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Exam 3
Pathophys-Pulmonary
212
Medical
Graduate
02/26/2011

Additional Medical Flashcards

 


 

Cards

Term
Which is better; CT angiogram or CT scan?
Definition
CT angiogram
Term

This test can be used for:

evaluating pulmonary nodules, distinguishing pleural thickening from pleural fluid, evaluation presence of pericradial fluid or thickening, identifying patterns in ILD, identifying intracavitary processes or detecting proximal clots in the pulmonary arteries

Definition
CT Scan
Term
Pulmonary Functions Tests
Definition
Spirometry, DLCO, ABG
Term
Lung tests other than PFTs
Definition

VQ scan

PET

MRI

CTA

Pulm angiography

Term
Episodic and reversible obstriction of airway
Definition
Asthma
Term
Reversible obstruction presisting for days or weeks
Definition
Status asthmaticus
Term
Which type of asthma is male predominant, more severe at presentationa dn more ikely triggered by llergies, exercise & social stress?
Definition
Sudden progression
Term
Sudden progression asthma has what type of chronoligic deterioration
Definition
rapid. <6hrs
Term
Which type of asthma is female predominant, less severe on presentation and more likely a result of URTI?
Definition
Slow progression
Term
Slow progresion asthma has what type of chronolgic deterioration?
Definition
>6hrs (days or weeks)
Term

Worsening of symptoms on exposure to allergen.

FH of allergic diseases

SKin tests (+) to allergens

Serum IgE may be increased

Definition
Allergic Asthma
Term

Often develop bronchospasm after a URTI and may experience worsening of symptoms on exercise or cold air exposure

(-) allergic hx

POssible increase in wheezing following viral URI or emotional stress

Definition
Idiosyncratic Asthma
Term
What is the #1 trigger for an acute asthma attack?
Definition
Aspirin
Term
Airway inflamation is believed to play a fundamental role in airway hyperresponsiveness of this disease
Definition
Asthma
Term
Dehydration can ontribute to the formation of mucus plugs that can blocl airways in this disease.
Definition
Asthma
Term
Airway inflammation is the cardinal feature of this disease
Definition
Asthma
Term
These cells produce potent mediators of onflammation that cause exudation of mucus that obsructs airways in this disease
Definition
Mast; asthma
Term
Airways are infiltrated with _______ in which disease
Definition
mast cells, eosinophils, macrophaes; asthma
Term
Why is it important to avoid antihistamines with an asthmatic?
Definition
The bronchial tree must stay hydrated.  Drying the bronchial tree can cause formation of mucus plugs
Term
Which piece of info in taking a pt's hx of an asthmatic could lead to a worsened prognosis or higher mortality rate.
Definition
Previous E-T intubation
Term
Which risk factors are greatest for near-fatal asthma
Definition

Previous episode of near-fatal asthma

Hospitalizations for asthma w/in the previous year

Term

These PE findings describe what disease

Tachypnes, Tachycardia, Cyanosis, Use of accessory muscles, Pulsus paradoxus, Wheezing, prolongation o expiratory phase, hyperinflation

Definition
Asthma
Term
What does wheezing during an asthma attack tell you
Definition
Air is still being exchanged
Term
Hand held device used to monitor pulmonary function which results are correlated with FEV1
Definition
Peak flow meters
Term
3 Most important measurements is PFTs
Definition

FVC

FEV1

FEV1:FVC

Term
How are PFTs affected in asthmatics
Definition

FVC, FEV1, FEV1:FVC decreased

RV & TLC increased during episodes of obstruction

Term
What indicates "severe" asthma
Definition
FEV1 <25% or <,75L after bronchodilator administration
Term
This test helps r/o dx of asthma and establish pt best attainable lung function.  It is assessed by spirometry before and after administration of inhaled bronchodilator
Definition
Bronchodilator reversability test
Term
What is a significant response in the bronchodilator reversibility test
Definition
Increase >12% and 200mL in either FEV1 or FVC
Term
If only one PFT can be obtained it should be _____
Definition
FEV1
Term
Which labs would you conduct to dx asthma?
Definition
ABG only helpful lab
Term
What would ABGs during an asthma attack show?
Definition

reduced CO2 (hypOcarbia) & respiratory alkalosis initially

Normal or elevated CO2 is worrisome as it may demonstrated need for intubation

Term
How do you determine on an CXR if a foreign body is lodged in trachea or esophagus
Definition
Trachea-the object will present A/P and esophagus-the object will present horizontally
Term
What will you hear upon ausculation of a pneumothorax
Definition
decreased breath sounds
Term
Rupture of esophageal wall due to vomiting
Definition
Boergaave's syndrome
Term
Beta-adrenergic agonist as Treatment of asthma
Definition

Albuterol (short acting)

Salmeterol (long acting-not for acute tx)

Relaxes bronchial smooth muscle (smaller airway dilation)

Rapid onset <5min

Fewer systemic SE (decreases K)

Term
Theophylline as Treatment of asthma
Definition

DO NOT USE

narrow therapeutic window causing cardiotoxicity

Term
Glucocorticoids as Treatment of asthma
Definition

Methylprednisolone (IV)

Prednisone (PO)

require >6hr to have effect in acute asthma

Term
Mast cell-stabilizing agent useful in chronic asthma therapy prevention but not during acute attacks.
Definition
Cromolyn/Nedocromil sodium
Term
This Rx dilates larger airways and when used alone is not as effective as beta-agonists.  Works w/in 1 min of acute exacerbations and peaks w/in 20 min
Definition

Anticholinergics

(Atrovent)

Term
Asthma Treatmnt options for Emergencies
Definition

Aerosolizes B2 agonist-every 20 min (3x) then every 2 hrs

Aminophylline-(no longer used in acute care)

Magnesium2-4g IV over 10-20m (inhibits Ca ch sm mm activity_

Term

The following are indication for ________

Impending resp arrest

altered mental status

hypoxemia on mask

rising PaCO2 w/ falling pH

failure of NIPPV

Definition
Mechanical ventilation
Term
When would you use Epi in an asthmatic
Definition

aerosols have failed

Can not tolerate nebulizer tx

1:1000 subq q 20min

Term
How does Epi afect Pulse and BP in asthmatic
Definition
decrease pulse & BP b/c hypoxia is lesseed leading to less catecholaine release
Term

Group of chronic and slowly progressive respiratory disorders characterized by max expiratory flow during forced exhalation and elevated FRC

IREVERSIBLE

Definition
Obstructive Lung Disease (OLD)
Term
Term applied to both emphysema & chronic bronchitis usually caused by cigarette smoking or other chronic irritant inhalation
Definition
COPD
Term
Components of COPD
Definition
Emphysema, Chronic bronchitis, CF (bronchiectasis)
Term

Destructive enlargement of airspaces distal to terminal bronchioles w/o obvious fibrosis & w/ loss of normal architecture

Decreased ability to oxygenate

Definition
Emphysema
Term

Progressive dyspnea w/ late onset of nonproductive cough

Mucopurulent cough w/ 2nd infections

Progressive exercise intolerance

Cachexia & late resp failure

Definition
Emphysema
Term

Thin w/ barrel chest (increase AP diameter)

Tripod position

hyperresonant chest

pursed lips

distant heart sounds

"pink puffer"

Definition
Emphysema
Term
Presence of cough productive of sputum for at least 3 months over 2 years
Definition
Chronic Bronchitis
Term

Mucus production w/ airway obstruction

undamaged pulm capillary beds early

PHTN & RHF later

Inflammatory response leading to fibrosis

Frequent & recurrent pulm infections

Alteration in mental status 2nd to hypercarbia and hypoxemia

Definition
Chronic bronchitis
Term

Frequent cough & expectoration

Use of accessory muscles of respiration

Coarse rhonchi & wheezing

RHF & cyanosis

"blue bloaters"

Definition
Chronic bronchitis
Term

CXR shows small heart, vertical heart

Flat hemidiaphragms

Increase in retrosternal air space (hyperinflation)

Upper lobes become hyperlucent due to trapped air

Predominantly upper lob disease

Definition
Emphysema
Term
Can develop bulllae which may rupture leading to pneumothorax
Definition
Emphysema
Term

CXR shows bronchovascular markings

cardiomegaly 2nd to cor pulmonale & late biventricular failure

Definition
Chronic Bronchitis
Term

EKG shows Cor pulmonale:

peaked P waves in inferior leads, RAD and atrial arrythmias

Definition
COPD
Term

Lab findings show hypxia (PO2<60mmHg)

possible hypokalemia

Polycythemia (Increase RBC mass-Hgb >15; Hct>48 (blood is sludge and could form emboli)

Definition
COPD
Term
What would ABG show in COPD
Definition

progressive hypoxemia

resp acidosis 2nd to hypercarbia

pH <7.3

Term

PFTs show decreased FEV1 & FEV1:FVC

poor/absent reversibility w/ bronchodilators

Increased RV and normal or increase TLC

Definition
COPD
Term
Stage I COPD
Definition
mild; FEV1 50% predicted
Term
Stage II COPD
Definition
moderate; FEV1 35-49% predicted
Term
Stage III COPD
Definition
Severe; FEV1 <35% predicted
Term
How do bronchodilators affect COPD
Definition

Improve dyspnea/exercise tolerance

Improve airflow

Term
Which Bronchodilators work best on smaller airways
Definition
B2 agonists
Term
Which bronchodilators work best on larger airways
Definition
Anticholinergics
Term
This is used for acute exacerbations but may elevate bld sugar and long terms use is associated with HTN, osteoporosis and Cushings
Definition
Systemic glucocorticoids (Prednisone)
Term
When should Atbx be used?
Definition
Fever present, purulent sputum, infiltrate on CXR
Term
When is long term O2 therapy indicated?
Definition

PaO2<55mmHg or SaO2<88%

PaO2 56-59mmHg w/ SaO2 <89% when Hct >55%

resting awak PaO2<60mmHg w/ SaO2<90% if hypoxic during sleep

Term
COPD prophylaxis
Definition

Yearly influenza

Penumococcal w/ 23valent polysaccharide

Amantadine for unvaccinated ptsat risk by inluenza A outbreak

Term
Most common indication of lung trnsplantation
Definition
Emphysema
Term
When is Lung transplantation considered forCOPD patients
Definition

FEV1<25% predicted & w/ PHTN or RHF despite medical therapy

Priority given to pts w/ PaCO2 >55mmHg & progressive deterioration

Term

Abnormal dilation of bronchi

Often result from bronchial injury due to infection

Sx: chronic purulent sputum, crackles

Dx: dilated tortuous airways on CT

Definition
Bronchiectasis
Term
Tx of bronchiectasis
Definition
Atbx, bronchodilators, chest physiotherapy
Term
Gene mutation creating abnormal sweat, abnormal digestive juices, abnormal mucus (resin) in lungs and sinuses
Definition
CF
Term
Meconium ileus in newborns, inadequate wight gain, resp sxs, sterility, steatorrhea
Definition
CF
Term
CF triad includes
Definition

Lung disease

Pancreatic enzyme insufficiency

High sweat chloride and Na levels

Term
Tx of this disease could include bilateral lung transplant, pancreatic transplant and liver transplant
Definition
CF
Term
A 55 y/o male presents with a chronic cough for the past 10 years and progressive dyspnea with exertion for the past 2 years.  The cough is productive of scant clear mucous at times.  He has a 70 pack/year tobacco use history and quit smoking cigarettes approximately 2 years ago.  Physical examination reveals a blood pressure of 160/85, heart rate 96 bpm, and a respiration rate of 20. On auscultation he has course breath sounds and end-expiratory wheezes throughout the lung fields. What is the best diagnostic study in this pt?
Definition
Spirometry
Term
Contraindications to PFTs
Definition
Hemoptysis of unk origin, vomitting, vertigo, Pneumothorax, Recent abdominal/thoracic surgery, recent ye surgery, recent MI, thoracic aneurysm
Term
PFT measurements in O.L.D.
Definition

FVC normal or decreased

FEV1:FVC decreased markedly

RV increased (barrel chest)

TLC normal or increased

DLCO decreased in COPD; Normal in asthma

Term
PFT measurements in R.L.D.
Definition

FVC decreased

FEV1:FVC normal or decreased

RV normal or increased

TLC decreased markedly

DLCO decreased

Term
What lung volumes can NOT be mesured with spirometry
Definition
FRC & RV
Term
Maximal volume of air exhaled from end-expiration
Definition
ERV
Term
Maximal volume of air inhaled from end-inspiration
Definition
IRV
Term
Volume of air remaining in lungs after maximal exhalation
Definition
RV
Term
Volume of air inhaled or exhaled during each respiratory cycle.
Definition
TV
Term
Volume of air in lungs at resting end-expiration
Definition
FRC
Term
Maximal volume of air that can be inhaled from expiratory level
Definition
IC
Term
Volume of air in lungs at maximal infaltion
Definition
TLC
Term
Largest volume meaured on complete exhalation aftr full inspiration
Definition
VC
Term
volume of air exhaled in the 1st second under force after maximal inhalation
Definition
FEV1
Term
Percentage of FVC expired in one second
Definition
FEV1/FVC
Term
Decreases in FEV1:FVC are indicative of _______
Definition
O.L.D.
Term
Reduced FVC is indicative of ________
Definition
Resrictive lung disease
Term

Pressure is applied over the ulnar and the radial arteries so as to occlude both of them.

Ulnar pressure is released and the color should return in 7 seconds.

This test is called?

Definition
Allen's
Term
FiO2 on room air is _____
Definition
21%
Term
pH >7.4 is  ______
Definition
alkalodic
Term
ph<7.4 is ________
Definition
acidodic
Term
pCO2 >40 is _______
Definition
acidodic
Term
pCO2<40 is _____
Definition
alkalodic
Term
HCO3>24 is _______
Definition
akalodic
Term
HCO3<24 is _______
Definition
acidodic
Term
ABG of Mr. Jones reveals a pH of 7.28
Definition
Acidodic
Term
ABG of Mrs. Wright reveals a pH of 7.54
Definition
Alkalodic
Term
When CO2 accumulates in blood, acid builds up & pH decreases.  This is called______
Definition
respiratory acidosis
Term
Example or respiratory acidosis
Definition
hypOventilation
Term
Increased CO2 elimination decrreased acid in blood and increases pH.  This is called _______
Definition
respiratory alkalosis
Term
Example of Respiratory alkalosis
Definition
HypERventilation
Term
Acidodic pH & Acidodic PaCo2 lead to ______
Definition
Respiratory acidosis
Term
Acidodic pH & Acidodic HCO3 lead to _____
Definition
Metabolic acidosis
Term
Infection of lung parenchyma
Definition
Pneumonia
Term
Typical pathogens of CAP
Definition

Strep pneumoniae

H. influenzae

Morxella catarrhalis

Term
Cause of "nursing home pneumonia"
Definition
Gm- Staph aureus
Term
Pathogens of Hospital acquired Pneumonia
Definition

Gm- bacilli

P. aeruginosa

Stap aureus

MRSA

Term
Painful vesicle on tympanic membrane are called ______ and often associated with which pathogen
Definition
Bullous myringitis; mycoplasma
Term
Sxs: Fever, chills, tachypnea, tachycardia, productive cough
Definition
Pneumonia
Term
S. pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Legionella  associated with?
Definition
COPD
Term
S. pneumoniae, Klebsiella pneumoniae, oral anaerobes., M. tuberculosis associated w/?
Definition
Alcoholism
Term
S. pneumoniae, H. influenzae  associated w/?
Definition
Asplenia
Term
“Typical” bacterial pathogens, M. tuberculosis, Pneumocystis jiroveci, cytomegalovirus, Cryptococcus spp., Histoplasma spp., Coccidioides spp. assoc w/?
Definition
HIV infection
Term
Pseudomonas aeruginosa, Burkholderia cepacia, S. aureus assoc. w/?
Definition
Bronchiectasis & CF
Term
Chlamydia psittaci assoc. w/?
Definition
Exposure to birds
Term
Francisella tularensis assoc. w/?
Definition
Exposure to rabbits
Term
Histoplasma capsulatum assoc w/?
Definition
Exposure to bat or bird droppings, caves & construction sites
Term
Coccidioides spp., Hantavirus assoc w/?
Definition
Travel to desert, SW US
Term
S aureus, anaerobes, M. tuberculosis, and S. pneumoniae assoc. w/?
Definition
IV drug use
Term
M. tuberculosis assoc w/?
Definition
Incarceration
Term
S. pneumoniae, S. aureus, Streptococcus pyogenes, H. influenzae assoc w/?
Definition
Postinfluenza
Term
Cough >2 wk w/ whoop or posttussive vomiting assoc w/
Definition
Bordatella pertussis
Term
Hotel or cruise ship stay in prior 2 weeks assoc w/?
Definition
Legionella
Term
What drug should be stopped if pulmonary fibrosis develops?
Definition
Amiodarone
Term
Mississippi and ohio river valley areas or spelunking assoc w/?
Definition
Histoplasmosis
Term
SW US central & south america assoc w?
Definition
Coocidiomycosis
Term
Mississipi & Ohio river valleys assoc w?
Definition
Blastomyocosis
Term
Mediastinal widening w/o infiltrate on CXR could indicate?
Definition
Inhalation anthrax
Term
Interstitial infiltrate on CXR could indicate
Definition
Viruses, Pneumocystis, Mycoplasma, Chlamydia psittaci
Term
Miliary infiltrate on CXR could indicate
Definition
AFB, fungal
Term
Cavitary infiltrate on CXR could indicate
Definition
Bacterial abscess, fungal, acid-fast bacilli (AFB), Nocardia
Term
Focal infiltrate or large pleural effusion on CXR could indicate
Definition
Bacteria
Term
How many blood cultures should be obtained before starting atbx?
Definition
2
Term
Gm + pathogens
Definition

Pseudomonas, Klebsiella, Moraxella, Haemophilus

(pink)

Term
Gm + pathogens
Definition
S. Pneumoniae, S. aureus
Term
What dx test would you do if the patient is deteriorating and there is no definite pathogen identified
Definition
Bronchoscopy, thoracoscopic or open lung biopsy or radiographically-guided transthoracic aspirate
Term
What is the CURB-65 criteria
Definition

Admit the patient if

Confusion, Uremia(BUN>20), RR>30, BP<90/60, Age>65

Term
Penumonia Severity Index Risk Class I & II
Definition
Outpatient therapy
Term
Pneumonia Severity Index Risk Class III
Definition
Outpatient or brief inpatient.  Clinical judgement
Term
Pneumonia Severity Index Risk IV & V
Definition
Hospital admission
Term
How would you treat a pneumonia pt previously healthy
Definition
macrolide or doxycycline
Term
How would you treat a pneumonia pt w/ the presence of 3 comorbidities, use of antimicrobials in the prior 3 months or risks for DRSP infection?
Definition
Fluoroquinolone or beta-lactam plus macrolide
Term
How would you treat a pneumonia inpatient, non-ICU
Definition
resp fluoroquinolone or beta-lactam plus macrolide
Term
Therapy for tx S. Pneumoniae
Definition
Penicillin G; amoxicillin, macrolides, doxycyline, fluoroquinolones, clindamycin, vancomycin, TMP-SMZ, linezolid
Term
Therapy for tx H. influenzae
Definition
2nd or 3rd generation cephalosporin, doxycycline, beta-lactam or beta-lactamase inhibitor, azithromycin, TMP-SMZ
Term
Therapy for tx Moraxella catarrhalis
Definition
2nd or 3rd generation cephalosporin, TMP-SMZ, macrolide, beta-lactam or beta-lactamase inhibiter
Term
Therapy for tx Legionella
Definition
Macrolide +  rifampin, respiratory fluoroquinolone alone
Term
Therapy fr tx Mycoplasma pneumoniae
Definition
Doxycycline; macrolide
Term
Therapy for tx Chlamydophila pneumoniae
Definition
Doxycycline; macrolide, flouroquinolone
Term
Therapy for tx Anaerobes
Definition
Beta-lactam or betalactamase inhibitor, clindamycin
Term
Therapy for tx P. aeruginosa
Definition
Aminoglycoside + ticarcillin, piperacillin, mezlocillin, ceftazidime, cefepime, aztreonam, or carbapenem
Term
Therapy for tx influenza
Definition
Oseltamivir, Zanamivir
Term
Therapy for tx Clamydia psittaci
Definition
Tetracycline, Doxycyline, Macrolides
Term
Acquired disease that leads to abnormal and permanent dilatation of the bronchi leading to pooling of secretions in the airway and recurrent infections.  Results mostly from neglected or recurrent infections
Definition
Bronchiectasis
Term
CXR shows increased lung markings, honeycombing, atelectasis or pleural changes
Definition
Bronchiectasis
Term
What diagnostic study is reguired by most infiltrative lung diseases?
Definition
HRCT scan guided needle bopsy o open lung biopsy
Term
Transmitted person-to-person by droplet nuclei
Definition
TB
Term
What is the most important tx of ILD
Definition
removal of causative agent (smoke, dust, medication)
Term
What is the mainstay Rx tx of ILD
Definition
Corticosteroids (prednisone) for 8-12 weeks.  Cyclophosphamide or azathioprine if corticosteroids not tolerated
Term

Most common ILD

Risk factors include exposure to smoke, metal dust, farming dust & hairdressing chemicals

Definition
IPF (iodiopathoc pulm fibrosis)
Term

Late inspiratory crackles @ post lung bases

Signs of PHTN & clubbing occur late inc ourse

ESR elevated

Hypoxemia common

HRCT demonstrates bibasilar, peripheral reticular abormalities w/ focal honeycob cystic change

Definition
IPF
Term

Restrictive patterb, reuced TLC, RV, VC DICO and normal or increased FEV1/FVC

Resting ABG may be normal or hypoxemis & resp alkalosis

Definition
IPF
Term
Tx of IPF
Definition

No known current effective treatment

o2 supplementation

Lung transplant

Term
ILDs associated w/ CVD
Definition

Rheumatoid Arthritis

Scleroderma

SLE

Term
Characterized by recurrent pulmonary hemorrhage
Definition
Idipathic Pulm Hemosiderosis
Term
Relapsing pulmonary hemmorhage, anemia & renal failure
Definition
Goodpasture's Syndrome
Term

Systemic granulomatous disease of unk etiology

Most common ILD in US

Highest incidence in blacks & north. europeans women>men

Multisystm inflammatory disorder commonly involving lungs

Definition
Sarcoidosis
Term

Fever, Mailaise, Dyspnea.  CXR shows bilaeral hilar adenopathy & R paratracheal lymphadenopathy.

 

All Sxs related to skin, eyes, peripheral nerves, liver, kidney or heart

Definition
Sarcoidosis
Term

ESR & hypercalcemia

elevates ACE

PFTS - decreased lung volume & diffusion capacity

ECG shows conduction disturbance and arrythmias

Definition
Sarcoidosis
Term
Tx of Sarcoidosis
Definition

Corticosteroids when required

Opthalmalogic examination

Term
Immunologically mediated inflammation of lung parenchyma involving alveolar walls & terminal bronchioles  to repeated inhalation of a variety of organic dusts by susceptible host
Definition

Hypersensitivity Pneumonitis

aka Extrinsic Allergic Alveolitis

Term

The following are examples of ________

Farmer's lung, Bagassosis, Bird Fancier's disease, Mushroom worker's disease, Pigeon breeder's lung, Duck fever, Turkey handler's disease, Lab workers _______, Epoxy resin lung

Definition
Hypersensitivity Pneumonitis
Term
What are the 3 presentation of hypersensitivity pneumonitis
Definition
Acute -Cough, fever, chills, dyspnea appear 6-8 h after exposure to antigen.  May last 18 to 24 hours
Sudden SOB, CP, fever, chills, malaise, cough that may be productive of purulent sputum.
Subacute- Manifestations differ only in severity of symptoms & have a more insidious onset
Chronic - May be asymptomatic for several years, then may present with severe, disabling disease.
Results in progressive fibrosis & restrictive lung disease
Term
Bronchalveolar lavage may show increased lymphocytes.  Lung biopsy may be necessary.  PE may reveal rales
Definition
Hypersensitivity Pneumonitis
Term
Tx for Hypersensitivity Pneumonitis
Definition

Avoidance of antigen

Prednisone fo 7-14d tapering off over 2-6 weeks

Term

Acute or subacute dyspnea & cough.  1/3 of pts have preceding viral illness failing to improve despite atbx.

HRCT demonstrates non-segmental consolidations in a subpleural and peripheral distribution

Definition
COP/BOOP
Term
Tx of COP/BOOP
Definition
Oral corticosteroids. If fails then cytotoxic immunosuppressive agents
Term

The following are examples of ________

Antimony, Arsenic, Barium & drilling compounds, Cadmium dust, Cement dust, Chromium, Coal dust, coke oven emissions, graphite, iron dust, Mica, Rock dusts, Vanadium, phosphorous, sulfides, elemental chlorides

Definition
Inorganic Occupational Dusts assoc. w/ musus hypersecretion
Term
Inflammation commonly leading to fibrosis of lungs caused by inhalation of dust in various occupations
Most common asbestosis, silicosis, coal miners pneumoconiosis
Definition
Pneumoconiosis
Term
Chest pain, cough, dyspnea, reduced thoracic excursion, possible cyanosis, fatigue after slight exertion
Definition
Pneumoconiosis
Term
Diffuse interstitial fibrosing disease of lung
Related to intensity & duration of exposure usually requiring > 10 years of moderate to severe exposure
PFT’s show restrictive pattern
Definition
Asbestosis
Term
CXR shows plaques, fibrosis, effusions, atelectasis & mesothelioma, parenchymal scarring, irregular or linear opacifies in lower lung fields
Definition
Asbestos Exposure
Term
Dense white encircling tumor mass arising from visceral pleura or big bulky tumors tha can fill chest cavity
Definition
Mesothelioma
Term
Exposure to free silica inducing a fibrogenic response resulting in production of scattered nodular foci of collagen deposition in lung
Definition
Silicosis
Term
Associate with a 2-30x higher risk for TB than normal
Definition
Chronic Cilicosis
Term
Bundles of interlacing pink collagen w/ minimal infalammatory reaction
Definition
Silicosis
Term
Eggshell calcification of hilar lymph nodes and upper lung zone predominant abnormalities
Definition
Chronic silicosis
Term
Form of peumoconiosis due to presence of dust
Definition
Siderosis
Term
Result of chronic inhalation of coal dust.  For of progressive massive fibrosis.  SMall nodular opacities on CXR.  No proven tx
Definition
CWP (coal workers pneumoconiosis)
Term

TTB skin test induration >5mm (+) in

 

Definition
HIV, organ transplnats, immunospurpressed, recent contact w/ TB pt
Term
TB skin test induration >10mm (+) in
Definition
<5y immigrant, IV drug users, children <4, high risk pts
Term
TB skin test unduration >15mm (+) in
Definition
anyone
Term
Tx for latent infection of TB
Definition
9 months INH & B6
Term

Fever, loss of appetite, weight loss, night sweats, fatigue, blood streaked sputum.

CXR with apical localization

Definition
Pulmonary TB
Term
Dx & Tx of active TB
Definition
Respiratory isolation and x3 sputum cultures (acid fast)
Term

Caused by Pneumocustis Jirovecii

Sxs: dyspnea, fever, non-productive cough, hypoxemia

CXR: diffuse, bilateral, symmetrical interstitial infilatrates

Definition
Pneumocystis pneumonia (PCP)
Term
Tx of PCP
Definition
PO Bactrim
Term

Caused by the dimorphic fungus Histoplasma capsulatum.

Sxs: Fever, fatigue, weight loss, hepatosplenomegaly, and lymphadenopathy. Cough, chest pain, and dyspnea may also occur (sxs mostly limited to resp tract in HIV)

Definition
Hstoplasmosis
Term
Tx of histoplasmosis
Definition
Antifungal meds
Term
Caused by a soil-dwelling fungus that consists of two species: Coccidioides immitis and C. posadasii
Definition
Coccidiodomycosis
Term
Tx of coccidiodomycosis
Definition
antifungal meds
Term
Tx for MAC
Definition
Clarithromycin + Ethambutol
Term
Tx for Aspergillosis
Definition
Antifungal meds
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