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
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
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
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)
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
1 min
Rifampin
- Tuberculosis (TB)
- Blocks RNA Polymerization
- Haemophilus influenzae Type B
- Leprosy
- Meningitis
- P450 inducer
- Red-orange urine
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
40 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
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)
2 mins
Idiopathic pulmonary fibrosis
- Insidious onset (months)
- Cough
- Path: Honeycomb lung
- Clubbing
- Collagen deposition increased (repeated injury)
- Stimulates RBC Production (chronic hypoxia)
Emphysema
- Clinical Features
- Pink Puffer
- Exhale through Pursed Lips
- Barrel Chest
- Pathophysiology
- Obstructive Lung Disease
- Increased Lung Compliance
- Types
- Centriacinar
- Panacinar
2 mins
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
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
2 mins
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
2 mins
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
1 min
Busulfan
- Indications
- CML
- Bone Marrow Ablation
- Mechanism
- Cross-Links DNA
- Side Effects
- Myelosuppression
- Pulmonary Fibrosis
- Hyperpigmentation
55 secs
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
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
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
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)
2 mins
