SU5505 Midterm Test

Annie Nguyen
Flashcards by Annie Nguyen, updated more than 1 year ago
Annie Nguyen
Created by Annie Nguyen almost 6 years ago
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ANP: LUNG and Heart

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Question Answer
List the 7 steps for Spirometry interpretation 1. Six seconds long 2. Flow volume loop shape 3. FEV1/ FVC >70% 4. FVC > 80% 5. FEV1 > 80% 6. ID pattern 7. Classify Severity
LV hypertrophy: Increased R wave peak time:Left ventricular strain pattern: *T wave inversion in the lateral leads V5-6*
Proventil HFA, ProAir, Xopenex is an example of ? SABA: Short- acting beta agonist ( short-acting bronchodilator)
Aerospan, Flovent, Pulmicort and Qvar are examples of ? ICS- inhaled corticosteriods
Foradil and Serevent are examples of ? LABA
Atrovent, Combivent, Tudorza, and Spiriva are examples of ???? Anticholinergics
Advair, Breo, Dulera, and Symbicort are examples of????? Combo Medications: ICS and LABA
Gold Standard DX for COPD Spirometry
Diagnostics for Asthma 20% variation in PEF (liters/mins) Spirometry
Peak Flow Measurement 1. Stand___ 2. Cursor at _____ 3. Blow _____& _____ 4. Best of _____ attempts 5. Record _______ best. 1. Stand up 2. Cursor at zero 3. Blow hard & fast 4. Best of 3 attempts 5. Record personal best.
Deaths from Asthma is best reduced by.... 1. written _______ plan 2. Oral _______ prior to severe attack 3. Use of Peak _____ meter ( Liters/mins.) 1. written Action plan 2. Oral corticosteroids prior to severe attack 3. Use of Peak Flow meter ( Liters/mins.)
This type of Asthma Medication benefits those who are obese, smoke, or triad of asthma Leukotriene medications: Singulair
Triad Asthma criteria Nasal polyps ASA sensitivity Severe asthma
Asthma Control Test A score of ____ is controlled asthmatic. <19 not controlled >20 is well controlled
What medication increase the risk of pneumonia in COPD patients? Corticosteroid do not cause Pneumonia or osteoporosis in asthmatics, however those with COPD .
Peak Flow Monitoring 1. best lung function __ pm & lowest __am 2. ___% fluctuation is healthy 3. ___% variation DX of asthma 4. NOT USED FOR _____. 1. best lung function 4 pm & lowest 4am 2. 8% fluctuation is healthy 3. 20% variation DX of asthma 4. NOT USED FOR COPD. * effort dependent*
Schedule of Asthma Follow up 1st F/U within ____ month. Routine visit ___ to ___ months. 1st F/U within 1 month. Routine visit 1 to 6 months. *assess correct use of inhaler, spacer, peak flow meter (PFM)*
COPD is not fully ________. COPD is not fully reversible. Preventable and treatable.
Productive cough for 3 consecutive months for 2 consecutive years. Chronic Bronchitis
COPD SOB manifest at __ % of lung function SOB manifest at 50 % of lung function
PATHO of COPD 1. increases in ______ and neutrophils. 2. ______ hyperplasia. 3. Bronchiolar ______. 4. Peribronchiolar ________. 5. Loss of _______ attachments. 1. increases in macrophages and neutrophils. 2. bronchiolar hyperplasia. 3. Bronchiolar edema. 4. Peribronchiolar fibrosis. 5. Loss of alveolar attachments.
COPD presentation 1. SXS present at 1 PPD for > ____ years. 2. manifestation at _____ decade: chronic cough after viral infx. 3. Dypsnea at ___ or ____ decade. 1. SXS present at 1 PPD for > 20 years. 2. manifestation at fifth decade: chronic cough after viral infx. 3. Dypsnea at sixth or seventh decade.
COPD Physical Exam 1. ______ and _____ expiration. 2. Chest wall _______inflation. 3. Distant _____ and ____ sounds. 4. Pursed ____ breathing. 5. Cor ______: JVD, edema, heptomegaly 1. Slow and prolonged expiration. 2. Chest wall hyperinflation. 3. Distant heart and breath sounds. 4. Pursed lip breathing. 5. Cor pulmonale: JVD, edema, heptomegaly
COPD Chest Xray COPD Chest XRAY 1. flat diaphragm 2. tear shaped heart 3. Increase AP/ retrosternal airspace *Emphysema: pruning of pulmonary vessels and bullae*
COPD assessment test (CAT) < 10 > 10 Group A: low risk, less SXS (CAT< 10) Group B: low risk, more SXS (CAT>10) Group C: high risk, less SXS (CAT< 10) Group D: high risk, high SXS (CAT >10) *GROUP B &D: 5x risk for cardiovascular dx and cancer*
COPD Treatment : 1st Choice Group A and B Group A: SAAC (Atrovent/ combivent) or SABA (Proair, Proventil) Group B: LAAC (spiriva/anora ) or LABA (Foradil/ Serevent) * add- on exercise and pulmonary rehab*
COPD 1st choice treatment for Group C and D Group C: LAAC (Anora/Spriva) and (+)LABA ( Foradil/Serevent) Group D: ICS (Flovent/ Pulmicort) and(+)LABA or LAAC * add- on exercise, oxygen therapy pulmonary rehab*
Spirometry List the predicted values/ criteria. 1. Gender 2. Race 3. Age 4. height
____ _____ _____ (FVC) maximum volume of air exhaled _____ _____ ______ (FEV1): volume exhaled during the first second. Forced Vital Capacity: maximum volume of air exhaled Forced Expiratory Volume: volume exhaled during the first second.
Normal Lung Volume Values FEV / FVC1 >____% FVC > _____% FEV1 > _____% Normal Lung Volume Values FEV / FVC1 >70% FVC > 80 % FEV1 > 80 %
Obstructive vs Restrictive Disease pattern Obstructive: FEV1 / FVC _____, FVC _____ FEV1_____ Obstructive: FEV1 / FVC down , FVC normal, FEV1 down
Obstructive vs Restrictive Disease pattern Restrictive : FEV1 / FVC _____, FVC _____ FEV1_____ Restrictive : FEV1 / FVC normal , FVC down FEV1 down Combined:FEV1 / FVC down, FVC down, FEV1 down
Obstructive Lung Diseases Asthma COPD Bronchiectasis Cystic Fibrosis
Obstructive Reversibility defined as a change of ____% post Albuterol (SABA) or Ipratropium (Atrovent) and increase of _______ mL. Obstructive Reversibility defined as a change of 12 % post Albuterol (SABA) or Ipratropium (Atrovent) and increase of 200 mL.
CAD inflammation marker. < 1 low risk for CV events 1-3 intermediate >3 high High Sensitivity CRP (hs-CRP)
Which is an independent risk factor for CHD? HDL, LDL, Triglycerides Elevated Triglycerides are an independent risk factor for CHD. Low HDL independent predictor (inverse relationship) Normal < 150 Borderline 150-199 High > 200- increased risk for pancreatitis
What are the criteria for Metabolic syndrome? Metabolic syndrome- 3+SXS to DX 1. Abdominal obesity (M >40in. W> 35) 2. Triglyceride> 150 mg/dl 3. Low HDL ( M<40, W< 50) 4. High BP ( 130/85) 5. Fast blood glucose (> 110)
DXD for Dyslipidemia 1. DM 2. Hypothyroidism 3. obstructive liver dx 4. Chronic renal failure 5. Protease inhibitor ( HIV meds) 6. BBB, HCTZ= low HDL 7. Prednisone ( high TG) 8. Tamoxifen- high TG ( Breast CA)
Non occlusive thrombus unstable angina and non-Q wave MI
Occlusive thrombus Q wave MI and sudden death
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