Step 2 ck pulmo 1

kafopaci2016's version from 2016-05-28 19:56

Section 1

Question Answer
a pt pulmonary-flow volume loop is showing flattening of both the top and the bottom. the cause is fixed upper-airway obstruction. the obstruction limits airflow during inspiration and expiration.
describe pulmonary-flow volume loop in pt with asthma and why?scooped-out pattern during exhalation. cuz bronchoconstriction ->decrease airflow during (effort-independent phase)of exhalation
in a kid with hx suspicious for foreign body inhalation . after -ve CXR you do bronchoscopy cuz CXR is limited cuz most objects are radiolucent
in pt with lung consolidation auscultation:breath sounds will be ?? as long as the airway is?breath sounds will be louder (bronchial) as long as the airway is patent
auscultation of consolidation gives:egophony, bronchial breath sounds(louder),crackels, dulness to percussion
pt with PE and GFR<30ml/min/1.73m.ttt is unfractionated heparin
Enoxaparin islow molecular wight heparin (eno=whenoo its low & tiny u can't c it )
Fondaparinux isinjection factor Xa inhibitor (irkab honda w tbe66ek al fonda=injection)
RivaroxabanOral factor Xa inhibitor (drink river=oral)
pt with difficult breathing,wheezing on aspirin for cardiac reason .why?aspirin-exacerbated resp. disease is a non IgE mediated reaction resulted form aspirin induced prostaglandin/leukotrien mis balance
CAP(community acquired pneumonia) causes & tttS.pneumo,H.infuenza,atypical(mycoplasma) outpt:doxycycline or macrolides. inpt:floruquinolones
if the elastic recoils increase the lung compliance will? example?decrease. ex:pull fibrosis
indication of tube thoracotomy in pt with plural effusion?why?1-PH:<7.2(almost always empyema) . 2-glucose <60
causes of transudate VS exudatetransudate:( 1-increase hydrostatic pressure. or 2- decrease oncotic pressure.) Exudate:Increase capillary permeability
pt in wisconson with pulm,skin,bone S/S Dx is ?ttt?blastomycosis(productive cough,skin lesions,bone lytic lesions)=systemic blastomycosis ..Wisconson is a BLAST :D . TTT: itraconazole or amphotricin B
ARDS is assoc with decreased lung compliance, Increased pulm arterial pressure(pulm.HTN)
in COPD flattening of the diaphragm leads toincrease work of breathing
COPD its have increased(TLC,FRC,RV)->hyperinflation
in post octal state.what kind of acid base imbalance and why?respiratory acidosis(hypercapnea). due to hypoventilation.
pathophysiology of cor pulmonaleCOPD->PULM HTN->RHF*isolated*:(JVD,increase intensity of S2(pulmonic component), RT vent. heave , hepatomegaly, dependent pitting edema, ascitis.

Section 2

Question Answer
first step in newborn with resp. distress & suspected cong. diaphragmatic hernia is endotracheal intubation then immediately gastric tube to decompress stomach and bowl
+ve bronchodilator response =>12% increase in FEV1 ->dx is asthma
dx of upper are way cough syndrome is confirmed with H1 histamin receptor antagonist->if cough & nasal discharge elimintaed=confirmed dx
needle thortacosotmy is used in tension pneumothorax..followed by tube thoracotomy with under water seal

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