Pulmonology 2

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HuskerDevil
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Pulmonology 2
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2011-07-18 16:51:52
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DPAP2012 Pulmonology
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Pulmonology flashcards made by previous students
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  1. Radiographic findings include infiltrates in mid or lower lung fields, hilar adenopathy, cavitation
    tuberculosis
  2. Cough, weight loss, fever, night sweats, hemoptysis, fatigue, decreased appetite, chest pain can be the clinical presentation of _____
    reactivated tuberculosis
  3. CXR with upper lobe infiltrates, particularly the apical and posterior segments, cavitation common
    reactivated tuberculosis
  4. PCO2
    partial pressure of CO2
  5. percent of CO2 carried in the plasma
    10%
  6. the faster and more deeply the patient breaths the
    more CO2 is blown off
  7. as CO2 levels increase
    blood pH decreases
  8. as CO2 levels increase
    blood PCO2 increases
  9. a rise in PCO2 stimulates a rise in
    respiratory rate
  10. in metabolic acidosis the lungs attempt to compensate by
    blowing off CO2
  11. in metabolic alkalosis the lungs attempt to compensate by
    retaining CO2
  12. Most of the CO2 content in the blood is
    HCO3-
  13. Bicarbonate ion
    HCO3-
  14. CO2 content is an indirect measurement of
    HCO3-
  15. _____ is a measurement of the metabolic (renal) component of the acid-base equilibrium
    HCO3-
  16. in respiratory alkalosis the _____ excrete HCO3 in an attempt to lower pH
    kidneys
  17. the measure of the tension of O2 dissolved in the plasma
    PO2
  18. patients in whom venous blood mixes prematurely with arterial blood have a decrease in ____
    PO2
  19. the indication of the percentage of hemoglobin filled with O2
    O2 saturation
  20. when ___% to 100% of the hemoglobin carries O2 the tissues are adequately provided with O2
    92
  21. non-invasive method of determining O2 saturation
    pulse oximetry
  22. a negative base excess indicates
    metabolic acidosis
  23. a positive base excess indicates
    metabolic alkalosis or compensation to prolonged respiratory acidosis
  24. acidosis is present if the pH is less than
    7.4
  25. alkalosis is present if the pH is greater than
    7.4
  26. if the PCO2 is low in a patient who has been said to have acidosis the patient has
    metabolic acidosis
  27. if the PCO2 is high in a patient who has been said to have acidosis the patient has
    respiratory acidosis
  28. if the PCO2 is low in a patient who has been said to have alkalosis the patient has
    respiratory alkalosis
  29. if the PCO2 is high in a patient who has been said to have alkalosis the patient has
    metabolic alkalosis
  30. O2 saturation can be falsely increased by the inhalation of
    carbon monoxide
  31. In patients with COPD the stimulus to breathe is not triggered by CO2 levels but by
    O2
  32. Perform which test before performing an arterial puncture in the radial artery
    Allen test
  33. low pH, low HCO3-, low CO2
    metabolic acidosis
  34. low pH, high HCO3-, high CO2
    respiratory acidosis
  35. high pH, high HCO3-, high CO2
    metabolic alkalosis
  36. high pH, low HCO3-, low CO2
    respiratory alkalosis
  37. pH <7.4
    acidemia
  38. pH >7.4
    alkalemia
  39. normal pCO2
    40
  40. normal HCO3-
    22-29
  41. __|__|__/ (bottom) | |X \ chem 7
    creatinine
  42. X |__|__/ | | \ chem 7
    Na
  43. __|X |__/ | | \ chem 7
    Cl
  44. __|__|X / | | \ chem 7
    BUN
  45. __|__|__/ (bottom) X | | \ chem 7
    K
  46. __|__|__/ (bottom) |X | \ chem 7
    HCO3-
  47. __|__|__/ | | \ X chem 7
    glucose
  48. if bicarb is low you expect pCO2 to be
    low
  49. if pCO2 is high you expect bicarb to be
    high
  50. example of cause of non-anion gap metabolic acidosis
    diarrhea
  51. example of cause of anion gap metabolic acidosis
    excessive alcohol consumption
  52. non-anion gap metabolic acidosis is characterized by
    loss of bicarb
  53. anion gap metabolic acidosis is characterized by
    gain of acid
  54. normal Cl- is
    96-106
  55. normal BUN is
    18-Jul
  56. normal glucose
    70-115
  57. normal creatinine
    0.6-1.2
  58. normal K
    3.5-5.1
  59. normal Na
    135-145
  60. normal anion gap
    16-Jul
  61. normal osmolality
    275-295
  62. primary etiology of respiratory acidosis
    lungs fail to eliminate CO2
  63. example of a cause of metabolic alkalosis
    protracted vomiting
  64. example of a cause of metabolic alkalosis
    ingestion of a large quantity of base
  65. in a metabolic alkalotic state will you have hypokalemia or hyperkalemia
    hypokalemia
  66. in a metabolic acidotic state will you have hypokalemia or hyperkalemia
    hyperkalemia
  67. primary etiology of respiratory alkalosis
    lungs are eliminating too much CO2
  68. in acute respiratory acidosis for every increase of pCO2 of 10mm pH decreases by
    0.08
  69. in chronic respiratory acidosis for every increase of pCO@ of 10mm, ph decreases by
    0.03
  70. in acute respiratory alkalosis for every decrease of pCO2 of 10mm pH increases by
    0.08
  71. in chronic respiratory alkalosis for every decrease of pCO2 of 10mm pH increases by
    0.03
  72. a pH which is too acid for the PCO2
    metabolic acidosis
  73. the only acid which can be exhaled via the lungs
    carbon dioxide
  74. includes all of the body's acids except carbon dioxide
    metabolic acids
  75. difference between the sum of the major anions and the major cations
    anion gap
  76. _____ is the same as Respiratory Acidosis
    high pCO2
  77. The normal value of pCO2 in arterial blood is __mmHg
    40
  78. implies a raised [H+] level with a normal PCO2
    pure metabolic acidosis
  79. high PCO2 causes molecules of CO2 and water to form carbonic acid which ionizes to increase both [HCO3-] and [H+]
    pure respiratory acidosis
  80. hematocrit >60
    polycythemia
  81. increases blood viscosity
    polycythemia
  82. idiopathic recurrent alveolar hemorrhage and rapidly progressive glomerulonephritis
    good pasture syndrome
  83. disease of children or young adults characterized by recurrent pulmonary hemorrhage
    idiopathic pulmonary hemosiderosis
  84. pulmonary hypertension is characterized by elevated mean pulmonary pressure of greater than __mmHg at rest
    25
  85. patients with pulmonary hypertension also have
    low cardiac output
  86. the most common secondary cause of pulmonary hypertension
    connective tissue disease (scleroderma)
  87. this should be performed in all patients suspected of pulmonary hypertension
    right ventricular catheterization
  88. median survival after diagnosis of pulmonary hypertension ____ years
    3
  89. a proximal DVT is above the _____
    knee
  90. stasis, hypercoagulability, venous injury
    Virchow's triad
  91. a break down product of a thrombus
    d-dimer
  92. characteristic of d-dimer
    sensitive, but not specific
  93. d-dimer is best for _______ DVT, or PE
    ruling out
  94. gold standard for suspected DVT, however it is rarely done
    contrast venography
  95. most common and practical means of detecting DVT
    ultrasound
  96. for a patient with DVT treat with ____ for about 5 days
    UFH or LMWH
  97. for a patient with DVT treat with ____ for at least 3 months
    warfarin
  98. Increased bioavailability, Once or twice daily subcutaneous delivery, Monitoring not generally required, Outpatient therapy facilitated, Lower rate of HIT
    advantages of LMWH over UFH
  99. Dyspnea 73%,Pleuritic CP 66%, Cough 37%, Leg swelling 28%,Leg pain 26%, Hemoptysis 13%
    history of PE
  100. Tachycardia 70%, Tachypnea 30%, Crackles 51%, Loud P2 23%, Diaphoresis 11%, Hypotension 8%
    physical exam of PE
  101. most common test for PE
    spiral CT
  102. gold standard for PE but rarely done
    pulmonary arteriogram
  103. noninvasive method of monitoring SaO2
    oximetry
  104. Fetal oxygen saturation monitoring
    FSpO2
  105. Normal oxygen saturation for baby in the womb is between 30% and ___%
    70
  106. the amount of light absorbed by oxygen-saturated hemoglobin is measured by the sensor to determine saturation levels
    oximetry
  107. a machine that can measure air volumes
    spirometer
  108. in spirometry values greater than __% of predicted values are considered normal
    80
  109. most labs use _____ to measure diffusing capacity because of its great affinity for hemoglobin
    carbon monoxide
  110. amount of air that can be forcefully expelled from a maximally inflated lung position
    FVC
  111. volume of air expelled during the first second of FVC
    FEV1
  112. in restrictive lung disease ______ should be measured
    FEV1/FVC ratio
  113. maximal rate of air flow through the pulmonary tree during forced expiration
    MMEF (maximal midexpiratory flow)
  114. MMEF volumes are lower than expected in
    obstructive pulmonary disease
  115. MMEF volumes are normal in
    restrictive pulmonary disease
  116. maximal volume of air a patient can breath in and out during 1 minute
    MVV (maximal volume ventilation)
  117. MVV is less than the predicted value in
    both obstructive pulmonary disease and restrictive pulmonary disease
  118. volume of air inspired and expired with each normal respiration
    TV (tidal volume)
  119. maximal volume of air that can be inspired from end of normal inspiration
    IRV (inspiratory reserve volume)
  120. maximal volume of air that can be exhaled after normal exhalation
    ERV (expiratory reserve volume)
  121. volume of air remaining in the lungs following forced expiration
    RV (residual volume)
  122. maximal volume of air that can be inspired after normal expiration
    IC (inspiratory capacity)
  123. amount of air left in lungs after normal expiration
    FRC (functional residual capacity)
  124. maximal amount of air that can be expired after maximal inspiration
    VC (vital capacity)
  125. volume to which lungs can be expanded with greatest inspiratory effort
    TLC (total lung capacity)
  126. volume of air inhaled and exhaled in a minute
    MV (minute volume)
  127. Part of VT that does not participate in alveolar gas exchange
    dead space
  128. Portion of air flow curve most affected by airway obstruction
    FEF (forced expiratory flow)
  129. flow rate of inspired air during maximum inspiration. indicates large airway disease
    PIFR (peak inspiratory flow rate)
  130. maximum airflow rate during forced expiration
    PEFR (peak expiratory flow rate)
  131. typically used to detect the presence of hyperactive airway disease
    methacholine or histamine challenge
  132. highlighted by perialveolar inflammation followed by fibrosis
    interstitial lung disease
  133. Patients with COPD can be expected to have increased ______
    RV and ERV
  134. these patients have reduced lung volumes, impaired diffusing capacity, and exercise-induced hypoxemia
    inhalant pneumonitis (farmer's lung, miner's lung)
  135. post-pneumonectomy no changes in ______ would be expected
    air flow rates
  136. What studies are indicated in any person who snore's excessively; experiences narcolepsy, excessive daytime sleeping, or insomnia
    sleep studies
  137. includes insomnia, sleep apnea, narcolepsy and RLS
    dyssomnia
  138. includes sleep walking, sleep talking, sleep terrors, REM disorders
    parasomnia
  139. the most common type of sleep apnea
    obstructive
  140. obstructive sleep apnea is caused by relaxation of the
    posterior pharyngeal muscles
  141. ____ sleep apnea is characterized by a simple cessation of breathing
    central
  142. frequent and irreversible need for sleep during daytime hours
    narcolepsy
  143. acute sensation of discomfort during periods of inactivity making sleep difficult
    restless leg syndrome
  144. causes patients to act out their dreams, these patients can vividly recall dreams
    REM disorders
  145. inability to sleep
    insomnia
  146. most common form of sleep disorder
    insomnia
  147. in spirometry ____ impairments are defined by a low FEV1 and a low FEV1/FVC%
    obstructive
  148. in spirometry _____ impairments are characterized by a proportional decrease in FEV1 and FVC, leading to a preserved FEV1/FVC%
    restrictive
  149. _____ impairments will have a flattened flow-volume loop
    obstructive
  150. disease associated with increased elastic recoil
    lung fibrosis
  151. diseases associated with increased elastic recoil are associated with _____ FRC
    decreased
  152. disease associated with decreased elastic recoil
    emphysema
  153. diseases associated with decreased elastic recoil are associated with _____ FRC
    increased
  154. extrinsic cause of restrictive lung disorder
    obesity, pleural effusion
  155. Pulse oximetry is not accurate in using to titrate O2 therapy in
    advanced COPD
  156. pulse oximetry of <___% at rest required for O2 therapy
    88
  157. low DLCO with restriction can be seen in
    interstitial lung disease, pneumonitis
  158. low DLCO with obstruction can be seen in
    emphysema, cystic fibrosis, bronchiolitis
  159. low DLCO with normal spirometry can be seen in
    anemia, pulmonary vasculitis, early interstitial lung disease
  160. This test records several body functions during sleep
    polysomnography
  161. Used for quick relief of asthma symptoms no matter the classification
    short acting beta2 agonist
  162. used daily for long term control of asthma in all classifications except mild intermittent
    inhaled corticosteroids
  163. potent bronchodilators that are the drug of choice for mild intermittent asthma
    short acting beta2 agonist
  164. onset of action 5-30 minutes, with relief for 4-6 hours
    short acting beta2 agonist
  165. drug of choice for acute anaphylaxis
    epinephrine
  166. Beta 2 agonists have no anti-inflammatory effects and therefore
    should not be use as the sole therapeutic agent for management of persistent asthma
  167. albuterol
    short acting beta2 agonist
  168. terbutaline
    short acting beta2 agonist
  169. all patients with asthma should be prescribed a
    quick-relief inhaler
  170. salmeterol
    long acting beta2 agonist (LABA)
  171. xinafoate
    long acting beta2 agonist (LABA)
  172. formoterol
    long acting beta2 agonist (LABA)
  173. have slower onset of action and should not be used for quick relief of asthma symptoms
    long acting beta2 agonist (LABA)
  174. considered to be useful adjunctive therapy for attaining asthma control
    long acting beta2 agonist (LABA)
  175. drug of first choice for any degree of persistent asthma
    inhaled corticosteroids
  176. patients achieving ____ consecutive months of improved asthma control may be considered for a reduction in inhaled corticosteroid dosing
    6-Mar
  177. targets underlying airway inflammation
    inhaled corticosteroids
  178. patients with severe exacerbation of asthma may require
    intravenous injection of methylprednisolone or oral prednisone
  179. severe exacerbation of asthma
    status asthmaticus
  180. ____ decrease the deposition of drug in the mouth caused by improper inhaler technique
    spacers

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