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Boards: RESPIRATORY
Rhinosinusitis Assessment
Pathology
Sinus Obstruction
Assessment
Fever
Nasal Drainage
Facial Pain
Lower Forehead
Cheeks
Nose
Retro-orbital
Persistent Symptoms
2 mins
Deep Vein Thrombosis (DVT) Characteristics
Mechanism
Virchow's Triad
Venous Stasis
Endothelial Damage
Hypercoagulability
Symptoms
Tenderness
Homan's Sign
Warmth
Redness
Swelling
Asymptomatic
1 min
Deep Vein Thrombosis (DVT) Management
Diagnosis
Compression Ultrasound (CUS) with Doppler
D-Dimer
Contrast Venography
Treatment
IVC Filter
Heparin for Acute Management
Warfarin for Long-term Management
Thrombectomy/Thrombolysis
Stockings
Walking
4 mins
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
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
Wells' Criteria for Pulmonary Embolism
Scoring
Clinical Symptoms of DVT (+3)
Pulmonary Embolism Most Likely Diagnosis (+3)
Tachycardia (+1.5)
Immobilization > 3 Days (+1.5)
Previous DVT or PE (+1.5)
Hemoptysis (+1)
Malignancy (+1)
Probability
> 6 = High
2-6 = Moderate
< 2 = Low
3 mins
Mediastinal Mass
Anterior
Thymoma
Germ Cell tumor
Lymphoma (anterior or middle)
Middle
Bronchogenic Cyst
Posterior
Neuroblastoma
Schwannoma
Pheochromocytoma
Obstructive Lung Disease
Blocked Airflow
Increased residual volume
V/Q Mismatch
Decreased forced vital capacity (FVC)
Decreased FEV1/FVC ratio
Asthma
Bronchiectasis
Chronic bronchitis
Emphysema
51 secs
Chronic Bronchitis
Pathophysiology
Chronic Inflammation of Bronchi
Signs and Symptoms
Early-Onset Cyanosis
Blue Bloaters
Productive Cough
Wheezing
Chronic Obstructive Pulmonary Disease (COPD)
Late-Onset Dyspnea
Crackles
Diagnosis
Reid Index > 50%
2 mins
Chronic Bronchitis Interventions
Tripod Position
Humidified Oxygen
Pursed Lip Breathing
Increase Fluid Intake
ABGs
Early Detection of Exacerbation
Considerations
Lowest O2 Therapy
Assisted Ventilation
Increased Infection Risk
2 mins
Emphysema
Clinical Features
Pink Puffer
Exhale through Pursed Lips
Barrel Chest
Pathophysiology
Obstructive Lung Disease
Increased Lung Compliance
Types
Centriacinar
Panacinar
2 mins
Asthma
Obstructive lung disease
Bronchial Hyperresponsiveness
History of Atopic Disease
Beta2 agonists
Corticosteroids
Curschmann's spirals
Hypertrophy of smooth muscle
Reversible
Charcot Leyden crystals
Methacholine challenge
Wheezing
Cough
Initially decreased PaCO2
Pulsus paradoxus
2 mins
Persistent Mild Asthma
Diagnosis
Symptoms (Brochoconstriction) and Rescue Inhaler Use > 2 Days / Week
Nighttime Awakening 3-4 / Month
Greater or equal to 80 % of Predicted FEV1
1 min
Intermittent Asthma
Diagnosis
Symptoms (Bronchoconstriction) and Rescue Inhaler Use ≤ 2 / Week
No Interference With ADLs
Nighttime Awakening < 2 / Month
> 80 % of Predicted FEV1
1 min
Persistent Moderate Asthma
Diagnosis
Symptoms (Bronchoconstriction) and Rescue Inhaler Use Daily
Nighttime Awakening > 1 / Week
60-80% Predicted FEV1
FEV1/FVC Decreased 5%
2 mins
Persistent Severe Asthma
Diagnosis
Symptoms (Bronchoconstriction) and Rescue Inhaler Use: Multiple/ Day
With Minimal Activity
Nighttime Awakening: Nightly
< 60% Predicted FEV1
> 5% Decrease FEV1/FVC
2 mins
Stages of Asthma Treatments
Mild Intermittent
Short-acting Inhaled Beta-Agonist
Mild Persistent
Low-Dose Inhaled Corticosteroid
Montelukast (Leukotriene Receptor Antagonist)
Moderate Persistent
Low to Medium-dose Inhaled Corticosteroid
Zileuton
Severe Persistent
High-Dose Inhaled Corticosteroid
Systemic Corticosteroids
Omalizumab (Allergies)
2 mins
Bronchiectasis
Obstructive Lung Disease
Chronic Necrotizing Infection
Permanent Airway Dilation
Poor Ciliary Motility
Kartagener's Syndrome
Cystic Fibrosis
Allergic Bronchopulmonary Aspergillosis
Hemoptysis
Increased Sputum
2 mins
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
Restrictive vs. Obstructive Lung Diseases
Restrictive Lung Disease
Decreased Lung Volume
FEV1/FVC Ratio Normal to Increased
Obstructive Lung Disease
Increased Lung Volume
Decreased FEV1/FVC Ratio
2 mins
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