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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)
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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
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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
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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 and Schaumann Bodies
Bronchoalveolar Lavage shows Increased CD4:CD8 Ratio
X-ray Shows Bilateral Hilar Lymphadenopathy
Treatment
Corticosteroids
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2 mins
Sarcoidosis Symptoms
Black Females
Symptoms
Asymptomatic
Uveitis
Interstitial Fibrosis
Erythema Nodosum
Hepatomegaly
Myocardial Sarcoidosis
Lupus Pernio
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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
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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
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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
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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
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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
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2 mins
Reading a Chest X-Ray
ABCDE Approach
Airway and Appliances
Bones
Cardiac
Diaphragm
Everything Else
Masses
Pulmonary Vasculature
Lung Parenchyma
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2 mins
Pulmonary Embolism Assessment
Assessment
Shortness of Breath (SOB)
Pleuritic Chest Pain
Tachypnea
Hemoptysis
Hypoxemia
Considerations
Sudden Death
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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
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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
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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 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
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
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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
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1 min
Lung Sounds - Wheezes
Location
Throughout Lung
Description
High Pitched
Sounds Like
Musical
Cause
Air Moving through Narrowed Airways
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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"
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1 min

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Shiza Shared Pulm Exam 1 - 26 Picmonics