Pulmonary Review
From Iusmicm
(Difference between revisions)
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==History and Physical Exam== | ==History and Physical Exam== | ||
| - | Know the key details of the pulmonary history and | + | *Know the key details of the pulmonary history and physical exam |
| - | physical exam | + | *Interpret basic acid-base disorders |
| - | + | *Diagnose pneumothorax, pleural effusion, and atelectasis on exam or xray (know what to look for!) | |
| - | + | *Know how to treat a pneumothorax, atelectasis secondary to mucus plug, and pleural effusion | |
| - | atelectasis on exam or xray (know what to look for!) | + | *Know basic bronchoscopic indications |
| - | + | *Know the objective findings in vocal cord dysfunction syndrome | |
| - | secondary to mucus plug, and pleural effusion | + | |
| - | + | ||
| - | + | ||
| - | syndrome | + | |
==Pulm Function Testing== | ==Pulm Function Testing== | ||
| Line 24: | Line 20: | ||
==Pneumonia== | ==Pneumonia== | ||
| - | |||
| - | |||
===Concepts=== | ===Concepts=== | ||
| Line 61: | Line 55: | ||
==Obstructive Airways Diseases== | ==Obstructive Airways Diseases== | ||
| - | Know the components of COPD (asthma, | + | *Know the components of COPD (asthma, chronic bronchitis, emphysema) and their defining characteristics including: |
| - | chronic bronchitis, emphysema) and their | + | **Basic pathophysiology |
| - | defining characteristics including: | + | **Symptomatology |
| - | + | **Diagnostic studies | |
| - | + | **Classifications (asthma & emphysema) | |
| - | + | **Treatment strategies (asthma & emphysema) | |
| - | + | **Factors indicating poor prognosis (emphysema) | |
| - | + | **Management goals (asthma) | |
| - | + | ||
| - | + | ||
==The Pleura & Neurologic Disorders== | ==The Pleura & Neurologic Disorders== | ||
| - | + | *Recall the anatomy and physiology of the normal pleural space | |
| - | normal pleural space | + | *List the signs and symptoms of pleural effusion and pneumothorax |
| - | + | *Identify pathophysiologic causes of an effusion or pneumothorax | |
| - | effusion and pneumothorax | + | *Differentiate a transudative from an exudative effusion |
| - | + | *Identify the characteristics of pleural fluid analysis in common pleural diseases | |
| - | effusion or pneumothorax | + | *Identify the pulmonary function abnormalities associated with neuromuscular weakness |
| - | + | *List those neuromuscular diseases associated with respiratory failure | |
| - | effusion | + | |
| - | + | ||
| - | analysis in common pleural diseases | + | |
| - | + | ||
| - | abnormalities associated with | + | |
| - | neuromuscular weakness | + | |
| - | + | ||
| - | associated with respiratory failure | + | |
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==Treatment of Respiratory Failure== | ==Treatment of Respiratory Failure== | ||
| - | + | *Be able to calculate the A-a gradient given an ABG and FiO2 | |
| - | FiO2 | + | *Define Shunt & V/Q Mismatch (increased and decreased) |
| - | + | *Know what influences the Oxygen dissociation curve to the right and left | |
| - | + | *Learn the types and FiO2’s of various supplemental oxygen devices | |
| - | right and left | + | *Understand the types and indications for Non-invasive positive pressure ventilation |
| - | + | *Understand the procedure of endotracheal intubation and indications for mechanical ventilation | |
| - | oxygen devices | + | *Learn basic mechanical ventilation (not covered on exam) |
| - | + | *Review for the Pulmonary Exam | |
| - | positive pressure ventilation | + | |
| - | + | ||
| - | indications for mechanical ventilation | + | |
| - | + | ||
| - | + | ||
==Pulmonary & Critical Care Case Conference== | ==Pulmonary & Critical Care Case Conference== | ||
| - | + | *Introduce you to “real-world” clinical medicine through actual case studies | |
| - | through actual case studies | + | *Cases not on exam |
| - | + | ||
| - | + | ||
| - | + | ||
| - | + | ||
| - | + | ||
| - | + | ||
| - | + | ||
| - | + | ||
Revision as of 16:39, 5 March 2012
Introduction
Approach to Shortness of Breath
History and Physical Exam
- Know the key details of the pulmonary history and physical exam
- Interpret basic acid-base disorders
- Diagnose pneumothorax, pleural effusion, and atelectasis on exam or xray (know what to look for!)
- Know how to treat a pneumothorax, atelectasis secondary to mucus plug, and pleural effusion
- Know basic bronchoscopic indications
- Know the objective findings in vocal cord dysfunction syndrome
Pulm Function Testing
Peds Pulmonary
Pneumonia
Concepts
- Time of onset informs the likely causative agent:
- 0-2 days: bacterial
- 0-2 days: mycoplasma, viral, legionella, pneumocystis, fungal
- chronic: anaerobic, mycobacterial, fungal, nocardia, actinomycosis
- Distribution informs the likely causative agent:
- Lobar: bacterial, anaerobes
- Diffuse: viral, pneumocystis, mycoplasma, fungal
- Nodular / cavitary: mycobacterial, fungal, anaerobes
Details
- Workup for the pt with pneumonia:
- H&P
- CBC, electrolytes, glucose, BUN / Cr, LFTs
- ABG, puls oximetry
- Chest radiograph
- Sputum gram stain, sputum culture (2 days)
- Blood culture x2 (hospitalized pts, only)
- Legionella
- Fungi
- Mycoplasma
- Respiratory viral titers
- Thoracentesis
Pulmonary Hypertension
Pulmonary Embolism
Obstructive Airways Diseases
- Know the components of COPD (asthma, chronic bronchitis, emphysema) and their defining characteristics including:
- Basic pathophysiology
- Symptomatology
- Diagnostic studies
- Classifications (asthma & emphysema)
- Treatment strategies (asthma & emphysema)
- Factors indicating poor prognosis (emphysema)
- Management goals (asthma)
The Pleura & Neurologic Disorders
- Recall the anatomy and physiology of the normal pleural space
- List the signs and symptoms of pleural effusion and pneumothorax
- Identify pathophysiologic causes of an effusion or pneumothorax
- Differentiate a transudative from an exudative effusion
- Identify the characteristics of pleural fluid analysis in common pleural diseases
- Identify the pulmonary function abnormalities associated with neuromuscular weakness
- List those neuromuscular diseases associated with respiratory failure
Interstitial Lung Disease and SPNs
Treatment of Respiratory Failure
- Be able to calculate the A-a gradient given an ABG and FiO2
- Define Shunt & V/Q Mismatch (increased and decreased)
- Know what influences the Oxygen dissociation curve to the right and left
- Learn the types and FiO2’s of various supplemental oxygen devices
- Understand the types and indications for Non-invasive positive pressure ventilation
- Understand the procedure of endotracheal intubation and indications for mechanical ventilation
- Learn basic mechanical ventilation (not covered on exam)
- Review for the Pulmonary Exam
Pulmonary & Critical Care Case Conference
- Introduce you to “real-world” clinical medicine through actual case studies
- Cases not on exam
