RESPIRATORY

RESPIRATORY
1. Peritonsillar Abscess uvula away; Head tilted toward, Trismus (can't open mouth)Strep or Bacteroides

2. Epiglottitis H.flu type B, Insp. Stridor, Dysphagia with drooling, Thumbprint sign on xray

3. Larengitracheitis Croup; Paraflu #1, RSV, Flu, barking cough, stridor hoarse, r/o epiglottitis

4. Acute Bronchitis non smokers = M. pneumonia; smokers=S.pneumonia & H.flu

5. Bronchiolitis Circumoral cyanosis (blue around mouth) RSV; kids < 2

6. Strep Pneumonia Red-brown sputum, lobar pneumonia, most common adult community acquired
7. Pneumovax vaccine = >65, immunocompromised, chronic disease

8. H.Flu Pneumonia COPD, children, slow onset with URI sx 1st, patchy bronchial infiltration on xray

9. Viral Pneumonia Most common cause in kids, flu like prodrome, patchy infiltrates; WBC not incr. a lot

10. Klebsiella Pneumonia Alcoholics, aspiration, Currant Jelly Sputum, Encapsulated gram neg rod

11. Staph Pneumonia Salmon colored sputum, Nosocomial, pneumatoceles on xray are pathognomic

12. Mycoplasma Pneumonia atypical no cell wall to stain, young adults in close contact; xray worse than pt looks

13. Pseudomonas Pneum. hospital acquired, CF, immunocompromised

14. Legionella Pneumonia atypical, CNS & GI sx; confusion & ataxia, aerosolized water (air conditioning)

15. TB fever, night sweats, wt loss, bloody sputum, Miliary = disseminated; Acid fast stain, PPD>10mm nonimmunocompromised; ppd>5mm AIDS; Extrapulmonary manifestations= meningitis, pericarditis, bone invasion (Pott's Disease)

16. Bronchiectasis chronic destructive; dilation of bronchial tree, cough with incr. incr. incr. sputum, dyspnea, hemoptysis, Xray = incr. bronchial markings, "honeycombing"

17. Emphysema Destroyed alveolar walls, Risks: smoking, alpha 1 antitrypsin deficiency;
18. PFTS: ß decr. FEV1; decr. VC, FEV1/FVC < 60% normal

19. Blue Bloaters Bronchitis>Emphysema; cough w/ mucous 3mos/yr x 2y; cyanosis, pulm HTN

20. Pink Puffers Emphysema >Bronchitis; gradual dyspnea not hypoxic, underweight

21. Cystic Fibrosis auto recessive, COPD, Pancreatic insufficiency; meconium illeus, incr. sweat chloride

22. Sarcoidosis non caseating granulomatous, increased Calcium, ground glass, bilateral hilar & paratracheal adenopathy is pathognomic

23. Asbestosis Increased risk of lung CA & mesothelioma, gradual dyspnea, nonproductive cough; no wheeze; diffuse linear opacities on xray

24. Silicosis increased risk of TB, SiO2 inhalation; metal mining; multiple small nodules & calcification of hilar lymph nodes

25. Resp Failure ABG=> PO2 50-60 mmHg; PCO2 >45 mmHg

26. Laryngeal CA squamous cell, smoking & alcohol, hoarsness for several weeks

27. Lung CA squamous>adeno>small(oat) cell; Squamous = hilar; Adeno = peripheral; Horner's Syndrome=invasion of the cervical symp. Ganglion= miosis, ptosis, anhydrosis
28. Pancoast tumor = Horners + pain in arm or shoulder on affected side

29. Asthma PFTs decr. FEV1; ABG resp alkalosis, decr. CO2; If CO2 incr. or normal resp failure imminet

30. Massive Hemoptysis >600 ml blood in 24 hrs; trauma; PE, aortic aneurysm, heart failure

31. Pneumothorax Spontaneous = 15-35 y/o males; Tension = pressure in pleural spaces; displaces heart & lungs (mediastinal shift) = surgical emergency

32. ARDS acute lung injury with non-cardiogenic pulm edema, ABG =acute resp alkalosis (ßO2 & ßCO2; Xray =pulm edema with normal cardiac silhouette, Positive pressure or PEEP ventilatory support

33. Pleural Effusions decr. tactile fremitus; dull; egophony (incr resonance; chg voice to high pitched)
34. Transudates: <3g protein, Plasma/serum protein<0.5; Plasma/serum LDH <0.6 caused by CHF, cirrhosis, nephrotic syndrome
35. Exudates:Reverse labs; neoplasms & infections; incr. triglycerides = chylous effusion; Pus = empyema (s. Aureus); Meiggs syndrome = pleural eff, ascites pelvic tumors)

36. Pulmonary Edema Pink, frothy sputum, Kerley B lines on xray; Incr cardiac silhouette if cardiac origin

37. Pulmonary Embolism DVT (iliac & femoral) V/Q useful, angiography is god std for dx

38. RDS <37>2, + PG; Beclomethasone hastens maturity; artificial surfactant for kid

39. Pulm HTN Primary = dx of exclusion; secondary valvular heart disease, L=>R shunt, chronic ateletasis (localized collapse of alveoli)