Term
| Path findings with airway remodeling |
|
Definition
| Increased muscle mass, angiogenesis, subepithelial fibrosis, mucous gland hyperplasia. |
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|
Term
| Reversibility of obstruction on PFTs is indicated by |
|
Definition
| improvement of > 12% with beta-2-agonist tx |
|
|
Term
| Peak expiratory flow rate scale |
|
Definition
Stable disease - baseline to 20% reduced
Moderate increased obstruction - 20-50% reduced
Severe airway obstruction - > 50% reduced |
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|
Term
| Methocoline challenge can be positive in... |
|
Definition
| cigarette smoking, COPD, allergic rhinitis, asthma, recent viral inf. |
|
|
Term
| allergy testing in asthma |
|
Definition
| Appropriate for hard to control disease with skin tests of radioallergosorbent serum IgE tests (when skin testing is unaavailable) |
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Term
|
Definition
| A disease state defined by localized, irreversible dilation of part of the bronchial tree. It is classified as an obstructive lung disease, along with emphysema, bronchitis and cystic fibrosis. Involved bronchi are dilated, inflamed, and easily collapsible, resulting in airflow obstruction and impaired clearance of secretions. |
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Term
|
Definition
| Inflammation of the bronchioles |
|
|
Term
| Treatment of allergic bronchopulmonary aspergillosis |
|
Definition
| oral steroids until dz is controlled, then tapered, with IgE level monitoring. |
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|
Term
| Vocal cord dysfunction on flow volume loops |
|
Definition
| Displays a flat inspiratory (bottom) loop. |
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|
Term
| COPD is clinically defined by... |
|
Definition
| post-bronchodialator FEV1 < 80% of predicted and FEV1/FVC < 0.70. This confirms a component of non-reversible airflow limitation AKA COPD. |
|
|
Term
| Lung volume reduction surgery in COPD is most effective on patients with... |
|
Definition
| severe upper lung disease with relatively preserved lower lungs, and FEV1 and DLCO > 20% of predicted. |
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|
Term
| Criteria for lung transplant |
|
Definition
| FEV1 < 35%, PO2 < 55, PCO2 > 50, secondary pHTN |
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|
Term
| Parenchymal lung diseases that can present acutely |
|
Definition
| Vasculidities (Wegeners, microscopic polyangitis, Churg-Strauss), acute interstitial PNA, eosinophillic PNA |
|
|
Term
| Little benefit from lung biopsy in patients with... |
|
Definition
| likely IPF and DLCO < 20% OR rapid decline |
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|
Term
| Radiation pnemonitis vs fibrosis |
|
Definition
Pneumonitis - 1-6 months, confluence on CXR, tx with steroids.
Fibrosis - 6-24 months, fibrotic changes, no tx. |
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|
Term
| Symptoms of hypersensitivity pneumonitis |
|
Definition
Dyspnea, dry cough, fever, weight loss, fatigue, body aches. Mid lung crackles, squeaks. Sx develop within 4-12 hours of exposure and go away with abstinence.
CXR - mid/upper lung fibrosis., HRCT with ground glass, centrilobular nodules and air trapping.
Histopath - poorly formed glanulomas, bronchiolitis, lymphoplasmacitic interstitial inflammation |
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|
Term
| ILDs associated with tobacco |
|
Definition
| Pulmonary langerhands cell histocytosis, respiratory bronchiolitis-assoc ILD, desquamative interstitial PNA. |
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|
Term
| Radiographic findings of pulmonary langerhans cell histiocytosis |
|
Definition
| HRCT with nodules accompanied by thin-walled cysts in upper and middle lung fields |
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|
Term
| Radiographic findings typical for IPF |
|
Definition
| HRCT with reticular opacities and honeycombing with a peripheral and basilar predominance and minimal-no ground glass |
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|
Term
| Findings in acute exacerbation of IPF |
|
Definition
| Rapid onset <30 days, HRCT with ground glass, no infection, PE, left heart failure. High mortality. |
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|
Term
| Nonspecific interstitial pneumonitis findings |
|
Definition
| CLinically similar to IPF, HRCT with basilar and mid-lung reticular changes, with rare honeycombing, but with ground glass. Histopath has lymphoplasacytic infiltration +/- fibrosis. |
|
|
Term
| Nonspecific interstitial pneumonitis findings |
|
Definition
| CLinically similar to IPF, HRCT with basilar and mid-lung reticular changes, with rare honeycombing, but with ground glass. Histopath has lymphoplasacytic infiltration +/- fibrosis. |
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|
Term
|
Definition
Usually after 6-8 weeks of symptoms, fater several courses of failed abx for bacterial PNA. CXR with scattered, peripheral, b/l opacities.
Tx with steroids. |
|
|
Term
|
Definition
| Diffuse alveolar damage and diagnosis of exclusion from acute IPF, connective tissues dz, PNA, sepsis, inhalational injury. |
|
|
Term
|
Definition
| steroids (initially 0.5 - 1 mg/kg/day x 1-3 months), methotraxate, hydroxychloroquine, azathioprine. Infliximab not proven successful. |
|
|
Term
| Lymphangioleiomyomatosis - diagnosis, associations, prognosis. |
|
Definition
| progressive, cystic lung disease, women in 20s-30s, connected with tuberous sclerosis. Slowly progressive, ends in lung transplant. |
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|
Term
|
Definition
| Sarcoid with fever, erythema nodosum, polyarthralgia, and hilar lymphadenopathy. |
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|
Term
| Asbestos exposure manifestations |
|
Definition
| Pleural plaques, b/l interstitial fibrosis, with latency of 20-30 years. Asbestosis only refers to interstitial fibrosis. Also seen are rounded atelectasis and and benign pleural effusion |
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|
Term
| Exposure related COPD causes |
|
Definition
|
|
Term
| Most likely causes of pleural effusions |
|
Definition
| Transudate - CHF. Exudate - Malignancy or parapneumonic. |
|
|
Term
|
Definition
Pleural fluid : serum total protein > 0.5 AND / OR
Pleural LDH : upper limit of normal serum LDH > 0.67 |
|
|
Term
| Black pleural fluid is from... |
|
Definition
| aspergillus niger infection |
|
|
Term
| Yellow-green pleural fluid is from |
|
Definition
|
|
Term
| Red pleural fluid is from... |
|
Definition
| malignancy, benign asbestos, post-cardiac injury, pulmonary infarct, trauma |
|
|
Term
| Differential of exudative plerual effusions with >80% lymphocytes |
|
Definition
| TB, lymphoma, chylothorax, sarcoid, rheumatoid pleuresy, post CABG, post lung transplant, yellow nail syndrome, fungal infections |
|
|
Term
| Pleural pH < 7.3 (or low glucose) narrows the diagnosis to... |
|
Definition
| complicated parapneumonic effusion, esophageal rupture, chronic rheumatoid pleurisy, malignancy, lups pleuritis, and TB. |
|
|
Term
| Pleural fluid : serum amylase concentration > 1 indicates |
|
Definition
| pancreatic disease, esophageal rupture, or malignancy, likely lung adenoCA |
|
|
Term
| Pleural fluid : serum amylase concentration > 1 indicates |
|
Definition
| pancreatic disease, esophageal rupture, or malignancy, likely lung adenoCA |
|
|
Term
| Treatment of secondary pneumothorax |
|
Definition
| Aspiration if <2cm, minimally breathless pts, < 50 yo -> else small bore catheter, if unsuccessful after 2-3 days -> chest tube |
|
|
Term
|
Definition
| COPD and other airways dz, ILDs, necrotizing PNA, PCP, connective tissue diseases with lung involvement, CF |
|
|
Term
| Indications for pleurodesis |
|
Definition
| Post-expansion PNX treated with tube thoracotomy. |
|
|
Term
|
Definition
| <2cm, observe, >2cm, repeat aspiration -> small bore catheter, if unsuccessful after 2-3 days -> chest tube |
|
|
Term
|
Definition
| Venous stasis, vascular endothelial damage, hypercoaguability |
|
|
Term
|
Definition
| Chronic thromboembolic pHTN, 1-2% of post_PE pts., VQ scan is positive, pulmonary angiography predicts success of treatment with thrombendarterectomy |
|
|
Term
|
Definition
| 93% idiopathic, must differential between primary and secondary causes, echo shows RV issues, VQ scan with moth-eaten appearance, right heart cath. |
|
|
Term
|
Definition
| prostacyclin analogues (epoprostenol (IV), trepostnil (SQ), iloprost (PO)), endothelin receptor antagonists(bostentan, ambrisentan) and sildenfil. |
|
|
Term
| Lung Nodule size and f/u recommendations |
|
Definition
< 4mm with low risk (non-smoker, no risk factors) no f/u.
<4 mm in high risk of 4-6mm low risk - f/u in 12 months, stop if unchanged
4-6 high risk 6-8 low risk - 6-12 mo f/u, if unchanged, check again in 18-24 months
6-8 high risk - check in 3-6 months, if unchanged in at 1 and 2 years.
> 8 CT contrast, PET scan, biopsy or follow at 3,9, and 24 months. |
|
|
Term
| NSCLC comprises ___ % of Lung CA |
|
Definition
| 80. - adenoCA, squamous cell, large cell. |
|
|
Term
| After not smoking for 15 years... |
|
Definition
| your rate of lung CA is stably twice a never-smoker. |
|
|
Term
|
Definition
| liver, brain, adrenals, bone |
|
|
Term
| Paraneoplastic autoantibodies |
|
Definition
| ANNA-1,2,3 PCA1 and PCA2. |
|
|
Term
|
Definition
| Stage I and II is surgery, well tolerated with post-op FEV1 and DLCO > 40% of predicted. PET scanning is cost effective for staging. |
|
|
Term
| Anterior mediastinal masses |
|
Definition
| 5 Ts. Thyroid, thymoma, teratoma, T-cell lymphoma, Thomas Hodgkin dz. |
|
|
Term
| bronchial carcinoid tumors |
|
Definition
| Neuroendocrine, obstructive, typical (10 yr survival rate of 90%) and atypical (worse - 5 yr survival rate of 60-70%) |
|
|
Term
|
Definition
| Head and neck, kidney, thyroid, colon, breast |
|
|
Term
|
Definition
Mild - 5-15 AHI/hr
Moderate - 16-30 AHI/hr
Severe - > 30 AHI/hr |
|
|
Term
|
Definition
| CPAP for opening the airway, BIPAP for opening the airway plus additonal support for hypoventilation. |
|
|
Term
| Oxygen therapy is indicated... |
|
Definition
| in NON-HYPERCAPNIC CENTRAL sleep apnea. CPAP is also indicated. |
|
|
Term
|
Definition
|
|
Term
| High altitude pulmonary edema is treated by... |
|
Definition
| O2, descent and nifedipine |
|
|
Term
|
Definition
(150 mm Hg - PCO2 / 0.8 ) - PO2.
< 10 is normal |
|
|
Term
|
Definition
< 200 is ARDS
200-300 is acute lung injury |
|
|
Term
| Measurements of neuromuscular disease in ventilatory failure |
|
Definition
| VC < 20 and NIF < 30 indicate high risk |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Initially, respiratory alkalosis. Resolving or low PCO2 is a sign of impending respiratory collapse. |
|
|
Term
| Gastric insufflation with NPPV occurs at... |
|
Definition
|
|
Term
|
Definition
| RR / tidal volume. Done of pts with O2 sat > 90%, FiO2 < 40%, PPEP < 5. Performed on low levels of CPAP, RSBI < 105 can proceed to spontaneous breathing trial. |
|
|
Term
|
Definition
Known or suspected infection and two of the following:
T > 38 or < 36
Leukocytes > 12 or < 4
RR > 20
HR > 90 |
|
|
Term
|
Definition
| SIRS + evidence of one sepsis-induced organ dysfunction. |
|
|
Term
| Indications for drotrecogin alfa |
|
Definition
a.k.a. Activated protein C - severe sepsis requiring vasopressors despite fluid resuscitation and sepsis-induced ARDS requiring intubation and two sepsis-induced ARDS end organs. Contraindicated in active bleeding, other AC and platelets < 30
Absolute increase in mortality at 2,5 years of 12% over placebo. |
|
|
Term
| In smoke inhalation injuries, early hypoexmia is linked with |
|
Definition
|
|
Term
|
Definition
| a compound formed by CO and HGB |
|
|
Term
|
Definition
| HGB with an Fe+3 instead of Fe+2 - therefore unable to carry O2. |
|
|
Term
| Antihypertensive emergency treatments |
|
Definition
| IV hydralazine, nitroprusside, NTG, labetalol, nicardipine, Enalapril |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Glucagon, CaCl, ventricuar pacing |
|
|
Term
|
Definition
| CaCl, glucagon, ventricular pacing |
|
|
Term
| Nitroprusside (cyanide) antidote |
|
Definition
| Nitrites, sodium thiosulfate, hydroxycobalamin |
|
|
Term
|
Definition
| digoxin specific antibody Fab fragments |
|
|
Term
| gamma-hydroxybuterate antidote |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Nitrites antidote (tx for methemoglobin) |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| uine alkalinization, dialysis |
|
|
Term
|
Definition
|
|
Term
|
Definition
| blood alkalanization, alpha-agonist |
|
|
Term
|
Definition
25-30 kCal/kg/day non-protein
1-1.5 kCal/kg/day protein.
Decrease protein with liver or kidney failure, increase with burns. |
|
|
Term
|
Definition
Intermittent <= 2 days week, nights / month FEV1 normal between exacerbations
Mild persistent - >2 days/wk but not daily, night 3-4/month FEV1 >80
Moderate persistent - daily, >1x/week at night but not every night FEV1 60-80
Severe persistent - Throughout the day and nightly FEV1 < 60 |
|
|
Term
| Long acting beta-agonists |
|
Definition
|
|
Term
| Long acting beta-agonists |
|
Definition
|
|
Term
|
Definition
GOLD I mild - FEV1 > 80, FEV1/FVC < 0.7
GOLD II moderate - FEV1 50-80, FEV1/FVC < 0.7
GOLD III severe - FEV1 30 - 50, FEV1/FVC < 0.7
GOLD IV very severe - FEV1 <30 or <50 and chronic resp. failure, FEV1/FVC < 0.7 |
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|
