Shiza Shared "Pulm Exam 1" - 26 Picmonics
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Pulm Exam 1
Spontaneous Pneumothorax
- Mechanism
- Accumulation of Air in Pleural Space
- Tall and Thin Young Males
- Bleb or Bulla Rupture
- Underlying Disease
- Signs and Symptoms
- Hypoxemia
- Chest Pain
- Decreased Breath Sounds
- Hyperresonance
- Shortness of Breath (SOB)
1 min
Tension Pneumothorax
- Mechanism
- Air Enters Pleural Space, but Can't Exit
- Trauma or Infection
- Signs and Symptoms
- Decreased Breath Sounds
- Trachea Deviates Away from Affected Side
- Chest Pain
- Tachycardia
- Tachypnea
- Hypotension
- Hypoxemia
- Hyperresonance
- Emergency
2 mins
Pleural Effusion
- Characteristics
- Accumulation of Fluid in Pleural Space
- Types
- Transudative
- Exudative
- Chylothorax
- Clinical Features
- Dyspnea
- Pleuritic Chest Pain
- Decreased Breath Sounds
- Diagnosis
- Chest X-ray
- Light Criteria
- Management
- Treat Underlying Disorder
- Thoracentesis
3 mins
Sarcoidosis Characteristics and Labs
- Mechanism
- Unknown Mechanism
- Immune-Mediated
- Noncaseating Granulomas
- Vitamin D Activation
- Labs
- Hypercalcemia
- Elevated ACE
- Asteroid and Schaumann Bodies
- Bronchoalveolar Lavage shows Increased CD4:CD8 Ratio
- X-ray Shows Bilateral Hilar Lymphadenopathy
- Treatment
- Corticosteroids
2 mins
Sarcoidosis Symptoms
- Black Females
- Symptoms
- Asymptomatic
- Uveitis
- Interstitial Fibrosis
- Erythema Nodosum
- Hepatomegaly
- Myocardial Sarcoidosis
- Lupus Pernio
1 min
Flail Chest
- Cause/Mechanism
- Trauma
- Assessment
- Shallow Respirations
- Chest Pain
- Paradoxical Chest Movement
- Interventions
- Mechanical Ventilation
- Analgesics
- Intercostal Nerve Blocks
- Considerations
- Surgical Rib Fixation
- Monitor Pulmonary Contusion
2 mins
Histoplasmosis
- Fungi
- 2-5 um
- Yeast Cells within Macrophages
- Starling Bird Poop
- Bat Poop
- Caves
- Mississippi and Ohio River Valleys
- Pneumonia
- Caseating Granuloma
- Erythema Nodosum
1 min
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
Light's Criteria
- Use
- Determines Transudative vs. Exudative Source of Pleural Effusion
- Exudate if (At Least One of the Following):
- Effusion/Serum Protein Ratio > 0.5
- Effusion/Serum LDH Ratio > 0.6
- Effusion LDH > Two-thirds Upper Serum LDH Range
2 mins
Pneumothorax
- Mechanism
- Air Enters Pleural Space
- Assessment
- Sudden Dyspnea
- Absent or Restricted Movement on Affected Side
- Decreased or Absent Breath Sounds on Affected Side
- Chest Pain
- Tracheal Deviation
- Vital Sign Changes
- Crepitus
- Considerations
- High Fowler's Position With Oxygen
- Prepare For Chest Tube Placement
- Educate High Risk Patients
2 mins
Reading a Chest X-Ray
- ABCDE Approach
- Airway and Appliances
- Bones
- Cardiac
- Diaphragm
- Everything Else
- Masses
- Pulmonary Vasculature
- Lung Parenchyma
2 mins
Pulmonary Embolism Assessment
- Assessment
- Shortness of Breath (SOB)
- Pleuritic Chest Pain
- Tachypnea
- Hemoptysis
- Hypoxemia
- Considerations
- Sudden Death
52 secs
Hypersensitivity pneumonitis
- inflamed alveoli
- "Bird fancier's lung"repeated inhalation of bird droppings
- Farmer's lung-- inhaling mold
- Pulmonary Fibrosis with chronic exposure
- if acute- fever, cough, malaise
- XRAY- "haziness", ground glass-- LOWER lung fields
- Treatment: Avoid antigen
- avoid antigen
- steroids do prevent disease progression
Berylliosis
- Berylliosis
- Associated with exposure to beryllium in aerospace and manufacturing industries
- Noncaseating granulomas in the lung, hilar lymph nodes, and systemic organs
- Bilateral infiltrates and hilar adenopathy
- Affects upper lobes
- Tx: Requires chronic corticosteroid treatment
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 Embolism Causes
- Causes
- FAT BAT Mnemonic
- Fat
- Air
- Deep Vein Thrombosis (DVT)
- Bacteria
- Amniotic Fluid
- Tumor
- Risk Factors
- Hypercoagulable
- Central Venous Lines
- Immobilized
1 min
Pulmonary Embolism Presentation and Diagnosis
- Presentation
- Sudden onset Shortness of Breath (S.O.B.)
- Tachypnea
- Pleuritic Chest Pain
- Hemoptysis
- Hypoxemia
- Sudden Death
- Diagnosis
- Gold Standard: CT Pulmonary Angiography
- X-Ray
- D-Dimer
- V/Q Scan
1 min
Oxygen Delivery Methods
- Nasal Cannula
- Simple Face Mask
- Non-Rebreather Mask
- Venturi-Mask
- Safety Precautions
- Oxygen In Use Sign
- No Electrical Sparks
- Six Feet Away from Open Flames
- Nursing Considerations
- Dry Nasal and Upper Airway Mucosa
- Skin Irritation
- Home Education
1 min
Lung Sounds - Wheezes
- Location
- Throughout Lung
- Description
- High Pitched
- Sounds Like
- Musical
- Cause
- Air Moving through Narrowed Airways
38 secs
Lung Sounds - Crackles
- Location
- Lower Lobes
- Description
- Fine/Coarse
- Sounds Like
- Fine: Twisting Hair through Fingers
- Coarse: Velcro
- Cause
- Collapsed Small Airways and Alveoli "Popping Open"
1 min
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