Jose Shared "Pulmonary 2" - 20 Picmonics

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Pulmonary 2

A-a Gradient
Partial pressure of alveolar oxygen (PAO2)
Partial Pressure of Arterial O2 (PaO2)
Normal 10 to 15 mmHg
Hypoxemia with an Abnormal A-a Gradient
Diffusion problem
Shunting (Low V/Q)
Dead space (high V/Q)
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1 min
Alveolar Gas Equation
Equation
Partial Pressure of Alveolar Oxygen (PAO2)
Partial Pressure of Oxygen in the Inspired Air (PIO2)
PIO2 Normally Approximated = 150 mmHg
Arterial Partial Pressure of CO2 (PaCO2)
Respiratory Quotient (R)
R Normally Approximated = 0.8
PAO2 = PIO2 - (PaCO2/R)
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1 min
Common Causes of Pneumonia: Neonates (< 4 Weeks Old)
Group B Streptococci
E. coli
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44 secs
Common Causes of Pneumonia: Children (4 Weeks - 18 Years)
Runts May Cough Chunky Sputum
RSV (Viruses)
Mycoplasma
Chlamydia pneumoniae
Chlamydia trachomatis
Streptococcus pneumoniae
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1 min
Common Causes of Pneumonia: Adults (18 - 40 Years Old)
Mycoplasma
Streptococcus pneumoniae
Chlamydia pneumoniae
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41 secs
Common Causes of Pneumonia: Middle-Aged Adults (40 - 65 Years Old)
Streptococcus pneumoniae
Mycoplasma
Haemophilus influenzae
Anaerobes
Viruses
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59 secs
Common Causes of Pneumonia: Elderly (65+ Years Old)
Influenza Virus
Haemophilus influenzae
Anaerobes
Streptococcus pneumoniae
Gram-Negative Rods
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59 secs
Montelukast (Singulair)
Mechanism
Leukotriene Receptor Blocker
Indications
Allergic Rhinitis
Asthma Prophylaxis
Exercise Induced Bronchospasm
Side Effects
Fatigue
Headache
Mood Changes
Suicidal Thoughts
Considerations
Increased Risk of Churg Strauss
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2 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
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
Bronchial Carcinoid Tumor
Characteristics
Excellent Prognosis
Signs and Symptoms
Symptoms of Bronchial Obstruction
Often Asymptomatic
Carcinoid Syndrome
Diarrhea
Wheezing
Flushing
Diagnosis
5-HIAA in Urine
Nests of Neuroendocrine Cells
Chromogranin A Positive
Treatment
Surgical Resection
Octreotide for Symptomatic Relief
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2 mins
Large Cell Carcinoma
Characteristics
Strong Correlation with Smoking
Poor Prognosis
Peripheral Lesions
Symptoms
Gynecomastia
Galactorrhea
Diagnosis
Anaplastic Cells
Pleomorphic Giant Cells
May Produce Beta hCG
Diagnosis of Exclusion
Treatment
Surgical Resection
Less Responsive to Chemotherapy and Radiation
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2 mins
Tuberculosis Skin Mantoux Test (PPD)
Delayed Hypersensitivity (Cell Mediated Response)
Intradermal Injection
Read 48-72 hours
Positive Results
≥ 5 mm Induration
Immunosuppressed
≥ 10 mm Induration
High Risk Patients
≥ 15 mm Induration
Considerations
Chest X-Ray
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3 mins
Sarcoidosis Characteristics and Labs
Mechanism
Unknown Mechanism
Immune-mediated
Noncaseating granulomas
Vitamin D activation
Labs
Hypercalcemia
Elevated ACE
Asteroid bodies
X-Ray shows Bilateral hilar lymphadenopathy
Treatment
Corticosteroids
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1 min
Sarcoidosis Symptoms
Black Females
Symptoms
Asymptomatic
Uveitis
Interstitial Fibrosis
Erythema Nodosum
Hepatomegaly
Myocardial Sarcoidosis
Lupus Pernio
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1 min
Granulomatosis With Polyangiitis (Wegeners) Characteristics
Pathophysiology
Granulomatosis With Polyangiitis
Vasculitis
Necrotizing
C ANCA
Lungs And Upper Airway
Crescentic Glomerulonephritis
Treatment
Cyclophosphamide
Corticosteroids
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1 min
Granulomatosis with Polyangiitis (Wegeners) Symptoms
Signs and Symptoms
Lung Involvement
Cough
Hemoptysis
Chronic Sinusitis
Saddle Nose
Perforation of Nasal Septum
Otitis Media
Glomerulonephritis
Hematuria
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3 mins
Pulmonary Embolism Causes
Causes
FAT BAT Mnemonic
Fat
Air
Deep Vein Thrombosis (DVT)
Bacteria
Amniotic Fluid
Tumor
Risk Factors
Hypercoagulable
Central Venous Lines
Immobilized
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1 min
Croup (Laryngotracheobronchitis)
Mechanism
Parainfluenza Virus
Assessment
3 Months to 3 Years
Nighttime
Barking Seal Cough
Inspiratory Stridor
Interventions
Cool Humidified Air
Dexamethasone
Racemic Epinephrine
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2 mins

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