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Pulmonology – Awesom

Random pulm associations

QuestionAnswer
the only type of lung disease with decreased residual volume intrathoracic restrictive
how to treat post-viral hypersensitivity daily inhaled steroid (budesonide)
increased mortality in asthma is related to their baseline airway lability - how constricted are their airways at baseline
oxygenation goal in asthma (PaO2 and SaO2) PaO2 > 60 and SaO2 > 90
what drug stabilizes mast cells cromolyn
Brownish mucous plugs, dx, which pts get this, what is tx? What if hemoptysis? Allergic Broncho Pulmonary Aspergillosis ABPA - colonization of upper airway with Aspergillus in asthma patients, tx with steroids; if hemoptysis then surgery. Type I immediate HSN IgE +skin reaction.
Pt with fever chills SOB after a day on a farm or has pet parakeet - what is this and what organism? Hypersensitivity pneumonitis - Type 3 Immune Complex - Thermophilic Actinomycetes
Thermophilic Actinomycetes Hypersensitivity pneumonitis
What are the findings on CXR with hypersensitivity pneumonitis? ground glass appearance, interstitial or alveolar infiltrates
What are the findings on BAL with hypersensitivity pneumonitis? what is this the opposite of? lymphocytosis with CD8 > CD4 (very specific), no eosinophils; opposite of sarcoidosis with CD4 > CD8
pt with asthma, neuropathy, nasal polyps, found to have hypereosinophils Churg Strauss - eosinophilic granulomatosis with polyangiitis - small to med vasculitis
medication for prevention of acute mountain sickness vs high altitude pulmonary edema, when to start acetazolamide for AMS and nifedipine for HAPE; start 24-48 hrs prior to mountain ascent
sx's of acute mountain sickness vs high altitude pulmonary edema AMS has HA n/v fatigue and dizziness; HAPE has all that plus SOB
symptoms of theophylline toxicity tachycardia and tremors, EKG shows MAT
criteria for intubation pH < 7.25, RR > 35, HR 120, or increased secretions or hemoptysis
Noninvasive ventilation for COPD vs CHF COPD you give BiPap and CHF you give CPAP
tram lines bronchiectasis, h/o PNA in the past
If you see pancreatitis in a young patient without known cause, what test must you do? sweat chloride for CF
leading cause of mortality in CF? how do you treat it? cepacia burkhdorferia, tx with Bactrim
honeycombing idiopathic pulmonary fibrosis, lymphangio leiomyomatosis, langerhan cell granuloma / eosinophilic granuloma / histiocytosis X - proliferation of dendritic cells
plaques on the diaphragm asbestosis plaques on your ass
egg shell calcifications silicosis
hilar LNs silicosis and sarcoidosis
non caseating granulomas sarcoidosis and berylliosis
Lymphangioleiomyomatosis - whats the pathology? What are the sx's? who gets it? proliferation of smooth muscle cells that invade all lung structures --> SOB, a lot of cystic changes, chylothorax, PTX. young girl
EKG changes for pulm embolism S1Q3T3, TWI in v1
mid-wall RV dyskinesia PE
hypokinesis at apex on ECHO RV infarct
pleural effusions with glucose of 80? 60? 30? 80 - TB, 60 - cancer, 30 - RA
what diagnosis if you see lung field hyper resonant to percussion with decreased breath sounds and decrease vocal fremitus/resonance PTX
what diagnosis if you hear bronchial breath sounds with lung exam dull to percussion and increased vocal fremitus/resonance PNA
what diagnosis if you hear decreased breath sounds with lung exam dull to percussion and no vocal fremitus/resonance pleural effusion
when to tap a pleural effusion 1. >10mm on lateral decubitus CXR, 2. PNA not better with abx, 3. empyema, 4. loculated effusion (needs thoracostomy)
When to insert a chest tube pH < 7.2, empyema, complicated parapneumonic effusion, malignancy
anterior mediastinum masses thyroid tumors, thymic tumors, and lymphomas, teratoma
middle mediastinal masses bronchogenic cysts, pericardial cysts, and lymphadenopathy
posterior mediastinal masses Posterior mediastinal masses are generally limited to growths of neural tissue or esophageal tumors or cysts
when to do pulm rehab in COPD? Current guidelines recommend pulmonary rehabilitation for patients with symptomatic COPD who have an FEV1 less than 50% of predicted.
who shouldn't get pulm rehab? It is not recommended for patients who cannot walk or who have unstable angina or recent myocardial infarction.
who gets O2 in COPD Oxygen therapy is indicated for patients who have hypoxemia, arterial PO2 of 55 mm Hg (7.3 kPa) or lower, or oxygen saturation of 88% or lower.
definition of COPD exacerbation change in baseline dyspnea, cough, and/or sputum production beyond normal daily variation. Main sxs: inc SOB often w wheezing and chest tightness, increased cough and sputum production, change in the color and/or tenacity of sputum, and fever.
most appropriate tests to assess impending respiratory failure in patients with neuromuscular weakness bedside vital capacity and maximal inspiratory pressure
what are the parameters that show a pt is at high risk for respiratory failure Patients with vital capacity less than 20 mL/kg, patients who cannot generate more than 30 cm H2O of negative inspiratory force, or patients with declining values are at high risk for ventilatory failure
In victims of smoke inhalation, when should you think about cyanide poisoning? blood lactic acid level of 90 mg/dL (10.0 mmol/L) or greater is sensitive and specific
How to tx cyanide poisoning antidote is sodium thiosulfate
Created by: christinapham