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;
23 Cards in this Set
- Front
- Back
|
cough induced by forced expiration
|
- indication of reactive airway disease --> think asthma
|
|
|
laryngeal nodule symptoms
|
- hoarseness, dysphagia
- rarely have cough |
|
|
symptoms of tracheomalacia
|
- stridor and airway collapse with INSPIRATION
|
|
|
treatment of asthma exacerbation
|
if >20% decreased peak flow:
- short acting beta agonist - systemic corticosteroids (not inhaled corticosteroids) if 40-50% decrease in peak flow - admit |
|
|
treatment of asymptomatic pulmonary sarcoidosis
|
- no treatment
- hilar adenopathy with erythema nodosum is very favorable, high rate of spontaneous remission, good prognosis |
|
|
hepatic hydrothorax
|
- right sided, transudative pleural effusion in pts with cirrhosis and ascites
|
|
|
most frequent allergen associated with asthma?
|
- house dust mites, not air pollution
|
|
|
first steps in rapid sequence intubation (RSI)
|
- IV etomidate and endotracheal intubation
|
|
|
signs of massive PE with poor prognosis
|
- RV strain: see RBBB, atrial arrhythmias, inferior Q waves, ST-segment changes
- on echo see signs of RV dysfx: increased RV size, decreased RV function, presence of RV thrombus, tricuspid regurg |
|
|
what is acute respiratory distress syndrome?
|
- non cardiogenic pulmonary edema
- occurs secondary to sepsis, PNA, severe trauma, burns, drowning, pancreatitis |
|
|
criteria for ARDS
|
- pulm capillary wedge pressure <18
- PaO2 to FiO2 of 200 mmHg or less - diffuse bilateral infiltrates on CXR - note: will typically have clear lung exam |
|
|
ARDS vs acute pulmonary edema?
|
- ARDS is non cardiogenic pul edema and there's no elevated JVD, edema, cardiomegaly
- acute pulm edema- see the above |
|
|
goals of mechanical ventilation in ARDS
|
- PEEP of around 9
- low FiO2 - low tidal volumes - goal is PaO2 55 or higher - adjust PEEP or FiO2 to get higher PaO2 - adjust tidal volume or RR to adjust PCO2 |
|
|
most important factors in determining prognosis of patients with COPD?
|
- FEV1 and age
|
|
|
SIADH is associated with which lung tumor?
Hypercalcemia is associated with which lung tumor? |
- small cell carcinoma
- squamous cell carcinoma due to PTHrp production |
|
|
treatment of SIADH?
|
- water restriction and possibly salt intake
- if doesn't work then consider demeclocycline or lithium or furosemide with concomitant hpertonic saline or salt tablets |
|
|
pt with hx of asthma now with increased flares and elevated eosinophils
|
- think allergic bronchopulmonary aspergillosis and do immediate skin test reactivity to aspergillus antigen
- if + skin prick then test for serum total IgE (>1000) and Ab to aspergillus - see involvement of upper lobes - colonization wth aspergillus - tx with oral prednisone (no fluconazole or itraconazole) |
|
|
signs and sx of PAH?
|
- sx similar to CHF
- loud S2, prominent pulmonary arteries on CXR, Right heart strain on EKG - get ECHO |
|
|
tx of PAH
|
- test to see if pt responds to vasodilator via right heart cath --> rx CCB
- else rx prostanoid (epoprostenol), endothelin receptor antagonist (bosentan), phosphodiesterase-5 inhibitor (sildenafil) |
|
|
preop assessment- when to get PFTs or ABG?
|
- pts undergoing lung resection, or hx of tobacco use or unexplained dyspnea and are undergoing coronary artery bypass surgery or upper abd surgery
- get PFTs in pts with COPD undergoing abdominal or lower extremity surgeries |
|
|
signs of a benign pulm nodule
|
- popcorn calcifications (pulmonary hamartoma)
- concentric or laminated calcifications - central calcifications - diffuse homogenous calcifications |
|
|
dx of asthma
|
- metacholine challenge test --> fall in FEV of >20% from baseline
- fall in FEV1 is more than fall in FVC so see reduced FEV1/FVC |
|
|
IV drug user with fever, cough, round lesions on CXR
|
- septic pulmonary embolism
- BCx and abx |
