Restrictive vs. Obstructive Lung Diseases
- Restrictive Lung Disease
- Decreased Lung Volume
- FEV1/FVC Ratio Normal to Increased
- Obstructive Lung Disease
- Increased Lung Volume
- Decreased FEV1/FVC Ratio
Restrictive Lung Diseases
- Poor Breathing Mechanics
- Interstitial Lung Diseases
- Goodpasture's Syndrome
- Eosinophilic Granuloma
- Granulomatosis with Polyangiitis
- Sarcoidosis
- Pneumoconiosis
- Idiopathic Pulmonary Fibrosis
- Drug Toxicity
- Acute Respiratory Distress Syndrome (ARDS)
- Neonatal Respiratory Distress Syndrome
Obstructive Lung Disease
- Blocked Airflow
- Increased residual volume
- V/Q Mismatch
- Decreased forced vital capacity (FVC)
- Decreased FEV1/FVC ratio
- Asthma
- Bronchiectasis
- Chronic bronchitis
- Emphysema
COPD Overview (Chronic Obstructive Pulmonary Disease Overview)
- Inhaled Toxins
- Smoking
- AAT Deficiency
- Emphysema
- Chronic Bronchitis
- Asthma
- Spirometry
- Slow Progression
Chronic Bronchitis
- Chronic Inflammation of Bronchi
- Early-Onset Cyanosis
- Blue Bloaters
- Productive Cough
- Wheezing
- Chronic Obstructive Pulmonary Disease (COPD)
- Late-Onset Dyspnea
- Crackles
- Reid Index > 50%
Chronic Bronchitis Interventions
- Tripod Position
- Humidified Oxygen
- Pursed Lip Breathing
- Increase Fluid Intake
- ABGs
- Early Detection of Exacerbation
- Lowest O2 Therapy
- Assisted Ventilation
- Increased Infection Risk
Emphysema
- Pink Puffer
- Exhale through Pursed Lips
- Barrel Chest
- Obstructive Lung Disease
- Increased Lung Compliance
- Centriacinar
- Panacinar
Asthma
- Obstructive lung disease
- Bronchial Hyperresponsiveness
- History of Atopic Disease
- Beta2 agonists
- Corticosteroids
- Curschmann's spirals
- Hypertrophy of smooth muscle
- Reversible
- Charcot Leyden crystals
- Methacholine challenge
- Wheezing
- Cough
- Initially decreased PaCO2
- Pulsus paradoxus
Bronchiectasis
- Obstructive Lung Disease
- Chronic Necrotizing Infection
- Permanent Airway Dilation
- Poor Ciliary Motility
- Kartagener's Syndrome
- Cystic Fibrosis
- Allergic Bronchopulmonary Aspergillosis
- Hemoptysis
- Increased Sputum
Acute Respiratory Distress Syndrome (ARDS) Assessment
- Damaged Alveolar-Capillary Membrane
- Restlessness
- Dyspnea
- Refractory Hypoxemia
- Decreased PaO2
- Diffuse Pulmonary Infiltrates
- Atelectasis
- Pulmonary Hypertension
Acute Respiratory Distress Syndrome (ARDS) Interventions
- Closely Monitor Patient
- ABG's (Arterial Blood Gases)
- Oxygen
- Assess for O2 Toxicity
- Mechanical Ventilation
- PEEP
- Assess for Pneumothorax
- Permissive Hypercapnia
- High Mortality Rate
Respiratory Syncytial Virus (RSV) Assessment
- Viral Infection Affecting Epithelial Cells
- Begins After a Upper Respiratory Infection
- Copious Secretions
- Coughing and Sneezing
- Wheezing
- Otitis Media or Conjunctivitis (Possible Ear or Eye Drainage)
- Poor Feeding
- Tachypnea
Respiratory Syncytial Virus (RSV) Interventions
- Palivizumab (Synagis)
- Hospitalization
- Contact Precautions
- Oxygen
- Separate Room
- Maintain Fluid Intake
- Short-acting Beta-Agonist Bronchodilator
Sarcoidosis Characteristics and Labs
- Unknown Mechanism
- Immune-mediated
- Noncaseating granulomas
- Vitamin D activation
- Hypercalcemia
- Elevated ACE
- Asteroid bodies
- X-Ray shows Bilateral hilar lymphadenopathy
- Corticosteroids
Sarcoidosis Symptoms
- Black Females
- Asymptomatic
- Uveitis
- Interstitial Fibrosis
- Erythema Nodosum
- Hepatomegaly
- Myocardial Sarcoidosis
- Lupus Pernio
Cystic Fibrosis Mechanisms
- Autosomal Recessive
- CFTR chromosome 7
- Cl- channel defect
- Decreased chloride secretion
- Increased Na and water reabsorption
- Increased Na and Cl in sweat
- Dehydration of mucous layers
Cystic Fibrosis Symptoms and Complications
- Recurrent Pulmonary Infections
- Chronic Bronchitis
- Nasal Polyps
- Pancreatic Insufficiency
- Intestinal Obstruction
- Malabsorption and Diarrhea
- Vitamin Deficiencies
- Chronic Hepatic Disease
- Infertility in Males
Cystic Fibrosis Diagnosis and Treatment
- Sweat chloride test > 60 mmol/L
- Meconium Ileus
- N-acetylcysteine
- Antibiotic Prophylaxis
- Pulmonary Maintenance
- Lung transplant
- Vitamin Replacement
Spontaneous Pneumothorax
- Accumulation of Air in Pleural Space
- Tall and Thin Young Males
- Underlying Disease
- Bleb or Bulla Rupture
- Chest Pain
- Hypoxemia
- Decreased Breath Sounds
- Hyperresonance
- Shortness of Breath (SOB)
Tension Pneumothorax
- Air Enters Pleural Space, but Can't Exit
- Trauma or Infection
- Decreased Breath Sounds
- Trachea Deviates Away from Affected Side
- Chest Pain
- Tachycardia
- Tachypnea
- Hypotension
- Hypoxemia
- Hyperresonance
- Emergency
Wells' Criteria for Pulmonary Embolism
- Clinical Symptoms of DVT (+3)
- Pulmonary Embolism Most Likely Diagnosis (+3)
- Tachycardia (+1.5)
- Immobilization > 3 Days (+1.5)
- Previous DVT or PE (+1.5)
- Hemoptysis (+1)
- Malignancy (+1)
- > 6 = High
- 2-6 = Moderate
- < 2 = Low
Pulmonary Embolism Causes
- FAT BAT Mnemonic
- Fat
- Air
- Deep Vein Thrombosis (DVT)
- Bacteria
- Amniotic Fluid
- Tumor
- Hypercoagulable
- Central Venous Lines
- Immobilized
Pulmonary Embolism Presentation and Diagnosis
- Sudden onset Shortness of Breath (S.O.B.)
- Tachypnea
- Pleuritic Chest Pain
- Hemoptysis
- Hypoxemia
- Sudden Death
- Gold Standard: CT Pulmonary Angiography
- X-Ray
- D-Dimer
- V/Q Scan
Deep Vein Thrombosis (DVT) Management
- Compression Ultrasound (CUS) with Doppler
- D-Dimer
- Contrast Venography
- IVC Filter
- Heparin for Acute Management
- Warfarin for Long-term Management
- Thrombectomy/Thrombolysis
- Stockings
- Walking
Deep Vein Thrombosis (DVT) Characteristics
- Virchow's Triad
- Venous Stasis
- Endothelial Damage
- Hypercoagulability
- Tenderness
- Homan's Sign
- Warmth
- Redness
- Swelling
- Asymptomatic
Croup (Laryngotracheobronchitis)
- Parainfluenza Virus
- 3 Months to 3 Years
- Nighttime
- Barking Seal Cough
- Inspiratory Stridor
- Cool Humidified Air
- Dexamethasone
- Racemic Epinephrine
Obstructive Sleep Apnea (OSA)
- Narrowed or Obstructed Air Passage
- Apnea
- Loud Snoring
- Startle Response
- Daytime Drowsiness
- Positional Therapy
- Oral Appliance
- Continuous Positive Airway Pressure (CPAP)
- Surgery
- Weight Loss
Systemic Inflammatory Response Syndrome (SIRS) Criteria
- Temperature < 36C or > 38C
- Pulse > 90 beats per minute
- Respirations > 20/min or PCO2 < 32
- WBC < 4,000 or > 12,000 or 10% bands
- Subset of Cytokine Storm and Related to Sepsis
Reading a Chest X-Ray
- Airway and Appliances
- Bones
- Cardiac
- Diaphragm
- Everything Else
- Masses
- Pulmonary Vasculature
- Lung Parenchyma
Oxygen Delivery Methods
- Nasal Cannula
- Simple Face Mask
- Non-Rebreather Mask
- Venturi-Mask
- Oxygen In Use Sign
- No Electrical Sparks
- Six Feet Away from Open Flames
- Dry Nasal and Upper Airway Mucosa
- Skin Irritation
- Home Education
Mycobacterium Tuberculosis Characteristics
- Mycolic Acid Cell Wall
- Acid-fast
- Carbolfuchsin Stain Red
- Lowenstein-Jensen Agar
- Serpentine Cord Factor
- Primary TB
- Caseating Granuloma
- Ghon Focus
- Hilar Lymph Nodes
- Ghon Complex
- Reactivation TB
- Reactivation in Apex
Mycobacterium Tuberculosis Disease
- Fever
- Night Sweats
- Weight Loss
- Hemoptysis
- Extrapulmonary Disease
- Addison's Disease
- CNS
- Liver
- Kidneys
- GI
- Bones
- Pott's Disease
Tuberculosis Intervention
- Airborne Isolation
- Combination Drug Therapy (RIPE)
- 6-12 Months
- DOT
- BCG Vaccination
- Medication Education
- 3 Negative Sputum Specimens
- Infection Control