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Pulmonary
PANCE Pulmonary
230
Health Care
Graduate
09/11/2007

Additional Health Care Flashcards

 


 

Cards

Term
Test for PE
Definition
ventilation-perfusion scan (VQ)
Term
Cells involved in asthma
Definition
Mast cells
T lymphocytes
macrophages
Term
role of basophils in asthma
Definition
none
Term
Test for presence of TB (spelled out)
Definitive dx test to TB
Definition
sputum for acid fast bacilli
Definitive: sputum culture
Term
pathogen of TB
Definition
mycobacterium tuberculosis
Term
ABG finding in TB, pulm inf, and most lung carcinoma.
Definition
NML
Term
CBC finding in TB
Definition
leukoctosis
Term
group of dx suspect for cystic fibrosis
Definition
pulm inf, pancreatitis, infertility
Term
dx test for cystic fibrosis
Definition
chloride sweat test
Term
purpose of islet cell bx
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
Bronchiectasis
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
signs Bronchiectasis
Definition
-foul smelling purulent sputum
-chronic productive cough
-hemoptysis
-persistent crackles over affected lung regions
Term
presention of asthma
Definition
-episodic dyspnea
-associated wheezing
-intermittent cough
Term
cachexia
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
other name for croup
Definition
laryngotracheitis
Term
classic presenation of croup
Definition
-noisy, barking cough
-low grade fever
-cough
-inspiratory stridor
Term
stridor
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
presentation infant pnx
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
Mild intermittent asthma
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
Mild persistent asthma
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
Severe persistent asthma
Definition
- Continual symptoms

- Limited physical activity

- Frequent exacerbations

- PM Symptoms Frequent

- FEV1 or PEF < 60% predicted

- PEF variability > 30%
Term
FEV1
Definition
forced expiratory volume in 1 second
Term
MMFR
Definition
maximum midexpiratory flow rate
Term
FVC
Definition
forced vital capacity
Term
PEFR
Definition
peak expiratory flow rate
Term
FEFmax
Definition
maximum forced expiratory flow rate
Term
FRC
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
severe sx of TB
Definition
blood-streaked sputum and hemoptysis
Term
Moderate sx of TB
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
HIV +
Can add rifampin
Term
What is not recommended in non-immunocompromised pts?
Definition
multi drug tx or prophylaxis
ie: INH and rifampin
Term
tx for active TB
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
PE findings for CAP
Definition
- altered breath sounds
- crackles
- dullness to precussion (with effusion)
- bronchial breath sounds over area of consolidation
Term
tx CAP
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
pathogens of CAP
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
erythromycin
Term
alternative to PCN in uncomplicated outpt pnx
Definition
erythromycin with cephalosporin
Term
CPAP
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
sx influenza
Definition
- myalgia
- chills
- HA
- Nasal congestion
Term
presentation of pneumocystis carinii
Definition
- chronic dry cough
- dyspnea with exertion
- HIV +
Term
sx costochondritis
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
frothy, pink sputum
Definition
interstitial pulmonary edema secondary to heart failure.
Term
chronic productive cough with rhonchi and wheezing auscultated in bilat lung fields.
Definition
chronic bronchitis
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
SE of isoniazid
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
PFTs
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
streptococcus pneumoniae
Term
People born before 1957 are considered immune to...
Definition
measles
Term
pathogen of pnx most common in ETOH abusers and/or pts with DM
Definition
klebsiella pneumoniae
Term
pathogen of pnx most common in young adults in ambulatory settings
Definition
mycoplasma pneumoniae
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
aspiration
Term
hx smoking and _______ markedly increase risk of lung CA
Definition
asbestos
Term
occupational pneumoconiosis
Definition
asbestos exposure
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
mycoplasma pneumoniae
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
infiltrates
Definition
to penetrate the interstices of a tissue or substance.
Term
TORCH
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
pleural effusion
Definition
the presence of fluid in the pleural space
Term
atelectasis
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
Somogyi phenomenon
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
rale
Definition
a discontinuous sound consisting of a series of short nonmusical noises, heard primarily during inhalation;

called also crackle.
Term
crackle
Definition
a discontinuous sound consisting of a series of short nonmusical noises, heard primarily during inhalation;

called also rales
Term
rhonchus
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
Streptococcus pneumoniae
Term
s/s CAP
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
metaproterenol
Definition
quick acting bronchodilator, relaxing airway smooth muscle

(beta2-agonist)
Term
albuterol
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
Symmetrel

anti-viral
Term
When does the flu vaccine kick in?
Definition
~ 2 weeks.
Term
How long should amantadine be given?
Definition
10 days
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
describe silicosis
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
pneumonconioses
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
pulmonary edema
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
egophony
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
PCN G
Term
abx of choice for mycoplasma pneumoniae
Definition
Erythromycin
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
15-30 min
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
sympathomimetic
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
nocturnal cough
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
bronchiectasis
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
bronchiolitis
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
cystic fibrosis
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
sputum cytology
Term
seroma
Definition
a tumorlike collection of serum in the tissues.
Term
tx post-op seroma
Definition
evacuation (needle aspiration) and sclerosis (injected tetracycline)
Term
paradoxical
Definition
occurring at variance with the normal rule.
Term
when do you see paradoxical chest wall movement?
Definition
chest wall injury
Term
flattening of the diaphragm
Definition
chronic lung dz
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.
Term
PE finding most consistent with pneumothorax
Definition
hyperresonance or tympany over the affected area
Term
whispered pectoriloquy
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
consolidation
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
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
ground glass appearance
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
O2
Term
examples of exudative effusions
Definition
PNX and malignancy
Term
Classic presentation of strep pneumoniae
Definition
sudden shaking rigor +/- rust colored sputum
Term
sx of pneumoconiosis
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
hyper-reactive airway
Term
ABG: NML pH
Definition
7.35 - 7.45
Term
ABG: NML PaO2
Definition
80 to 100 mm Hg
Term
ABG: NML HCO3
Definition
22 to 26 mEq/liter
Term
ABG: NML PaCO2
Definition
35-45 mm Hg
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
pulmonary angiography
Term
Why would a pt with COPD/emphysema have a mild resp acidosis?
Definition
Holding in CO2 creates a mild acidosis.
Term
Bacillus Calmette–Guérin
Definition
vaccine against tuberculosis
Term
Mantoux test
Definition
PPD test
Term
Preferred treatment for atypical pneumomnia
Definition
macrolides -mycin
Term
preferred treatment in PCP
Definition
TMP-SMX
Term
h-flu organism
Definition
gram negative coccobacillus
Term
strep pneumo organism
Definition
lancet shaped gm positive diplococci
Term
Neisseria meningitides organism
Definition
gm negative diplococci
Term
moraxella organism
Definition
gm negative cocci
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
-amivir
Term
macrolides end in...
Definition
-mycin
Term
ending of anti-viral drugs for flu A only
Definition
-anitidine
Term
ABX tx for pertussis
...for contacts?
Definition
macrolides (-mycin)
contacts with sulfa
Term
patchy infiltrates seen in...
Definition
atypical pnx
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
US Midwest
Term
coccidioides immitis region
Definition
desert areas of SW AZ
Term
hallmark imaging finding for fungal PNX
Definition
miliary pattern
Term
ABX for PNX with HIV
Definition
TMP/SMX
Term
90% of primary lung cancers
Definition
bronchogenic carcinoma
Term
imaging finding in CF
Definition
honeycombing
Term
Virchow's triad...what is it for?...what is it?
Definition
PE

statis
endothelial damage (trauma)
hypercoagulable state
Term
cor pulmonale
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
-tropium
Term
leukotriene inhibitors end in...
Definition
-lukast
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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