pulmonary

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Author:
connachtman
ID:
218111
Filename:
pulmonary
Updated:
2013-05-06 18:32:39
Tags:
pneumonia asthma COPD TB
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Description:
pulmonary review for NP boards
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  1. what is FEV1
    vol of air expelled in first sec of exhalation after full inhalation
  2. what is FVC
    forced vital capacity:  total vol of air that can be exhaled after a full inhalation
  3. normal FEV1/FVC
    80+%
  4. excessive mucus prod an early or late sx of COPD
    early
  5. high potency corticosteroids
    beclamethasone and dexamethasone
  6. medium potency corticosteroids
    all but dexamethasone and beclamethasone (high) and hydrocortisone and cortisone (low), i.e. prednisone, prednisolone, methylprednisone, triamcinolone
  7. in a pt hospitalized for CAP can you give pneumococcal and flu vaccines right away?
    yes
  8. smoker has CAP.  When should you order a CXR?
    7-12 weeks after dx
  9. when is bronchospasm worst in asthma?
    at night during sleep
  10. normal variation in PEF during day
    10-15%
  11. in moderate or severe persistent asthma which is more effective increasing ICS dose or adding a LABA
    adding a LABA
  12. does theophylline reduce inflammation or bronchospam
    a bronchodilator, it reduces bronchospasm
  13. tx for acute asthma flare with PEV LT 50-80%
    course of oral corticosteroids
  14. a beta blocker to avoid in asthma
    propranolol and other non-selective beta blockers
  15. 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
  16. is inspiration or expiration more of a problem in asthma?
    expiration
  17. lung exam findings in asthma
    prolonged expiratory phase, hyperresonance
  18. first line meds in stage 2 moderate COPD assuming pt has albuterol inhaler
    anticholinergic muscarinic antagonists like ipratropium bromide (Atrovent) or tiotropium bromide (Spiriva)
  19. FEV1/FVC that is diagnostic of COPD
    LT 0.70
  20. what percentage of pts with LTBI go on to develop active dz without tx
    10% so it is important to tx them
  21. after a primary infection what percentage of pts go on to develop progressive primary TB
    5%
  22. 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
  23. 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
  24. for most people what size induration on PPD is positive finding
    15mm or larger
  25. what is an anergy test
    give tests of substances other than TB to see if pt can mount an immune response
  26. 70 yo woman with COPD has CAP.  What abx?
    amox and a macrolide
  27. most common pathogen in CAP and what gram stain?
    S. pneumoniae, gram positive diplococci
  28. pathogen in CAP common in smokers
    H. influenzae
  29. atypical pathogens that are cough transmitted causes of CAP
    C. pneum, M. pneum
  30. risk factors for DRSP
    abx in last 3 mos, children in day care, older than 65, immunocompromised or comorbities
  31. abx that are effective against atypical pathogens in CAP
    levofloxacin and moxifloxacin, tetracyclines, macrolides like azithromycin
  32. abx efffective vs H. influenzae
    levofloxacin and moxifloxacin, cephs, augmentin

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