Pulmonology Flashcards
Asthma Triad
aspirin sensitivity, asthma, nasal polyps
COPD
Increased (AP) chest diameter, decreased tactile fremitus, hyperresonance on percussion, decreased breath sounds
Hyperinflation on CXR
PARENCHYMAL BULLAE/BLEBS pathognomonic
Bronchodilators mainstay of treatment, usually with anticholinergic
O2 only agent that prolongs survival
Cystic Fibrosis
Sinusitis in infancy
Nasal polyposis
Bronchitis/pneumonia–bronchiectasis
PSEUDOMONAS
Extra pulmonary manifestations: MECONIUM ILEUS (pathognomonic) Infant FTT Pancreatic insufficiency/steatorrhea Infertility Screening test: sweat chloride test
Bronchiectasis
Disorder of large bronchi characterized by PERMANENT DILATION/DESTRUCTION OF BRONCHIAL WALLS
Common etiologies: CF, IG deficiencies, recurrent pneumonias
Treat underlying etiology if possible
Bronchogenic Carcinoma
Lung cancer is a HASSLE
A&L peripheral- imaging
S&S central- bronchoscope
Clinical manifestations:
Pleural Effusion
Hoarseness (compression of laryngeal nerve)
Superior Vena Cava Syndrome
Pancoast tumor--Pancoast syndrome
Horner's Syndrome (mitosis, ptosis, anhidrosis)
Rib Destruction
Brachial Plexopathy
Extra thoracic manifestations:
Common mets: bones, liver, brain
Paraneoplastic Syndromes:
Hypercalcemia
SIADH
Mesothelioma
Tumors of pleural surface lining
Linked to asbestos exposure
Present with slow-onset dyspnea, nonpleuritic CP & weight loss
Carcinoid Tumors
Hemoptysis, cough, focal wheezing, or recurrent pneumonia
CARCINOID SYNDROME (rare)-caused by systemic release of vasoactive substances (serotonin)–cutaneous flushing, diarrhea, bronchi spasm
ABG analysis
ACIDOSIS:
High CO2=respiratory
Low CO2=metabolic
ALKALOSIS:
High CO2=metabolic
Low CO2=respiratory
Community Acquired Pneumonia
Typicals: S. pneumo>H. Flu (most common in COPD)>M. Catarrhalis
Atypicals: Legionella, Mycoplasma
PCP if AIDS with low CD4 count
Tuberculosis
Caused by Mycobacterium tuberculosis
ACID-FAST BACILLUS
Risk factors: impaired immunity and increased exposure
Pulmonary presentation: fever, night sweats, anorexia, weight loss
Classic sxs=cough, pleuritic CP, SOB, hemoptysis
Non-pulmonary presentation: TB lymphadenitis, skeletal TB (ex. Pott’s disease)
Sarcoidosis
Multi system disease characterized by granular pus inflammation
Unknown etiology
More common in blacks and European
Pulmonary Manifestations: DOE, dry nonproductive cough, PERIHILAR LYMPHADENOPATHY
Non-pulmonary manifestations: Skin-erythema nodosum Heart-conduction abnormalities Ocular-uveitis Parotid gland enlargement
BILATERAL PERIHILAR INFILTRATE on CXR
Biopsy definitive Sx-NONCASEATING GRANULOMAS
Idiopathic Pulmonary Fibrosis
Most common Interstitial Lung Disease
History-cough and progressive dyspnea over months to years
Exam findings-VELCRO CRACKLES
Serial CXR over years–progressive fibrosis (ground glass)
Pneumoconioses
Coal workers pneumoconiosis
Silicosis-prolonged inhalation of crystalline silica (30x increased incidence of TB)
Asbestosis-pleural plaque on CXR
Associated with Mesothelioma
Pleural effusion
Fluid in pleural space
Percussion dullness, decrease tactile fremitus, decrease/absent breath sounds
Exudates usually pneumonia or CA
Transudates usually fro CHF
Pneumothorax
Air in pleural space
Spontaneous:
Primary-no underlying disease
Secondary-complication of underlying disease (most commonly=COPD)
Acquired: *Iatrogenic, traumatic, barotrauma (mechanical ventilation)
