Card Set Information
pneumonia asthma COPD TB
pulmonary review for NP boards
what is FEV1
vol of air expelled in first sec of exhalation after full inhalation
what is FVC
forced vital capacity: total vol of air that can be exhaled after a full inhalation
excessive mucus prod an early or late sx of COPD
high potency corticosteroids
beclamethasone and dexamethasone
medium potency corticosteroids
all but dexamethasone and beclamethasone (high) and hydrocortisone and cortisone (low), i.e. prednisone, prednisolone, methylprednisone, triamcinolone
in a pt hospitalized for CAP can you give pneumococcal and flu vaccines right away?
smoker has CAP. When should you order a CXR?
7-12 weeks after dx
when is bronchospasm worst in asthma?
at night during sleep
normal variation in PEF during day
in moderate or severe persistent asthma which is more effective increasing ICS dose or adding a LABA
adding a LABA
does theophylline reduce inflammation or bronchospam
a bronchodilator, it reduces bronchospasm
tx for acute asthma flare with PEV LT 50-80%
course of oral corticosteroids
a beta blocker to avoid in asthma
propranolol and other non-selective beta blockers
how do medications like ipratropium bromide (Atrovent) and tiotropium (Spiriva) work?
muscarinic antagonists they block stimulation of muscarinic receptors that induce bronchoconstriction thus they induce bronchodilatation
is inspiration or expiration more of a problem in asthma?
lung exam findings in asthma
prolonged expiratory phase, hyperresonance
first line meds in stage 2 moderate COPD assuming pt has albuterol inhaler
anticholinergic muscarinic antagonists like ipratropium bromide (Atrovent) or tiotropium bromide (Spiriva)
FEV1/FVC that is diagnostic of COPD
what percentage of pts with LTBI go on to develop active dz without tx
10% so it is important to tx them
after a primary infection what percentage of pts go on to develop progressive primary TB
PPD result of 5+mm is positive for what groups of people
HIV and other immunocompromised ; those on 15mg or more of prednisone ; those with close contacts with active TB or old dz
PPD of 10+mm is positive in what groups of people
from countries with endemic TB ; health care providers ; live in facilities ; have dz like FM, renal failure ; children 4yo and younger
for most people what size induration on PPD is positive finding
15mm or larger
what is an anergy test
give tests of substances other than TB to see if pt can mount an immune response
70 yo woman with COPD has CAP. What abx?
amox and a macrolide
most common pathogen in CAP and what gram stain?
S. pneumoniae, gram positive diplococci
pathogen in CAP common in smokers
atypical pathogens that are cough transmitted causes of CAP
C. pneum, M. pneum
risk factors for DRSP
abx in last 3 mos, children in day care, older than 65, immunocompromised or comorbities
abx that are effective against atypical pathogens in CAP
levofloxacin and moxifloxacin, tetracyclines, macrolides like azithromycin
abx efffective vs H. influenzae
levofloxacin and moxifloxacin, cephs, augmentin