Shared Flashcard Set

Details

Lung/Resp DO's
Internal Med I
58
Health Care
Graduate
09/09/2009

Additional Health Care Flashcards

 


 

Cards

Term
dyspnea w/ wheezing is most likely d/t what
Definition
acute bronchitis
Term
pts w/ hx of prolonged immobilization, estrogen tx, or risks for DVT are likely to have dyspnea d/t
Definition
pulmonary embolism
Term
pts w/ chest pain that are either thin, young males or w/ underlying lung dz are most likely to have dyspnea d/t
Definition
spontaneous pneumothorax
Term
what test is used to determine dyspnea d/t carbon monoxide
Definition

% carboxyhemoglobin

(only minimal changes in P02)

Term
what test should be used to measure incr mechanical effort causes of dyspnea?
Definition
ABG's (art. blood gases)
Term

maximal laryngeal height is used to measure

(distance bw top of thyroid cart. and suprasternal notch @ end respiration)

Definition
hyperinflation
Term
Pulse Ox w/ O2 sat > 96% = PO2 ?
Definition
PO2 > 70 mmHg
Term

pulse Ox < 94% represents what clinically?

 

what are the exceptions?

Definition

hypoxemia!

 

exceptions: carbon monoxide tox, or methemoglobinemia

Term
high resolution CT is useful to evaluate
Definition

PE

interstitial lung dz

Term
BNP levels are sensitive and specific for evaluating what type of dyspnea
Definition

CARDIAC!

--> if incr, then pt has LVEDP in sx pts!

Term
cough < 3 weeks =
Definition
Acute
Term
cough > 3 weeks =
Definition
persistent!
Term

cough d/t acute resp tract infxn is most likely dt what in healthy adults? 

how long until it resolves?

Definition

viral infxn

resolves in 3 wks (90%)

Term
what should be suspected in previously immunized adults w/ a severe cough lasting 2-3 wks or esp > 3 wks!
Definition
pertussis
Term
in pts w/ cough, unexplained wt loss, night sweats, and fever, what should be suspected
Definition

CA (bronchiogenic)

 

esp w/ smoking/enviro exposure

Term
what diagnostic study should be done for ANY adult w/ acute cough and abnormal vitals, or with chest exam suggestive of pneumonia?
Definition
CXR!
Term
wheezing and ronchi are findings in adults w/
Definition
ACUTE BRONCHITIS--> NOT adult onset asthma
Term
what consitutes massive hemoptysis?
Definition
> 200-600 mL / 24 hrs or that is hemodynamically significant
Term
what virus is on of the most common pathogens associtated w/ acute bronchitis (viral)
Definition
influenza virus
Term
early phase asthma mediated by
Definition
IgE w/ histamine release from mast cells
Term

late phase asthma assoc w/ release of what?

tx w/ what?

Definition

cytokine release

tx w/ steroids

Term
excessive secretions of mucus w/ daily productive cough for 3 mos or more in at least 2 consecutive yrs
Definition

chronic bronchitis

"blue bloater"

Term
abnormal permanent enlargement of the air spaces distal to the terminal bronchiole w/ destruction of wall w/o fibrosis
Definition

emphysema

"pink puffers"

Term
Decreased FEV1/FVC is found in what
Definition

obstructive lung dz

COPD

Term
normal to incr FEV1/FVC is found in what type of lung dz
Definition
restrictive!
Term
what on radiographs are diagnostic of emphysema
Definition
parenchymal bullae
Term
single most important intervention in ambulatory COPD pts
Definition
smoking cessation!
Term
what COPD tx can improve the natural hx of the dz in pts w/ resting hypoxemia?
Definition
O2
Term
single most important pharm agent for management of pts w/ COPD
Definition

bronchodilators

Ipatropium brominde (anticholinergic)

albuterol (SA B2 agonist)

Term
which bronchodilator is preferred in management of COPD, and why?
Definition

ipatropium bromide!

longer duration of action!

 

Term

what meds are used in acute exacerbations of COPD?

what meds are NOT helpful?

Definition

steroids

ABX (bactrim, amox, doxycycline)

 

MUCOLYTICS NOT HELPFUL!

Term
what is the most important predictor of survival at the time a pt is first seen with COPD?
Definition

FEV1-->

degree of pulmonary fxn

 

Term
dz with chronic productive cough(purulent) w/ dyspnea, wheezing, pleuritic chest pain and recurrent infxns requiring ABX
Definition
Bronchiectasis
Term
"tram tracks" on imaging is indicative of what dz
Definition

bronchiectasis

 

CT best study!

Term
what causes about 1/2 of all cases of bronchiectasis?
Definition
Cystic Fibrosis
Term
bronchiolitis in infants and children is most likely caused by?
Definition
RSV or adenovirus
Term
bronchiolitis in adults is what kind of condition in response to injury to what airways?
Definition

chronic, progressive condition

injury to small distall airways

Term
chronic inflamm, concentric scarring, and sm mm hypertrophy causing luminal obstxn. minimal radiograph abnormalities, and UNRESPONSIVE to steroids is seen in what type of bronchiolotis?
Definition
constructive!
Term
intraluminal polyps (fibroblasts, foamy macrophages and lymphocytes) obstruct the bronchioles is seen in what type of bronchiolitis
Definition
proliferative
Term
more commonly called cryptogenic organizing pneumonitis (COP) and is seen in proliferative bronchiolitis where the exudates extend to alveolar spaces
Definition

BOOP

(bronchiolitis obliterans w/ organizing pneumonia)

Term
tx of BOOP
Definition

steroids!

possibly up to 6 mos!

Term
most common cause of CAP
Definition
strep pneumo
Term
normal vitals, CXR, and PE rule out what?
Definition
PNEUMONIA!--> more likely bronchitis
Term
on PE dull to percussion and egophony are evidence of what
Definition
consolidation
Term
on PE crackles on auscultation indicate what
Definition
interstitial infiltrates
Term
on PE dull to percussion and decr. breath sounds indicate what?
Definition
pleural effusion
Term
ABX for pnuemo
Definition

fluoroquinolones

amoxicillin

doxycycline

Term
sputum first in the AM on 3 successive days examined with an acid fast stain indicates what
Definition
Pulm TB
Term
xray with  nodular infiltrates and cavitation show signs of what dz
Definition
Pulm. TB
Term
first clue that a pts has been exposed to TB
Definition
+ PPD test
Term
"coin lesion" < 3 cm
Definition
solitary pulm nodule--> incr risk of CA
Term
digital clubbing of recent onset suggests
Definition
CA--> NOT COPD!
Term
most aggressive in AA, mean age 40, non-caseous/necrotizing granuloma; systemic dz w/ dx on eye involvement
Definition
Sarcoidosis
Term
most common finding on EKG in a pt w/ pulmonary thromboembolism
Definition
sinus tachy
Term
is incr. D-dimer diagnostic of DVT?
Definition
NO! but if normal--> rules out DVT!
Term
What tool is commonly used to evaluate pts for PE?
Definition
V-Q scanning--> if normal, it R/O PE!
Term
spontaneous pneumothorax is most likely to occur in who?
Definition
young, tall, males!
Term
in a tension pneumothorax, which way does the trachea deviate?
Definition
AWAY from the collapsed side!
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