Term
| What FEV1/FVC ratio confirms diagnosis of COPD? |
|
Definition
| postbronchodilator FEV1/FVC ratio less than 70% confirms airflow limitation and dx of OBSTRUCTIVE LUNG disease. |
|
|
Term
| What guidelines are currently used to assess COPD? |
|
Definition
GOLD guidelines
(Global initiative for Chronic Obstructive Lung disease) |
|
|
Term
| What spirometry value further determines the severity of COPD? |
|
Definition
| FEV1 (meausre of airflow obstruction) |
|
|
Term
| What is considered MILD COPD? |
|
Definition
|
|
Term
| What is considered MODERATE COPD? |
|
Definition
|
|
Term
| What is considered SEVERE COPD? |
|
Definition
|
|
Term
| What is considered VERY SEVERE COPD? |
|
Definition
|
|
Term
| What intervention will decrease the risk of REintubation? |
|
Definition
| NPPV for 24 hrs post extubation |
|
|
Term
| What does one use an INCENTIVE SPIROMETER? |
|
Definition
POSTOPERATIVE pts
(has no role in the routine management of nonsurgical patients following extubation) |
|
|
Term
| Is heliox used in the management of COPD? |
|
Definition
|
|
Term
| What does N-acetylcysteine do for a pulmonary pt? |
|
Definition
| When nebulized it acts a MUCOLYTIC used to thin secretions |
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|
Term
| What is POST-ICU NUEROPSYCHIATRIC IMPAIRMENT? |
|
Definition
| long-term complication of critical illness, especially those with the dx of either severe sepsis or ARDS. The syndrome appears clinically as an aquired dementia |
|
|
Term
| What are the factors are associated with develpoment of Post-ICU NEUROPSYCHIATRIC IMPAIREMENT? |
|
Definition
AGE
duration of mechanical ventilation
glycemic control (hyper and hypoglycemia) |
|
|
Term
| What breathing pattern is typically noted in a CHF pt when sleeping? |
|
Definition
| Cheyne-Stokes breathing - correlates with cardiac function. Therefore, if Cardiac function improves CSA may dissipate |
|
|
Term
| What is ADAPTIVE SERVO-VENTILATION? |
|
Definition
a type of NPPV used in pts with CHF induced Cheyne stokes breathing.
It works by stopping during Cheyne-stokes breathing, and starting during periods of weaker respirations |
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|
Term
| Other then medical therapy, what other internvention is indicated for a pt with severe COPD (FEV1 < 50%)? |
|
Definition
|
|
Term
| What are the radiographic characteristics of a pulmonary granuloma? |
|
Definition
| densely, CENTRALLY calcified and SMOOTHLY bordered |
|
|
Term
| What radiographic characteristics of a benign CALCIFICATION in a pulmonary nodule? |
|
Definition
1. Popcorn - amorhpous calcification in rings and arcs
2. lamellar (concentric rings)
3. Central
4. diffuse |
|
|
Term
| What is the treatment for ethylene glycol poisoning? |
|
Definition
| FOMEPIZOLE + HEMODIALYSIS |
|
|
Term
| What is the management with spontaneous pneumothoraces? |
|
Definition
ADMIT - due to secondary respiratory reserve
Serial CXRs
O2
(if larger than 2cm insert small bore chest tube) |
|
|
Term
| What dx should suspected in a pt with HARD-TO-CONTROL-ASTHMA and recurrent PULMONARY INFILTRATES with CENTRAL bronchiectasis? |
|
Definition
ABPA
(allergic bronchopulmonary aspergillosis) |
|
|
Term
What is the next step in a pt with:
hard-to-control asthma
recurrent pulmonary infiltrates
CENTRAL bronchiectasis? |
|
Definition
| Allergy skin testing for aspergillus |
|
|
Term
| If a pt has a positive ABPA skin test, do they have ABPA? |
|
Definition
Not necessarily, it means they are sensitized, but not necissarily infected.
The test has high sensitivity and negative predictive value. |
|
|
Term
| What is the next step if a pt has a positive ABPA skin test? |
|
Definition
evaluation of IgE levels
(levels greater than a 1000 IU/ml) |
|
|
Term
|
Definition
| apnea-hypopnea index (AHI - the number of apneic or hypoapneic episodes in an hour) |
|
|
Term
| What should be evaluated in an asthmatic complaining of no improvement of their symtpoms with their inhaler? |
|
Definition
|
|
Term
| What is rhinitis medicamentosa? |
|
Definition
| rebound rhinitis that occurs after discontinuing topical a-adrenergic decongestant sprays (oxymetazoline) |
|
|
Term
| What is the treatment for CPAP related nasal congestion? |
|
Definition
|
|
Term
| Pts with silicosis are at significant increased risk for _________ |
|
Definition
| TB (along with several autoimmune disease) |
|
|
Term
| Results of a D-dimer assay performed after a period of anticoagulation therapy have been shown to be predictive of _________ |
|
Definition
| thombotic recurrence (therefore restart anticoagulation in D-dimer is elevated after a DVT/PE) |
|
|
Term
|
Definition
|
|
Term
|
Definition
| rare cystic lung disease that occurs sporadically in women of childbearing age or in association with tuberous sclerosis |
|
|
Term
| What are the characteristic findings in LAM? |
|
Definition
| diffuse, thin-walled, small cysts on CT |
|
|
Term
| When should you suspect LAM? |
|
Definition
| consider this in emphysema, spontaneous pneumothorax, in a young women with dypsnea and chest radiography demonstrating hyperinflation |
|
|
Term
| What diagnostic test do you order if you suspect LAM? |
|
Definition
|
|
Term
| What is the pathophysiology of LAM? |
|
Definition
| occurs secondary to smooth muscle cells that infiltrate the lung with inactivating tuberous sclerosis complex gene mutations. The mutations result in activation of mammalian target of rapamycin (mTOR) signaling pathyway. |
|
|
Term
| What is the treatment for LAM? |
|
Definition
|
|
Term
| What is sirolimus and how does it work? |
|
Definition
| it is an immunosuppressant that blocks mTOR activation of downstream kinases. |
|
|
Term
| What is respiratory bronchiolitis interstitial lung disease? |
|
Definition
| form of bronchiolitis that occurs in most smokers |
|
|
Term
| What is seen on high resolution CT in a pt with respiratory bronchiolitis ILD? |
|
Definition
| pattern of centrilobular nodules with air-trapping and scattered ground-glass attenuation. |
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