for stopping warfarin prior to surgery

Back 141

3 - 4 days prior to surgery

Front 142

what are the indications for operating on an AAA

Back 142

sx'c/ruptured

Males: > 5.5 cm; Females > 5.0 cm

rapidly enlarging (incr's > 0.5 cm / 6 months)

Front 143

when might subclinical mitral stenosis from rheumatic heart disease become clinically apparent

Back 143

incr'd blood volume (e.g. pregnancy)

Front 144

what medications are used prior to intubation in head injury pt's

Back 144

lidocaine (to blunt ICP elevations)

fentanyl (to blunt pain response & BP elevations)

atropine (to decrease AW secretions & prevent bradycardia in children during intubation)

Front 145

Rx for obstructive sleep apnea

Back 145

weight loss

avoid CNS depressants/sedatives
(Benzo's, EtOH, antihistamines)

CPAP

SURGICAL OPTIONS:
tonsillectomy & adenoidectomy
uvulopalatopharyngoplasty (UPPP)

Front 146

medical combination for TB Rx

Back 146

rifampin
INH
pyrizinamide
ethambutal

Front 147

preferred Dx test for PE

Back 147

spiral CT (IV contrast)

V/Q scan (if constrast contraindicated)

Front 148

what are the indications for surgical parathyroidectomy

Back 148

symptomatic hypercalcemia
[Ca2+] > 1mg/dL above ULN
Cr clearance decr'd by 30%
T score < -2.5 (any site)
< 50 y/o

Front 149

what are some classic symptoms of croup

Back 149

INFLAMMATION OF LARYNX/TRACHEA/BRONCHI:
barking, seal-like cough
respiratory distress
upper AW obstruction with stridor

SX'S WORSE AT NIGHT/EARLY MORNING

Front 150

what are some classic symptoms of epiglotitis

Back 150

ACUTE ONSET OF SX'S: fever, severe sore throat, dysphagia, drooling, & toxic appearance

MUFFLED SPEECH ("hot potato voice")

"TRIPODING" (attempt to maximize AW diameter)arms extended
chest forward
neck hyperextended
chin thrust forward

CBC: leukocytosis with bandemia

LAT NECK XRAY:
"thumb print" sign (enlarged epiglotitis)

Front 151

Rx for epiglotitis

Back 151

MINIMIZE ANXIETY

INTUBATION

CULTURE & SENSITIVITY blood & epiglottal surface

EMPERIC IV ANTIBIOTICS:
S. Aureus coverage ( oxacillin, nafcillin, cefazolin, clindamycin, or vancomycin)
HiB coverage (ceftriaxone or cefotaxime)

Front 152

Rx for croup

Back 152

O2 support (e.g. humidified O2 mask), if needed

steroids (e.g. dexamethasone)

racemic epi (if stridor at rest)

Front 153

Rx for RSV bronchiolitis

Back 153

O2 support, if needed

albuterol or racemic epi, if working
(otherwise discontinue)

Front 154

Dx & Rx
smoker with rapid onset JVD, facial swelling and altered mental status

Back 154

Dx: SVC syndrome

steroids & endovascular stent

emergency radiation (for acute AW obstruction & laryngeal edema)

Front 155

Dx & Rx
px presents with chronic sinusitis, hemoptysis and hematuria

Back 155

Dx: Wegener's

cyclophosphamide
steroids

Front 156

Dx & Rx
px with lung disease is found to have antiglomerular basement membrane antibodies

Back 156

Dx: Good Pasture's

plasmaphoresis
steroids
immunosuppression

Front 157

CXR characteristic to neonatal RDS

Back 157

low lung volumes

diffuse ground glass appearance

air bronchograms

Front 158

Rx for neonatal RDS

Back 158

surfactant

CPAP

Front 159

CXR characteristic features of transient tachypnea of newborn (TTN)

Back 159

increased lung volumes with flattened diaphragm

prominent vascular markings from the hilum
(sunburst pattern)

fluid streaking in interlobular fissures

+/- pleural effusions

Front 160

at what gestational age do the lungs mature & what physiologic change takes place that is used to measure lung maturity

Back 160

35 weeks

amt of lecithin (L) increases while sphingomyelin (S) remains constant

L:S < 1.5 predicts 75% chance of RDS development
L:S > 2.0 indicates full lung maturity

Front 161

how can CF be Dx

Back 161

sweat chloride test

genetic test for CFTR gene mutation

nasal transepithelial chloride secretion
(measures abnormalities in ion transport across the nasal epithelium)

Front 162

general Rx strategies for management of pulmonary component of CF

Back 162

B2-agonist (albuterol, salmeterol, formoterol)

DNA-ase I (to decrase sputum viscosity)

hypertonic saline (for chronic cough)

physiotherapy such as aerobic exercise
(for increased mucous clearance)

Azithromycin & FQ's, prn, if decr'd lung fxn
(to slow decline of lung function & tx P. Aeruginosa)

N-acetylcysteine (to help with mucous plugs)

Front 163

general Rx strategies for management of GI component of CF

Back 163

nutritional counseling

pancreatic enzyme supplementation

fat-soluble vitamin supplementation (i.e. A,D,E, & K)

Front 164

shortly after birth a child has stridor, wheezing, & SOB despite medical therapies; what is likely to be causing sx's

Back 164

Dx: vascular ring

FYI: sx's persist despite medical therapies b/c medical tx does not affect structural abnormalities