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Terms in this set (70)
high pitched, whistling, continuous sound- usually louder during expiration, produced by narrowed obstructed airways
Wheezing is seen with?
obstructive lung disease, bronchiectasis, bronchiolitis, lung CA, sleep apnea, CHF, GERD, anaphylaxis, FB
continuous, rumbling, coarse LOW pitched sound, may clear with cough
Rhonchi is caused by?
increased secretions or obstruction in bronchial airways
DIScontinuous high pitched, during inspiration, NOT cleared by cough,
Crackles/ rales are due to?
popping open of collapsed alveoli & small airways
Crackles/ rales seen with?
pneumonia, atelectasis, bronchitis, bronchiectasis, pulmonary edema, pulmonary fibrosis
monophonic sound, loudest over anterior neck, heard throughout breathing
Stridor due to?
narrowing of larynx or anywhere over trachea
volume moved into or out of lungs during QUIET breathing
volume remaining ing in lungs after maximal expiration- this maintains alveolar patency during end expiration
Expiratory reserve volume:
volume of air that can be further exhaled at end of normal expiration
Inspirator recerve volume:
volume of air that can be further inhaled at end normal inspiration
maximum volume of air that can be exhaled following maximum inspiration
Total lung capacity:
volume in lungs at maximum inspiration
Functional residual capacity:
volume of gas in lungs at normal tidal volume end expiration
increase in FRC seen with?
disorders of hyperinflation (due to loss of elastic recoil, PEEP)
decrease FRC seen with?
restrictive lung diseases
Forced expiratory volume in 1 second:
volume of air that has been exhaled at end of the 1st second of forced expiration
Forced vital capacity:
measurement of volume of air that can be expelled from a maximally inflated lung with patient breathing hard & fast as possible
Mycoplasma pneumoniae s/s?
low grade fever
Pneumocystis jiroveci s/s?
slower onset, immunosuppression
increased lactate dehydrogenase
more hypoxemic than appears on CXR
Legionella pneumoniae s/s?
chronic cardiac or respiratory disease
Diarrhea (GI) or systemic symptoms
Chlamydia pneumoniae s/s?
sore throat, hoarseness
Streptococcus pneumoniae s/s?
RUST colored sputum
Klebsiella pneumoniae s/s?
currant jelly sputum
chronic illness, EtOH abuse
CXR of klebsiella?
upper lobes- R upper lobe, bulging with fissure, cavitations
pneumonia patient: EtOH abuse?
pneumonia patient: COPD?
pneumonia patient: CF?
pneumonia patient: young adults, college settings?
Mycoplasma or Chlamydia pneumoniae
pneumonia patient: air conditioning/ aerosolized water?
pneumonia patient: Leukemia, lymphoma?
pneumonia patient: < 1years?
pneumonia patient: <2 years?
Most common cause of bacterial pneumonia is all groups?
CXR of CAP pneumonia?
lobar or segmental infiltrates, air bronchograms, pleural effusions
Appropriate outpatient Tx for CAP pneumonia?
macrolide (calrithro, azithro) or doxycycline
Pneumonia- CAP patients with underlying chronic disease Tx?
fluroquinolone or macrolide plus beta lactam
Pneumonia- CAP inpatient treatment?
cover S. pneumoniae and Legionella with fluroquinolone or combo Beta lactam (ceftriaxone or cefotaxime) plus macrolide
Who gets the pneumococcal polysaccharide vacine?
kids age 2-5, not been previously immunized, 65+, or with chronic illness
Who gets the pneumococcal conjugate vaccine (7 valent vaccine) series of 4 doses?
6 weeks to 15 months
How often are pnemococcal vaccine boosters needed?
every 6 years
Most common atypical pneumonia pathogen?
CXR of atypical pneumonia?
segmental unilateral lower lung zone infiltrates or diffuse infiltrates
Atypical pneumonia s/s?
low grade fever, mild pulmonary symptoms, non productive cough, myalgia and fatigue
reddened TM or bullous myringitis
acute high fever, dry cough, dyspnea and systemic symptoms
with epidemics and upper respiratory symptoms
Tx: mycoplasma and legionella pneumonia?
erythromycin or doxycycline
with legionella add levofloxacin or azithromycin
Tx: chlamydia pneumonia?
Tx: viral pneumonia?
Tx: influenza A pneumonia?
combo oseltamivir and rimantadine
Hospital acquired pneumonia?
more than 48 hours after admission to the hospital
CXR: diffuse or perihilar infiltrates with no effusion?
HIV related pneumonia
Percussion: pleural effusion?
Percussion: pneumothorax or obstructive lung disease?
Fremitus: pleural effusion?
Fremitus: pneumothorax or obstructive lung disease?
Breath sounds: pneumonia?
Breath sounds: pleural effusion?
Breath sounds: pneumothorax or obstructive lung disease?
90% of the cases of acute bronchitis is caused by?
viruses- rhino, corna, and RSV
Bronchitis is characterized by?
airway inflammation and COUGH
S/S of acute bronchitis?
cough w or wo sputum, dyspnea, fever, HA, sore throat, myalgias, substernal discomfort, expiratory rhonchi or wheezes
IF bacterial acute bronchitis what is Tx?
1st: 2nd generation cephalosporins
2nd: 2nd generation macrolides or Bactrim
Most common cause of acute bronchiolitis?
What s/s indicate respiratory distress?
nasal flaring, tachypnea, and retractions
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