Term
Ipratroprium
- Brand name
- MOA
- Dosing |
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Definition
- Atrovent HFA
- Anti-cholinergic
- acetylcholine antagonist
- 2 puffs QID: 17MCG/ spray |
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Term
Non-acute Asthma Tx
- 3 tiers |
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Definition
- INH Bronchodilator
- INH Steroid
- INH Long acting Beta2
- such as salmeterol |
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Term
Salmeterol
- Brand name
- MOA
- Dosing |
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Definition
- Serevent Diskus
- Long acting B2 agonist
- 1 puff Q12: 50mcg/puff |
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Term
| Best test for Dx asthma and Dx criteria |
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Definition
- PFT pre/post bronchodilator
- >12% increase in FEV1 post dilator |
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Term
Community Acquired Pneumonia
- Most common bugs
- Less common bugs
- Young & healthy vs COPD vs immunodef
- Typical Abx |
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Definition
- S. Pneumo >H. flu >M. Cat
- Legionella, Klebsiella, Flu A/B
- Mycoplasma & Chlamydia (young/healthy)
- COPD: H. Flu and M. Cat
- Rocephin + Azithro |
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Term
Hospital Acquired Pneumonia
- Bugs
- Tx |
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Definition
- GNR (Including pseudomonas)
- Klebsiella, Enterobacter Incl. E.coli
- MRSA, Serratia, Acinetobacter
- Rocephin+Azithro
- If pseudomona: Pip/Taz = Zosyn |
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Term
Omalizumab
- Brand name
- MOA
- Dosing |
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Definition
- Xolair
- anti.IgE
- 150-375mcg Q 3-4 Weeks |
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Term
Monteleukast
- Brand name
- MOA
- Use |
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Definition
- Singulair
- leukotriene Inhib
- Atopic Disease |
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Term
Is C02 rentention an indication to intubate someone with COPD exacerbation?
- why or why not? |
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Definition
No
- COPD = chronic CO2 retention.
- Intubate if pH drops on ABG |
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Term
| If FEV1/FVC is <75 - this suggests? |
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Definition
| Obstruction (such as COPD or asthma) |
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Term
| What are typical physical data findings for people with COPD? EKG - CXR - CBC - Chem - ABG - Residual Volume - DLCO |
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Definition
| EKG: RAD, RVH, RAH - CXR: hyperinflation - CBC: erythrocytosis (microcytic) - Chem: Increased HC03 - ABG: C02 up, PO2 down - Resid. vol.: Increased - DLCO: Decreased |
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Term
| Chronic Medical Therapy for COPD. - Inhalers - Vaccines - Smoking - When to start home O2 |
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Definition
| Inhalers: __tropium & albuterol - Vaccines: Heptavalent PNA & Influenza - Stop smoking - Start home O2: PO2 <55 or SpO2 < 88 |
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Term
| Suspect Alpha-1-antitrypsin deficiency when? |
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Definition
| COPD in a nonsmoker <40 or a smoker <30 |
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Term
| PFT results for ILD. FEV1 - FVC - FEV1/FVC ratio |
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Definition
| FEV1: low - FVC: low - FEV1/FVC ratio: normal to increased (because effect of ILD on FVC is worse than its effect on FEV1) |
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Term
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Definition
| Asbestosis - Silicosis - Coal worker's lung - Byssinosis (cotton) - Berylliosis (lightbulbs and electronics) |
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Term
| Which form of ILD responds to steroids? |
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Definition
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Term
| Patient presents with ILD Sx that developed over weeks (not months/years), they have no exposures and they also have Fv, malaise, myalgias. What is it and how to Tx? |
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Definition
| BOOP/COP - Tx with steroids - CXR shows patchy infiltrates |
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Term
| AfAm woman under 40 presents with cough, SOB and fatigue. Enlarged Lymph nodes on CXR and bronch shows Tlymphs and Monocytes. |
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Definition
| Sarcoidosis (caseating granulomatous Dz) Tx with steroids |
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Term
| Primary pulmonary HTN is idiopathic, but secondary has several causes such as? |
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Definition
| Mitral Stenosis, COPD, Polycythemia vera, ILD, OSA, chronic small PE's |
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Term
| Best diagnostic tests for Pulmonary HTN are? |
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Definition
| TTE (can get size of atrium and ventricles and only ESTIMATE PA pressure if there is Valve regurg) Single best test is Right Heart Cath. |
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Term
| Medical therapies for pulmonary HTN include? |
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Definition
| Bosentan (endothelin receptor inhibitor) - Epo/treproprostanil (Prostacyclin analogues [dilators]) - CCBs - Sildenafil (Revatio) PD5EI |
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Term
| The risk factors for PE: ITS Me |
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Definition
| Immobilization - Thrombophilia & Trauma - Surgery - Malignancy |
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Term
| Name the thromophilias that are worrisome for PE |
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Definition
| Factor V, Lupus anticoagulant, Protien C & S |
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Term
|
Definition
| hypoxia with an increased A-a gradient w/ mild respiratory alkalosis (2'2 tachypnea) |
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Term
| Most common xray finding in PE |
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Definition
| Normal > atelectasis > Westermark wedges and Hampton humps |
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Term
| For a VQ scan to be accurate the CXR must be _____. If totally neg, the VQ scan means ____ % chance of PE. Low probability VQ = ____% chance of PE. High probability scan means ____% of PE. |
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Definition
| For a VQ scan to be accurate the CXR must be NORMAL. If totally neg, the VQ scan means 0 % of PE. Low probability VQ = 15% chance of PE. High probability scan means 85% chance of PE. |
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Term
| What % of DVT's originate in pelvic veins making LEUS about ____ % Sensitive. |
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Definition
| 30% of DVT's originate in pelvic veins making LEUS about 70% Sensitive. |
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Term
| Protein and LDH of Exudative Effusion versus Protein and LDH of Transudative effusion. Also, name this criteria. |
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Definition
| Exudate: Protein and LDH >50% and >60% of serum values. Transudate <50% and <60% of serum values. >(Light's Criteria) |
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Term
| Exudative lung effusion is suggestive of? |
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Definition
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Term
| Transudative lung effusion is suggestive of? |
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Definition
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Term
| Which PFT parameter is best correlated with an obstructive process if Low? |
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Definition
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Term
| Which PFT parameter is best correlated with restriction if low? |
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Definition
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Term
| Pulmonary complication of Myasthenia Gravis treatment? |
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Definition
| Excessive pyridostigmine--> cholinergic effects: bronchorrhea |
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Term
| What is the first step in interpreting a PFT? |
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Definition
| Look at TLC. If < 80% - there is a restrictive process. |
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Term
| What is the second step in interpreting a PFT? |
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Definition
| Check RV. If > 120 - consider air trapping such as COPD |
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Term
| What is the third step in interpreting a PFT? |
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Definition
| Check FEV1/FVC. If <75 - Obstruction is present. ROAD, COPD (Emphysema or chronic bronchitis) |
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Term
| How can you check to see if small airways are affected on a PFT? |
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Definition
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Term
| IF DLCO is <80% in a restrictive pattern (TLC <80) this suggests? |
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Definition
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Term
| If DLCO is <80% in an obstructive pattern (FEV1/FVC <75) This suggests? |
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Definition
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