Thomas Shared "Pulm - John" - 36 Picmonics

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Pulm - John

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
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2 mins
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
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51 secs
Asbestosis
Asbestos = ferruginous (iron) bodies
Shipbuilding
Plumbing
Lower Lobes of lungs affected
Calcified pleural plaques on CXR (ivory white)
Golden brown rods on H&E
Prussian blue stain
Bronchogenic carcinoma
Smoking Increases Carcinoma Risk
Mesothelioma (lower risk) -> cancer of pleura
Psammoma Bodies in mesothelioma
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Pulmonary Arterial Hypertension (PAH)
Fibrosis of pulmonary arteries
Right Ventricular Hypertrophy -> Cor pulmonale
Causes
Genetic: BMPR2 gene inactivated
CT disease: Scleroderma
Portal Hypertension
Shistosomiasis -> Portal HTN
HIV/AIDS
Left Heart Failure
Hypoxic vasoconstriction (COPD)
Treatment
Bosentan (inhibit endothelin-1)
Sildenail (increases NO)
Epoprostenol, Iloprost (PGI2 prostacyclin)
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Isoniazid
Indications
Tuberculosis (TB)
Mechanism of Action
Requires Catalase Peroxidase
Decreases Mycolic Acid Synthesis
Fast vs Slow Acetylators
Side Effects
B6 Deficiency
Neurotoxicity
Hepatotoxicity
Drug-induced Lupus
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1 min
Rifampin
Tuberculosis (TB)
Blocks RNA Polymerization
Haemophilus influenzae Type B
Leprosy
Meningitis
P450 inducer
Red-orange urine
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55 secs
Ethambutol
Mechanism of Action
Bacteriostatic
Blocks Arabinosyltransferase
Arabinosyltransferase Polymerizes Carbohydrates
Carbohydrate Polymers Make Mycobacterium TB Cell Wall
Side Effects
Red/Green Color Blindness
Reversible with Drug Discontinuation
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39 secs
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
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2 mins
Neonatal Respiratory Distress Syndrome
Cause/Mechanism
Fetal Lung Immaturity
Lack of Surfactant
Assessment
Respiratory Distress
Nasal Flaring
Retractions
Grunting
Interventions
Surfactant
Oxygen
Mechanical Ventilation
Considerations
Total Parenteral Nutrition (TPN)
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2 mins
Idiopathic pulmonary fibrosis
Insidious onset (months)
Cough
Path: Honeycomb lung
Clubbing
Collagen deposition increased (repeated injury)
Stimulates RBC Production (chronic hypoxia)
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Emphysema
Clinical Features
Pink Puffer
Exhale through Pursed Lips
Barrel Chest
Pathophysiology
Obstructive Lung Disease
Increased Lung Compliance
Types
Centriacinar
Panacinar
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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
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2 mins
Respiratory Syncytial Virus (RSV) Assessment
Mechanism
Viral Infection Affecting Epithelial Cells
Signs and Symptoms
Begins After a Upper Respiratory Infection
Copious Secretions
Coughing and Sneezing
Wheezing
Otitis Media or Conjunctivitis (Possible Ear or Eye Drainage)
Poor Feeding
Tachypnea
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Methotrexate
Indications
Rheumatoid Arthritis
Cancer
Medical Abortion
Mechanism
Folic Acid Analog
Inhibits Dihydrofolate Reductase
Side Effects
Pulmonary Fibrosis
Myelosuppression is Treated with Leucovorin Rescue (Folinic Acid)
Macrocytic Anemia
Hepatitis
Teratogenic
Mucositis
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1 min
Bleomycin
Indications
Testicular Cancer
Hodgkin's Lymphoma
Mechanism of Action
Induces Free Radical Formation
Breaks in DNA Strands
Side Effects
Pulmonary Fibrosis
Skin Changes
Mucositis
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1 min
Busulfan
Indications
CML
Bone Marrow Ablation
Mechanism
Cross-links DNA
Side Effects
Myelosuppression
Pulmonary Fibrosis
Hyperpigmentation
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1 min
Class III Antiarrhythmics (K+ Channel Blockers)
Indications
Arrhythmias
Mechanism of Action
Increase AP Duration, ERP, and QT Interval
Drug Names
Amiodarone
Check Function Tests
Dirty Drug
Ibutilide
Dofetilide
Sotalol
Beta-Blocker
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2 mins
Small Cell (Oat Cell) Carcinoma
Characteristics
Aggressively Malignant
Strong Correlation with Smoking
Central Location
Amplification of myc Oncogenes
Signs and Symptoms
Narrowing of Bronchial Airways
Cushing's Syndrome
Ectopic ACTH
Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)
Lambert-Eaton Syndrome
Diagnosis
Kulchitsky Cells
Neuron-Specific Enolase Positive
Chromogranin A Positive
Treatment
Chemotherapy and Radiation
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3 mins
Adenocarcinoma of the Lung
Characteristics
Most Common Lung Cancer
Most Common in Nonsmokers
Peripheral Location
KRAS, EGFR, and ALK Mutations
Diagnosis
Glandular Pattern
Often Stains with Mucin
Clinical Features
Presents with Hemoptysis
Clubbing
Treatment
Surgical Resection
Chemotherapy and Radiation
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2 mins
Squamous Cell Carcinoma of the Lung
Characteristics
Strong Correlation with Smoking
More Common in Men
Central Location
Cavitating Lesion Extending to Hilum
PTHrP causes Hypercalcemia
Diagnosis
Keratin Pearls
Intercellular Bridges
Treatment
Surgical Resection (if Early Stage)
Chemotherapy and Radiation (if Later Stage)
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2 mins

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