Term
|
Definition
| ventilation-perfusion scan (VQ) |
|
|
Term
|
Definition
Mast cells
T lymphocytes
macrophages |
|
|
Term
| role of basophils in asthma |
|
Definition
|
|
Term
Test for presence of TB (spelled out)
Definitive dx test to TB |
|
Definition
sputum for acid fast bacilli
Definitive: sputum culture |
|
|
Term
|
Definition
| mycobacterium tuberculosis |
|
|
Term
| ABG finding in TB, pulm inf, and most lung carcinoma. |
|
Definition
|
|
Term
|
Definition
|
|
Term
| group of dx suspect for cystic fibrosis |
|
Definition
| pulm inf, pancreatitis, infertility |
|
|
Term
| dx test for cystic fibrosis |
|
Definition
|
|
Term
|
Definition
| characteristic changes in pt with type I diabetes |
|
|
Term
| purpose for lung bx in older pts. (DDx) |
|
Definition
| interstitial lung dz, ie: sarcoidosis |
|
|
Term
| test for pt suspect of asthma and spirometry is non-diagnostic |
|
Definition
| methacholine or exercise challenge testing. (not during acute phase) |
|
|
Term
|
Definition
-abnormal dilation of the proximal and medium-sized bronchi (>2 mm in diameter)
-caused by destruction of the muscular and elastic components of the bronchial walls.
-Affected areas may show a variety of changes including transmural inflammation, edema, scarring, ulceration, and other findings. |
|
|
Term
|
Definition
-foul smelling purulent sputum
-chronic productive cough
-hemoptysis
-persistent crackles over affected lung regions |
|
|
Term
|
Definition
-episodic dyspnea
-associated wheezing
-intermittent cough |
|
|
Term
|
Definition
| a profound and marked state of constitutional disorder; general ill health and malnutrition. |
|
|
Term
| presentation of emphysema |
|
Definition
-cachexia
-little or no sputum
-decreased expiratory flow rates
-hyperresonant percussive areas
-decreased breath sounds
- +/- digital clubbing |
|
|
Term
| presentation chronic bronchitis |
|
Definition
| -chronic productive cough (not large quantities) |
|
|
Term
|
Definition
|
|
Term
| classic presenation of croup |
|
Definition
-noisy, barking cough
-low grade fever
-cough
-inspiratory stridor |
|
|
Term
|
Definition
| a harsh, high-pitched breath sound such as the one often heard on inhalation with an acute laryngeal obstruction. |
|
|
Term
presentation epiglottitis
(include child ages) |
|
Definition
-acute onset
-high fever
-moderate to severe resp distress
-2-6 yo children |
|
|
Term
|
Definition
-high fever
-malaise
-GI sx
-nasal flaring or grunting resp
-consolidation on lung exam |
|
|
Term
| Goals of Asthma Management |
|
Definition
-Prevent asthma episodes (attacks)
-Sleep through the night without symptoms
-No missed school or work due to asthma
-Full participation in physical activities
-No ER visits or hospitalizations
-Little or no medicine side effects |
|
|
Term
| why are beta-blockers contraindicated in asthma? |
|
Definition
| They will block beta 2 agonists |
|
|
Term
|
Definition
- Symptoms < 2 times/week
- Asymptomatic and normal PEF between exacerbations
- Exacerbations brief
- PM Symptoms < 2 times/month
- FEV1 or PEF > 80% predicted
- PEF variability < 20% |
|
|
Term
|
Definition
- Symptoms > 2 times/week but < 1 time/day
- Exacerbations may affect activity
- PM Symptoms > 2 times/month
- FEV1 or PEF > 80% predicted
- PEF variability 20-30% |
|
|
Term
| Moderate persistent asthma |
|
Definition
-Daily symptoms
-Daily use of inhaled short-acting b 2 agonists
-Exacerbations affect activity
-Exacerbations > 2 times/week; may last days
- PM Symptoms > 1 time/week
- FEV1 or PEF 60%-80% predicted
- PEF variability > 30% |
|
|
Term
|
Definition
- Continual symptoms
- Limited physical activity
- Frequent exacerbations
- PM Symptoms Frequent
- FEV1 or PEF < 60% predicted
- PEF variability > 30% |
|
|
Term
|
Definition
| forced expiratory volume in 1 second |
|
|
Term
|
Definition
| maximum midexpiratory flow rate |
|
|
Term
|
Definition
|
|
Term
|
Definition
| peak expiratory flow rate |
|
|
Term
|
Definition
| maximum forced expiratory flow rate |
|
|
Term
|
Definition
| functional residual capacity |
|
|
Term
| Tx severe persistant asthma |
|
Definition
High-dose inhaled corticosteroids
AND
Long-acting inhaled beta2-agonists
AND, if needed:
Corticosteroid tablets |
|
|
Term
| Tx moderate persistant asthma |
|
Definition
| Low-to-medium dose inhaled corticosteroids and long-acting inhaled beta2-agonists |
|
|
Term
| Tx mild persistant asthma |
|
Definition
| Low-dose inhaled corticosteroids |
|
|
Term
| Tx mild Intermittent asthma |
|
Definition
No daily medication needed
Severe exacerbations may occur, separated by long periods of normal lung function and no symptoms. A course of systemic corticosteroids is recommended. |
|
|
Term
| most common and persistant sx TB in early stages |
|
Definition
| dry cough (months-weeks prior to other pulm sx) |
|
|
Term
|
Definition
| blood-streaked sputum and hemoptysis |
|
|
Term
|
Definition
| dyspnea (after prolonged dry cough) |
|
|
Term
| stages of TB sx from early to moderate to severe |
|
Definition
- prolonged dry cough
- dyspnea
- blood-streaked sputum and hemoptysis |
|
|
Term
| purulent sputum indicates |
|
Definition
| bacterial suerinfection or a ruptured abscess. |
|
|
Term
| Isoniazid tx reccommendations for recent PPD converters < 35 yo |
|
Definition
| 300 mg Isoniazid daily for 9 months (no rifampin) |
|
|
Term
| Why question treat of PPD converters > 35 yo? |
|
Definition
| Risk of hepatitis and other drug toxicities may outweigh the risk of developing active TB dz. |
|
|
Term
| Why 12 months Isoniazid (INH) tx for recent PPD converters? What else can you do? |
|
Definition
|
|
Term
| What is not recommended in non-immunocompromised pts? |
|
Definition
multi drug tx or prophylaxis
ie: INH and rifampin |
|
|
Term
|
Definition
| minimum of three anti-TB drugs |
|
|
Term
| presentation of community acquired pnx |
|
Definition
- 1-10 day hx of increasing cough
- yellow sputum
- SOB
- tachycardia
- pleuritic CP
- fever or hypothermia
- sweats
- rigors |
|
|
Term
|
Definition
- altered breath sounds
- crackles
- dullness to precussion (with effusion)
- bronchial breath sounds over area of consolidation |
|
|
Term
|
Definition
| PCN G benzathine (tx of choice) |
|
|
Term
| presentation of atypical pnx |
|
Definition
- low grade fever
- relatively mild pulm sx that are self-limited.
- non-productive cough
- myalgia
- fatigue |
|
|
Term
|
Definition
MOST COMMON: Streptococcus pneumoniae
Haemophilus influenza
Staphylococcus aureus
Klebsiella pneumoniae
- and gram NEGATIVE bacilli
VIRAL:
influenza
respiratory syncytial virus (RSV)
adenovirus
parainfluenza |
|
|
Term
| pathogens of atypical CAP |
|
Definition
MOST common: mycoplasma pneumoniae
Chlamydia pneumoniae
legionella
moraxella |
|
|
Term
| pathogens of hospital acquired pnx |
|
Definition
MOST COMMON: Staphylococcus aureus
and gram-NEGATIVE bacilli
MOST LIKELY ICU: Pseudomonas aeruginosa (worst prognosis) |
|
|
Term
| abx tx of choice in outpt atypical pnx |
|
Definition
|
|
Term
| alternative to PCN in uncomplicated outpt pnx |
|
Definition
| erythromycin with cephalosporin |
|
|
Term
|
Definition
| continuous positive airway pressure |
|
|
Term
| UPP (define and give success rate) |
|
Definition
| Uvulopalatopharyngoplasty - 2nd generation tx. 1/3 of pts benefit |
|
|
Term
| rx tx for depression and insomnia |
|
Definition
| tricyclic antidepressants |
|
|
Term
| classic presentation of TB |
|
Definition
- fatigue
- anorexia
- weight loss
- low-grade fever
- intermittent night sweats
- non-productive cough progressing to productive |
|
|
Term
|
Definition
- myalgia
- chills
- HA
- Nasal congestion |
|
|
Term
| presentation of pneumocystis carinii |
|
Definition
- chronic dry cough
- dyspnea with exertion
- HIV + |
|
|
Term
|
Definition
| - intermittent chest wall pain exacerbated by deep breathing and movement |
|
|
Term
| cause of cobblestoning of pharyngeal mucosa |
|
Definition
| inflammatory response attracting increased numbers of eosinophils, compounded by the presence or post nasal drip. |
|
|
Term
| cobblestoning is a sign of... |
|
Definition
| chronic allergic rhinitis |
|
|
Term
| cerumen impaction can cause... |
|
Definition
| stimulation of the cough reflex |
|
|
Term
|
Definition
| interstitial pulmonary edema secondary to heart failure. |
|
|
Term
| chronic productive cough with rhonchi and wheezing auscultated in bilat lung fields. |
|
Definition
|
|
Term
| rx tx for small pneumothorax. (and why does it work?) |
|
Definition
| high flow O2, resulting nitrogen gradient will speed resorption. |
|
|
Term
| rifampin toxicity is associated with... |
|
Definition
| liver dysfunction, rash, flu-like syndrome |
|
|
Term
|
Definition
| hepatitis and peripheral neuropathy |
|
|
Term
| most common SE of ethambutal and associated sx |
|
Definition
optic neuritis
sx: difficulty seeing, distorted areas of central vision |
|
|
Term
| common SE of pyrazinamide |
|
Definition
| hyperuricemia and hepatitis. |
|
|
Term
| relative contraindication for PFTs (and why?) |
|
Definition
| acute severe asthma (adds nothing to initial tx and may not be tolerated by pt.) |
|
|
Term
| test to gain info of resp status in advanced emphysema, CAP and silicone pneumoconiosis |
|
Definition
|
|
Term
| pneumococcal shot vaccinates against what pathogen? (Why is that important?) |
|
Definition
| streptococcus pneumoniae (causes 90% of bacterial pnx in US.) |
|
|
Term
| cause of 90% of bacterial pnx in US |
|
Definition
|
|
Term
| People born before 1957 are considered immune to... |
|
Definition
|
|
Term
| pathogen of pnx most common in ETOH abusers and/or pts with DM |
|
Definition
|
|
Term
| pathogen of pnx most common in young adults in ambulatory settings |
|
Definition
|
|
Term
| bacterial pnx following influenza is most common in... |
|
Definition
| elderly or pts with chronic pulmonary, cardiac or metabolic dz |
|
|
Term
| most common pathogens of bacterial pnx |
|
Definition
staphylococcus aureus
streptococcus pneumoniae
haemophilus influenzae |
|
|
Term
| After smoking, common historical factors of COPD |
|
Definition
| air pollution, airway inf, fanilial factors, allergies |
|
|
Term
| alcohol intoxication contributes to hat type of pnx |
|
Definition
|
|
Term
| hx smoking and _______ markedly increase risk of lung CA |
|
Definition
|
|
Term
| occupational pneumoconiosis |
|
Definition
|
|
Term
| rare familial factor associated with COPD |
|
Definition
| alpha 1 - antitrypsin deficiency |
|
|
Term
| tx for child living with active TB pt and negative PPD |
|
Definition
| Isoniazid for 3 months, repeat skin test, isoniazid for 9 more months of positive PPD. |
|
|
Term
| when is a CXR, and also sputum cx indicated in TB. |
|
Definition
CXR after + PPD
sputum cx for symptomatic dz |
|
|
Term
| pnx in which CXR appearance looks more severe than the pt presentation? |
|
Definition
|
|
Term
| mycoplasma pneumoniae typically affects... |
|
Definition
| young adults in the summer or fall |
|
|
Term
| CXR and sputum gram stain with mycoplasma pneumoniae PNX |
|
Definition
CXR worse than pt appears.
sputum has PMNs and monocytes |
|
|
Term
| CXR and sputum gram stain with legionella pneumoniae PNX |
|
Definition
CXR: patchy or lobar infiltrates
Sputum gram stain: PMNs and no bacteria. |
|
|
Term
| CXR and sputum gram stain with chlamydiae pneumoniae PNX |
|
Definition
CXR segmental infiltrates
Gram stain non-specific. |
|
|
Term
| who gets chlamydiae pneumoniae PNX |
|
Definition
| more common in immunocompromised pts, |
|
|
Term
Of the four, which have similar presentations?
mycoplasma pneumoniae
legionella pneumoniae
chlamydiae pneumoniae
pneumocystis carinii |
|
Definition
mycoplasma pneumoniae and
chlamydiae pneumoniae |
|
|
Term
| CXR and sputum gram stain with pneumocystis carinii PNX |
|
Definition
CXR diffuse interstitial infiltrates
gram stain nonspecific |
|
|
Term
|
Definition
| to penetrate the interstices of a tissue or substance. |
|
|
Term
|
Definition
(toxoplasmosis, other agents, rubella, cytomegalovirus, herpes simplex)
- any of a group of infections seen in neonates due to one of the causative agents having crossed the placental barrier; they all have similar symptoms in babies and may be clinically silent in the mothers. |
|
|
Term
|
Definition
| the presence of fluid in the pleural space |
|
|
Term
|
Definition
- incomplete expansion of a lung or a portion of a lung; it may be a primary (congenital), secondary, or otherwise acquired condition.
- airlessness or collapse of a lung that had once been expanded.
- absence of air in a normally air-filled space |
|
|
Term
|
Definition
a rebound phenomenon occurring in diabetes mellitus: overtreatment with insulin induces hypoglycemia, which initiates the release of epinephrine, corticotropin, glucagon, and growth hormone, which stimulate lipolysis, gluconeogenesis, and glycogenolysis, which in turn result in hyperglycemia.
(Called also rebound hyperglycemia and Somogyi effect.) |
|
|
Term
| pleural (tactile) fremitus |
|
Definition
| a palpable vibration of the wall of the thorax due to a friction rub between the opposing surfaces of the pleura. |
|
|
Term
|
Definition
a discontinuous sound consisting of a series of short nonmusical noises, heard primarily during inhalation;
called also crackle. |
|
|
Term
|
Definition
a discontinuous sound consisting of a series of short nonmusical noises, heard primarily during inhalation;
called also rales |
|
|
Term
|
Definition
a continuous sound consisting of a dry, low-pitched, snorelike noise, produced in the throat or bronchial tube due to a partial obstruction such as by secretions.
Sometimes called sonorous |
|
|
Term
| Most common pathogen in CAP |
|
Definition
|
|
Term
|
Definition
- productive cough
- fever
- shaking/chills
- diaphoresis
PE:
fremitus
rhonchi |
|
|
Term
| in PE, what is seen on pulmonary angiogram? |
|
Definition
- filling defects in partially occluded vessels
- abrupt cutoff of larger vessels
- "pruning", tapering or absence of smaller vessels. |
|
|
Term
| in PE, why VQ over pulmonary angiogram? |
|
Definition
- There is known morbidity and mortality with pulm angiogram and
- VQ is non-invasive. |
|
|
Term
| cromolyn sodium's use in asthma |
|
Definition
| mast cell-stabilizing agent used in the prophylaxis of asthma. (Non-acute phase) |
|
|
Term
|
Definition
quick acting bronchodilator, relaxing airway smooth muscle
(beta2-agonist) |
|
|
Term
|
Definition
bronchodilator, relaxing airway smooth muscle
(beta2-agonist) |
|
|
Term
| atrovent (other name and MOA) |
|
Definition
ipratropium
- antagonizes acetylcholine receptors
- producing bronchodilation
- anticholinergic |
|
|
Term
ipratropium
(other name and MOA) |
|
Definition
Atrovent
- antagonizes acetylcholine receptors
- producing bronchodilation
- anticholinergic |
|
|
Term
| amantadine (other name and class) |
|
Definition
|
|
Term
| When does the flu vaccine kick in? |
|
Definition
|
|
Term
| How long should amantadine be given? |
|
Definition
|
|
Term
| presentation of asbestosis |
|
Definition
- fibrosis
- pleural plaques (+/- clacifications)
- dyspnea
- common in shipbuilders |
|
|
Term
| Presentation of silicosis |
|
Definition
- does not have pleural plaques like asbestosis
- associated with silica (sandblasting)
- interstitial fibrosis |
|
|
Term
|
Definition
| crystalline silica (a component of silica dust) is inhaled, causes inflammation of the lung tissue, inflammation leads to scar tissue formation on the lungs. The scar tissue obstructs the flow of oxygen into the lungs and into the bloodstream. |
|
|
Term
| complications of silicosis |
|
Definition
- susceptible to bacterial or fungal infections.
- can also lead to other resp dz as lung cancer and tuberculosis. |
|
|
Term
| early and late sx silicosis |
|
Definition
Early:
- Shortness of breath following physical exertion
- Cough
- Minor fatigue
- Loss of appetite
- Occasional chest pains
- cyanosis
Late: (similar to TB)
- Chronic shortness of breath
- persistent cough
- Severe fatigue
- Chest pains
- Fever
- Weight Loss
- Night sweats
- Advanced degree of cyanosis
- Respiratory failure |
|
|
Term
| Lung dz associated with metallic iron exposure (who gets it?) (AKA?) |
|
Definition
Siderosis (mining and foundry workers)
AKA: Welder's lung |
|
|
Term
| name for chronic fibrotic lung dz |
|
Definition
|
|
Term
| Name 5 occupational pneumoconioses and their associated occupations. |
|
Definition
1. asbestosis - ship workers, construction
2. siderosis - iron exposure, foundry workers, welders and miners.
3. byssinosis - cotton workers
4. coal worker's pneumoconioses - coal dust
5. silicosis - sand blasters and silica dust. |
|
|
Term
| Physical Exam Lung findings are rarely seen in... |
|
Definition
Pulmonary embolism
Pulmonary HTN |
|
|
Term
| Elderly may present PNX with bronchial lung sounds, egophony, tactile fremitus, and dullness to percussion. But what may be absent and what may be present that differs from younger pts? |
|
Definition
Confusion may be only presenting sx.
Fever may be absent. |
|
|
Term
| Pulmonary edema presents where in the lungs? |
|
Definition
| bilaterally and is most pronounced in the bases. |
|
|
Term
|
Definition
- abnormal, diffuse, extravascular accumulation of fluid in the pulmonary tissues and air spaces due to changes in hydrostatic forces in the capillaries or to increased capillary permeability
- characterized clinically by intense dyspnea and, in the intra-alveolar form, by voluminous expectoration of frothy pink serous fluid and, if severe, by cyanosis.
- Called also wet lung. |
|
|
Term
|
Definition
| increased resonance of voice sounds, with a high-pitched nasal or bleating quality, heard especially over lung tissue that is compressed or consolidated by pleural effusion. |
|
|
Term
| pulmonary HTN (define and give causes) |
|
Definition
- increased pressure (above 30 mm Hg systolic and 12 mm Hg diastolic) within the pulmonary arterial circulation.
- Primary is idiopathic
- Secondary is
(1) hypoxic vasoconstriction,
(2) decreased area of the pulmonary vascular bed, and
(3) volume/pressure overload. |
|
|
Term
| moraxella catarrhalis (occurs in...and is treated with....) |
|
Definition
elderly with pre-existing lung dz
Sulfamethoxazole-trimethoprim |
|
|
Term
| abx of choice for streptococcus pneumoniae |
|
Definition
|
|
Term
| abx of choice for mycoplasma pneumoniae |
|
Definition
|
|
Term
| presentation of mycoplasma pneumoniae |
|
Definition
- children and young adults
- URI
- nonproductive cough
- general systemic sx
- minimal chest findings
- bullous myringitis |
|
|
Term
| Use cefotaxime for ______, _________, and _________ pnx which occurs with _________ and ________. |
|
Definition
haemophilus influenzae, klebsiella pneumoniae, escheria coli
chronic dz and hospitalized pts. |
|
|
Term
| risk factors for deterioration in infants with bronchitis |
|
Definition
---Initial presentation
1. Tachypnea (RR >60–80) or retractions
2. Hypoxia: cutoffs ranging from SaO2
<90% to <95%
3. Difficulty feeding or dehydration
---Age
- Age <12 months
- The lower the age, the higher the risk
---Comorbidities
- Bronchopulmonary dysplasia
- Cystic fibrosis
- Congenital heart disease
- Prematurity Gestational age at birth <36 weeks
---Lower annual family income |
|
|
Term
| Indications for hospitalization of patients with stridor (7) |
|
Definition
1. stridor at rest
2. dyspnea
3. actual or suspected epiglottis
4. repeatedly awakening from sleep with stridor
5. a history of rapid progression of symptoms
6. toxic appearance
7. apneic or cyanotic episodes. |
|
|
Term
| indication and MOA for racemic epinephrine |
|
Definition
Indication: bronchospasm
Mechanism Of Action:
stimulates alpha- and beta-adrenergic receptors, reducing mucosal secretions and relaxing bronchial smooth muscles (sympathomimetic) |
|
|
Term
| dosing for racemic epinephrine (also onset and duration) |
|
Definition
<4 yo
0.05 mL/kg NEB q2-4h
Max: 0.5 mL/dose q1-2h
>4 yo
0.5 mL NEB q3-4h
Onset 1-5min
Duration 1-3h |
|
|
Term
| When do you use oral steroids in a infant or child in resp distress? |
|
Definition
| After racemic epinephrine alone fails. Steroids are controversial. |
|
|
Term
| Onset of action for IV antihistamines? |
|
Definition
|
|
Term
| In pediatric anaphylaxis, how should epinephrine be given? |
|
Definition
0.3-0.5mg of 1:1000 sol (0.01 mg/kg) SC/IM q20min-4h prn
then 0.1-1.5 mcg/kg/min IV if severe anaphylactic shock |
|
|
Term
| indications and MOA for epinephrine |
|
Definition
ACLS, asystole/PEA
ACLS, VF/pulseless
ACLS, bradycardia
anaphylaxis
severe anaphylactic shock
asthma, severe
MOA: stimulates alpha- and beta-adrenergic receptors (sympathomimetic) |
|
|
Term
| stimulates alpha- and beta-adrenergic receptors |
|
Definition
|
|
Term
| In addition to epi, what should be given to the anaphylactic child? |
|
Definition
| high flow (positive pressure) O2 |
|
|
Term
| type of cough in asthma vs infection. |
|
Definition
asthma = dry
infection = productive |
|
|
Term
| common complaint in ped with asthma |
|
Definition
|
|
Term
| hemoptysis in ped is associated with... |
|
Definition
gram negative infections
bronchiectasis
cystic fibrosis |
|
|
Term
| snoring in peds associated with... |
|
Definition
| obstructive sleep disorder |
|
|
Term
|
Definition
chronic dilatation of the bronchi marked by fetid breath and paroxysmal coughing, with the expectoration of mucopurulent matter. Types are distinguished according to the nature of the dilatations.
Called also bronchiectasia. |
|
|
Term
|
Definition
| inflammation of the bronchioles, usually occurring in children less than 2 years old and resulting from a viral infection, particularly with respiratory syncytial virus. |
|
|
Term
| Most common lethal genetic dz in US |
|
Definition
|
|
Term
| presentation of cystic fibrosis |
|
Definition
- chronic cough/URI/pulm inf
- GI findings
- failure to thrive secondary to exocrine pancreatic insufficiency
(decrease in growth chart percentile) |
|
|
Term
| When does infant GERD occur? |
|
Definition
| first few months of life. |
|
|
Term
| Most common cause of bronchiolitis? |
|
Definition
| respiratory syncytial virus (RSV) |
|
|
Term
| Indications for bronchoscopy |
|
Definition
- Cough (persistent, unexplained)
- Hemoptysis
- Wheeze (localized/fixed)
- Unexplained hoarseness and/or vocal cord paralysis
- Suspected tracheo-esophageal fistula
- Chest trauma
- Focal/unilateral hyperinflation or hyperlucency
- Localization of broncho-pleural fistula
- Atelectasis (persistent)
- Abnormal chest radiograph
-- Pleural effusion
-- Paratracheal/mediastinal/hilar mass
-- Parenchymal mass/nodule
-- Diagnosis of etiology of pneumonia
---- Recurrent/nonresolving(imunocompetent host)
---- Nosocomial
---- Immunocompromised host
- Foreign body in airway (known or suspected)
- Evaluation for rejection in lung transplant recipient
- Delivery of brachytherapy |
|
|
Term
| Where does a mass have to be to be evaluated by brochoscopy? |
|
Definition
- Paratracheal
- mediastinal
- hilar mass
- perihilar mass |
|
|
Term
| When is CT helpful in dx of lung masses? (drawback?) |
|
Definition
| detecting calcification within the mass but will not definitively differentiate benign from malignant nodules. |
|
|
Term
| What will MRI tell you about lung masses? (drawback?) |
|
Definition
- nodule size
- shape
- margins
- exact location
- satellite lesions
- Will not depict cell type, benign or malignant. |
|
|
Term
| rarely diagnostic in extrabronchial plumonary nodules |
|
Definition
|
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Term
|
Definition
| a tumorlike collection of serum in the tissues. |
|
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Term
|
Definition
| evacuation (needle aspiration) and sclerosis (injected tetracycline) |
|
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Term
|
Definition
| occurring at variance with the normal rule. |
|
|
Term
| when do you see paradoxical chest wall movement? |
|
Definition
|
|
Term
| flattening of the diaphragm |
|
Definition
|
|
Term
| How do you visualize a radiolucent airway obstruction? |
|
Definition
Inspiratory and expiratory CXR.
Trapped air will be present on inspiration and remain distal to the obstruction on expiration. |
|
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Term
| PE finding most consistent with pneumothorax |
|
Definition
| hyperresonance or tympany over the affected area |
|
|
Term
|
Definition
the transmission of the sound of whispered words through the walls of the chest, heard upon auscultation and indicating an area of consolidation.
Called also whispered bronchophony or voice. |
|
|
Term
| bronchophony or pectoriloquy indicate.... |
|
Definition
|
|
Term
| increase and decrease of tactile fremitus indicates... |
|
Definition
INCREASED:
- increased density of the lung, e.g. consolidation by pneumonia or atelectasis.
DECREASED:
- an excess of fat tissue on the chest
- the presence of air or fluid in the pleura
- lung distension |
|
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Term
| What must a sputum sample contain to be valid? |
|
Definition
| A few epithelial cells and WBCs. |
|
|
Term
| In BNP what does the value indicate? |
|
Definition
<100 = pulmonary dyspnea
>200 - cardiac dyspnea |
|
|
Term
| x-ray finding in sarcoidosis |
|
Definition
|
|
Term
| x-ray finding in mesothelioma/asbestos |
|
Definition
| pleural calcified plaques |
|
|
Term
| Where would TB lesions be seen? |
|
Definition
| Apical cavitations and mediastinal |
|
|
Term
| constellation of sx for granulomatosis with polyangitis |
|
Definition
-upper and lower resp tract sx
-necrotizing granumlomatous lesions
-glomerulonephritis
-vasculitis |
|
|
Term
| what satellite sx are associated with sarcoidosis? |
|
Definition
| hepatosplenomegaly, iritis and erythema nodosum |
|
|
Term
| Only agent proven to improve COPD outcomes. |
|
Definition
|
|
Term
| examples of exudative effusions |
|
Definition
|
|
Term
| Classic presentation of strep pneumoniae |
|
Definition
| sudden shaking rigor +/- rust colored sputum |
|
|
Term
|
Definition
| typically asymptomatic with no associated fever |
|
|
Term
| What is the acronym to remember what drugs can be put in an endotracheal tube? What are the drugs? |
|
Definition
| NAVEL - Narcan, Atropine, Valium, epi, Lidocaine |
|
|
Term
| What are cold agglutinins and what types of PNX are they positive and negative? |
|
Definition
Agglutinins are antibodies that cause the red blood cells to clump together. Cold agglutinins are active at cold temperatures.
positive in myoplasma and atypical CAP
negative in viral pneumonia |
|
|
Term
| What is the hallmark of asthma? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Common causes of transudative effusion |
|
Definition
| CHF, renal failure, liver failure |
|
|
Term
| Common reasons for elevated D-dimer |
|
Definition
| trauma, tx of lung cancer, CHF, bleeding peptic ulcer |
|
|
Term
| Gold standard in dx of PE |
|
Definition
|
|
Term
| Why would a pt with COPD/emphysema have a mild resp acidosis? |
|
Definition
| Holding in CO2 creates a mild acidosis. |
|
|
Term
|
Definition
| vaccine against tuberculosis |
|
|
Term
|
Definition
|
|
Term
| Preferred treatment for atypical pneumomnia |
|
Definition
|
|
Term
| preferred treatment in PCP |
|
Definition
|
|
Term
|
Definition
| gram negative coccobacillus |
|
|
Term
|
Definition
| lancet shaped gm positive diplococci |
|
|
Term
| Neisseria meningitides organism |
|
Definition
|
|
Term
|
Definition
|
|
Term
| PPD positive at 5mm if... |
|
Definition
-HIV-infected persons
-A recent contact of a person with TB disease
-Persons with fibrotic changes on chest radiograph consistent with prior TB
-Persons who are immunosuppressed for other reasons |
|
|
Term
| PPD positive at 10mm if... |
|
Definition
-Recent immigrants (< 5 years) from high-prevalence countries
-Injection drug users
-Residents and employees of high-risk congregate settings
-Mycobacteriology laboratory personnel
-Persons with clinical conditions that place them at high risk
-Children < 4 years of age
- Infants, children, and adolescents exposed to adults in high-risk categories |
|
|
Term
| PPD positive at 15mm if... |
|
Definition
| any person, including persons with no known risk factors for TB. |
|
|
Term
| ending of anti-viral drugs for flu A &B |
|
Definition
|
|
Term
|
Definition
|
|
Term
| ending of anti-viral drugs for flu A only |
|
Definition
|
|
Term
ABX tx for pertussis
...for contacts? |
|
Definition
macrolides (-mycin)
contacts with sulfa |
|
|
Term
| patchy infiltrates seen in... |
|
Definition
|
|
Term
| highest mortality PNX organism. ABX? |
|
Definition
| Strep aureus, gram negative, -cillins |
|
|
Term
| histoplasma capsulatum regions...associated with... |
|
Definition
| MS and OH River Valleys...bat guano |
|
|
Term
| blastomyces dermatitides region |
|
Definition
|
|
Term
| coccidioides immitis region |
|
Definition
|
|
Term
| hallmark imaging finding for fungal PNX |
|
Definition
|
|
Term
|
Definition
|
|
Term
| 90% of primary lung cancers |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Virchow's triad...what is it for?...what is it? |
|
Definition
PE
statis
endothelial damage (trauma)
hypercoagulable state |
|
|
Term
|
Definition
| right ventricular hypertrophy |
|
|
Term
| short acting beta agonists end in... |
|
Definition
| -buterol (LABA end in -terol) |
|
|
Term
| long acting beta agonists end in... |
|
Definition
| -terol (SABA end in -buterol) |
|
|
Term
| anticholenergics in asthma end in... |
|
Definition
|
|
Term
| leukotriene inhibitors end in... |
|
Definition
|
|
Term
| two mast cell stabilizers |
|
Definition
| cromolyn and nedocromil (has -crom-) |
|
|
Term
| bug and ABX in epiglottitis |
|
Definition
H. flu
cefotaxime and ceftriaxone
(-cef) |
|
|
Term
| third-generation cephalosporin antibiotic cover... |
|
Definition
| broad-spectrum activity against Gram-positive and Gram-negative bacteria. |
|
|
Term
| name third-generation cephalosporins |
|
Definition
| cefotaxime and ceftriaxone |
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