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  1. Restrictive PFTs
    • Decreased FEV1
    • FEV1/FVC >80%
  2. Obstructive PFTs
    • Decreased FEV1 and FVC
    • FEV1/FVC ratio <80%
  3. recurrent pneumonia
    • same region: local anatomic obstruction, recurrent aspiration
    • different region: sinopulmonary disease, non-infectious, immunodeficiency
  4. Aspiration pneumonia
    risk, bugs, tx
    • altered consciousness
    • neurologic dysphagia
    • disruption of the gastroesophageal junction
    • mechanical disruption of the glottic closure
    • sedation for procedures
    • bugs: oral flora (aerobic and anaerobic)
    • tx: clindamycin, amp-sulbactam
  5. Atypical pneumonia
    • mycoplasma pneumonia, chlamydia pneumonia, legionella, coxiella, influenza
    • mycoplasma is the most common in ambulatory setting
    • indolent course: non-productive cough, extrapulmonary symptoms (headache, sore throat, skin rash)
    • Skin rash is typical of mycoplasma, also does not gram stain
  6. asthma exacerbation
    sign of severe attack
    • normal Pco2: indicates retaining, as normally patients are hyperventilating and will have low Pco2
    • speech difficulty
    • diaphoresis
    • altered sensorium
    • cyanosis
    • "silent" lungs
  7. idiopathic pulmonary fibrosis
    • PFTs: restrictive lung pattern
    • diffusing capacity is reduced, due to V/Q mismatch: A-a gradient increased
    • honeycomb pattern
    • pulmonary vascular congestion in the hilum
  8. modified Wells criteria
    for PE
    • 3 points: clinical signs of DVT, alternative diagnosis less likely than PE
    • 1.5 points: previous PE or DVT, HR >100, recent surgery or immobilization
    • 1 point: hemoptysis, cancer
    • >4 points: PE likely
Card Set
medicine shelf, pulmonary
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