Notes in Pulmonary Diagnostics & Infection

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Status	Last Update	Fields
Published	09/29/2023	List a few diagnostic pulmonary procedures:
Published	09/29/2023	indications for PFT- evaluation of symptoms and signs of respiratory illness (possible impairment and disability)- assessing response to therapy- pre{…
Published	09/29/2023	{{c1::Pulmonary Function Tests}} (PFTs)objective, reproducible, simple, non-invase, relatively inexpensive{{c2::quantifies}} function of r…
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Published	10/01/2023	PFT: {{c3::Spirometry}}- single most important test that can be measured in office setting as well as PFT lab - patient {{c1::inhales}} and {{c1:…
Published	09/29/2023	criteria for {{c2::spirometry}} PFT requires a full exhalation for at least {{c1::6}} seconds
Published	10/01/2023	Quality Standards for Spirometry- maximal {{c1::force}} on exhalation → continued exhalation for {{c2::6}} seconds - full {{c3::inspiration}} before m…
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Published	09/29/2023	spirometry indices{{c1::Forced Expiratory Volume}} (FEV1): measures volume of air exhaled in first second of FVC effort- indicates {{c2::large}} …
Published	09/29/2023	Race/Ethnicity in PFTs*remains controversial- in 2012, GLI put out 5 Reference Equations- but updated ATS guidelines recommend race {{c1::neutral…
Published	09/29/2023	COPD is mainly an {{c1::expiratory::expiratory/inspiratory}} issue
Published	10/01/2023	Obstructive Pattern- {{c1::FEV1/FVC}} ratio < LLN*in obstruction, there is higher pressure during expiration → airways collapse more easily → reduc…
Published	10/01/2023	Does this spirometry define obstruction? {{c2::Yes::Yes/No}}→ values: Low {{c1::FEV1}}, Low {{c1::FEV1/FVC ratio}}→ flow value loop: {{c3::scalloped}}…
Published	10/01/2023	{{c2::Severity}} of Obstruction - determined by the {{c1::Z-score}} of {{c3::FEV1}} parameter: more negative {{c1::Z-score}} → more sev…
Published	10/01/2023	Bronchodilator Responsiveness- inhale {{c1::albuterol}} and repeat spirometry after 15 minutes - {{c4::positive}} response is a magnitude of chan…
Published	09/29/2023	{{c1::Obstructive}} Diseases*can be seen with spirometry • {{c2::Asthma}} • {{c3::Bronchiectasis}}• {{c3::Bronchiolitis}} • {{c4::COPD}}: ch…
Published	09/29/2023	patients with asthma can have {{c1::normal}} spirometry
Published	10/26/2023	{{c1::Bronchoprovocation}} Test-  helps confirm {{c2::asthma}}- administration of a stimulus when no symtomps present → causes airway {{c3::…
Published	09/29/2023	A 65-year-old man presents with progressive shortness of breath and stridor. He undergoes pulmonary function testing, and his flow volume loop is show…
Published	09/29/2023	Variable intra-thoracic obstruction*typically obstructions below thoracic inlet → causes issues with {{c3::expiratory}} limb - during {…
Published	10/05/2023	lung volumes- {{c9::Tidal}} volume: normal breath volume  - {{c10::Expiratory reserve}} volume: the volume left behind after breathing out normal…
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Published	09/29/2023	Plethysmography (Body Box)- process: sit in box with known volume → breathe in and out → changes in pressure correlated with change in lung {{c2::volu…
Published	10/05/2023	Interpretation of Lung Volumessmall lung volumes *FRC and/or TLC {{c1::<::>/<}} {{c9::LLN}} - can be caused by decreased {{c3::comp…
Published	09/29/2023	CASE: 48-year-old male, non-smoker, dyspnea x 2 years and abnormal lung imaging. Diffuse centrilobular micronodules, lymphadenopathy. Worked in h…
Published	10/10/2023	Diffusion Capacity (DLCO)*may be indicated for differential diagnosis of  obstructive lung diseases, pulmonary restriction, screening/follow…
Published	09/29/2023	CASE: 44 yo diagnosed with pulmonary sarcoidosis at age 30.  Has required treatment with steroids.  Has cough, white sputum, severe dyspnea …
Published	10/01/2023	Algorithm for PFT interpretation & evaluation1. Is the test interpretable? 2. Look at absolute {{c1::FEV1/FVC}}*decreased {{c1::FEV1/FVC…
Published	09/29/2023	PFTs provides is a non-{{c1::invasive}} method to assess of lung function - accurate data require patient {{c2::effort}} and coordination  - res…
Published	09/29/2023	Pulmonary Infections- can be Upper Respiratory Tract Infection (above {{c1::larynx}}) - can be Lower respiratory Tract Infection (below {{c1::l…
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Published	10/01/2023	categories of pneumonia- place of acquisition (community vs. {{c1::nosocomial}})- {{c2::radiographic}} patterns (lobar, bronchiolar, {{c3::interstitia…
Published	10/01/2023	Normal defense mechanisms against LRTIMechanical mechanisms:- anatomical (nasal turbinates, nasal hairs, glottis, branching airways) - {{c7::mucocilia…
Published	09/29/2023	Clinical conditions that disrupts the normal defense mechanism of lungs: - {{c1::CF}} disrupts {{c6::mucociliary apparatus/escalator}} - {{c2::COPD}} …
Published	09/29/2023	When you suspect a pneumonia, consider the following in the initial assessment of the patient:{{c2::Medical}} hx: COPD, alcoholism, seizure disor…
Published	09/29/2023	This CXR is c/w {{c1::RML::which lobe}} {{c1::lobar}} pneumonia
Published	10/10/2023	{{c3::Lobar}} pneumonia – peripheral alveolar consolidation- imaging: {{c10::air bronchogram}} is characteristic- typically bacterial: {{c11::Str…
Published	09/29/2023	{{c1::Streptococcus pneumonia::organism}} typically causes {{c3::lobar}} pneumonia→ typically {{c2::community}}-acquired
Published	09/29/2023	This CXR is c/w {{c3::lobar}} pneumonia of the left lung → key feature is the {{c1::consolidation}} seen as the solid white area with {{c2::…
Published	10/01/2023	physical exam findings associated with {{c1::lobar}} pneumonia:- {{c3::bronchophony}}: enhanced transmission of air sounds through more {{c2…
Published	09/29/2023	CURB 65*5 point calculation of risk of mortality from {{c5::pneumonia}}• C{{c1::onfusion}}• U{{c2::rea}} > 7 mmol/L • R{{c2::espiratory rate}} >…
Published	09/29/2023	{{c2::Pneumonia Severity Index}} (PSI)*evaluates {{c1::20}} variables in a point system to determine severity of pneumonia
Published	09/29/2023	Treatment of {{c1::community-acquired pneumonia}} (CAP)*depends on outpatient vs. inpatientOutpatient - if no comorbidition or risk fac…
Published	09/29/2023	This CXR is c/w {{c1::broncho}}pneumonia*due to more fluffy appearance → typically caused by {{c2::Staph aureus::pathogen}} and {{c2::H. influenz…
Published	10/05/2023	{{c1::Aspiration}} pneumonia occurs when food or liquid is breathed into the airways or lungs, instead of being swallowed*more likely in patients…
Published	10/01/2023	Nosocomial Pneumonia- can be of two types {{c1::Hospital}}-Acquired Pneumonia (HAP) and {{c1::Ventilator}}-Associated Pneumonia (VAP)*higher stakes be…
Published	10/10/2023	This CXR is c/w {{c1::interstitial}} pneumonia, infection of the thin layer that surrounds alveoli → typically caused by {{c2::atypical}} pathoge…
Published	10/01/2023	histopathology of {{c2::CMV}}-caused {{c3::interstitial}} pneumonia:    - plasma cells with {{c1::cytoplasmic}} and {{c1…
Published	10/01/2023	pneumonia in immunocompromised host- usual {{c1::symptoms}}/{{c1::signs}} may or may not be present- unusual {{c2::rate}} of progression of disease an…
Published	10/05/2023	This CXR and CT scan are c/w {{c1::nodular}} pattern→ can be caused by septic embolization, {{c2::fungal}} or TB disease, lung abscess from aspiration…
Published	10/01/2023	HIV+ status with low CD4 count → particularly high risk of infection by {{c1::Pneumocystis jiroveci}}*common opportunistic infection involving the lun…
Published	09/29/2023	This CXR is c/w {{c1::miliary}} pattern *small seed-like distributed across both lungs→ typically infection by {{c2::mycobacterium tuberculosis (…
Published	09/29/2023	Pulmonary Tuberculosis:Risk Factors- close contact with TB in {{c2::congregate}} settings (dorms, health care workers) - from or traveled to ende…
Published	09/29/2023	Pulmonary Tuberculosis:Symptoms- non-specific systemic: loss of appetite, weight loss, easy fatigability- night sweats - hemoptysis - subacute/chronic…
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Published	10/05/2023	{{c3::Consolidation}}: white lung density with {{c2::air bronchogram}} (alveoli completely flooded with patent bronchi)*lobar pneumonia{{c1::Atel…
Published	10/05/2023	{{c1::nosocomial}} pneumonia or {{c1::hospital}}-acquired pneumonia occurs {{c2::48}} hours or more after hospital admission and is not present at adm…
Published	10/12/2023	{{c1::rhinovirus}} is the most common viral infectious agent in humans and is the predominant cause of the common cold
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