obinno59's version from 2015-12-08 18:03


Question Answer
EKG findings for PENot diiagnostic
but in rare cases you get a triad of:
S-wave in lead I
Q-wave in lead III
T-wave inversion in lead III

New onset RBBB can occur
ML finding on CXR in a pt with PENormal
The patient’s presentation (tachypnea, tachycardia, pleuritic chest pain)
What do you do next?
PE suspicion is HIGH
No need for further test. Give Heparin!!!
LMWH vs UFHLMWH: longer half life, more predictable, renally excreted, SubQ
Peak Expiratory flow rate cutoff for asthmapeak expiratory flow rate (PEFR)
PEFR < 40% of personal best or < 200 L/min indicates severe obstruction
Severe asthma would show what on lung Bx?Charcot–Leyden crystals
Slender and pointed at both ends, consisting of a pair of hexagonal pyramids joined at their bases
The most frequent allergen that causes allergic asthma exacerbations is the________house dust mite.
What can cause incre Creatinine in COPD ptsIn patients with COPD exacerbations and signs of right-sided heart failure or cor pulmonale, diuretics such as furosemide must be used carefully, as these patients can develop decreased cardiac output resulting in prerenal renal failure
Eval for PHTNCXR: narrowing of pulmonary arteries,bilateral hilar enlargement
Echocardiogram: right ventricular hypertrophy, elevated estimated PA pressure
Sarcoidosis PEmultisystem involvment including can be remembered by GRUELING
Rheumatoid arthritis
Erythema nodosum
Interstitial fibrosis
Negative TB
Sarcoidosis DDxPleural disease, alvelolar disease (pulmonary edema), interstitial lung disease, neuromuscular disease, idiopathic pulmonary fibrosis, TB, lyphoma, histoplasmosis, cocci, pneumoconioses, HIV, berylliosis
A 34-year-old male complains of several weeks of headaches, lightheadedness, nausea, and myalgias. He reports that his wife and teenage children have all be experiencing similar symptoms. The family uses a wood-burning stove for both heat and cooking.CO poisoning
CO poisoning eval and Tx?Oxygen saturation usually NORMAL though actualy O2 content is LOW
this is because pulse oximeter reads carboxyyhemoglobin as normally saturated hemoglobin so better to rely on co-oximetry
ABG and serum carboxyhemoglobin level
normal carboxyhemoglobin level is <5% in nonsmokers and <10% in smokers
anion-gap metabolic acidosis due to the build-up of lactic acid
check in elderly and those with history of cardiac disease due to increased risk for ischemia

tx: 02
CF in infants is a/w__________Meconium ileus in infants (15%)
Hemothorax mgmtNon-operative
aggressive fluid resuscitation with large-bore IV access before placing chest tube
supplemental oxygen

Thoracostomy(chest tube) placement to decompress chest cavity following fluid resuscitation
inserted at level of nipple and anterior to midaxillary line
CXR or CT scan post-chest tube placement to assess for remaining blood/pathology

emergent thoracotomy
if >1500ml removed from chest tube
or if bleeding does not stop
Pneumothorax vs hemothroaxHemothorax= DECREASED NOT absent breath sounds
Pneumo=decreased OR absent