Respiratory APEA 3P Exam Study Guide Flashcards

Comprehensive vocabulary flashcards generated from the Respiratory APEA 3P Exam Study Guide, covering lung findings, breath sounds, asthma, COPD, pneumonia, pleural effusion, empyema, hemoptysis, tuberculosis, pertussis, and croup.

Consolidation (Lung Finding)

A physical exam finding that raises fremitus and produces dullness on percussion.

Pleural Effusion (Physical Exam Finding)

A physical exam finding that lowers fremitus and produces dullness on percussion.

Air Trapping (Lung Finding)

A physical exam finding that lowers fremitus and produces hyperresonance on percussion.

Vesicular Breath Sounds

Normal breath sounds heard over the periphery where inspiration duration is longer than expiration.

Bronchovesicular Breath Sounds

Normal breath sounds heard near the 1st and 2nd intercostal spaces and between the scapulae, where inspiration and expiration durations are equal.

Bronchial Breath Sounds

Normal breath sounds heard over the trachea where expiration duration is longer than inspiration; abnormal if heard in the periphery.

Crackles

Added breath sounds associated with fluid or fibrosis.

Wheezes

Added breath sounds associated with narrowed airways.

Rhonchi

Added breath sounds caused by secretions that may clear with a cough.

Stridor

An added breath sound associated with upper airway obstruction or narrowing.

Pleural Rub

An added breath sound caused by inflamed pleura.

Asthma Pathophysiology

Chronic airway inflammation involving eosinophils and IgE, hyperresponsiveness, and reversible obstruction.

Silent Chest

An ominous assessment finding in asthma indicating severe airway obstruction.

Asthma Diagnostic Spirometry Criteria

Low FEV1/FVC that improves by $12\text{--}$ and $200\text{--}$ mL after bronchodilator administration.

Peak Flow Zones (Asthma)

Monitoring zones defined as green ($80\text{--}$ or more), yellow ($50\text{--}$ to $79\text{--}$), and red (under $50\text{--}$).

Albuterol Side Effects

Side effects of this short-acting beta-2 agonist include tremor, tachycardia, and low potassium (K).

Inhaled Corticosteroids (in Asthma)

The cornerstone therapy for asthma; causes thrush and hoarseness, which can be prevented by using a spacer and rinsing the mouth.

Montelukast Safety Warning

An asthma medication associated with a neuropsychiatric warning.

COPD Pathophysiology

Chronic bronchitis (mucus hypersecretion, productive cough $3\text{--}$ months a year for $2\text{--}$ years) plus emphysema (alveolar wall destruction, lost recoil, air trapping); associated with smoking and alpha-1 antitrypsin deficiency in the young.

COPD Diagnostic Spirometry Criteria

A post-bronchodilator FEV1/FVC under $0.70$.

Tiotropium

A long-acting muscarinic antagonist used in COPD that causes dry mouth and urinary retention.

Community-Acquired Pneumonia (CAP) Pathophysiology

Alveolar infection most commonly caused by Strep pneumoniae, with atypical pathogens including Mycoplasma (young adults, walking pneumonia) and Legionella.

Egophony

A physical exam finding of consolidation where the spoken sound 'E' is heard as 'A'.

CURB-65

A clinical scoring rule used to evaluate severity in community-acquired pneumonia.

Healthy Outpatient CAP Treatment

First-line oral regimens consisting of amoxicillin $1\text{--}$ g three times daily, or doxycycline.

Aspiration Pneumonia

Pneumonia caused by anaerobes, most commonly located in the right lower lobe.

Transudate Pleural Effusion

Pleural effusion caused by pressure imbalance, seen in heart failure, cirrhosis, and nephrotic syndrome.

Exudate Pleural Effusion

Pleural effusion caused by leaky capillaries, seen in infection, cancer, and pulmonary embolism (PE); differentiated using Light's criteria.

Empyema

Pus in the pleural space usually occurring after pneumonia, characterized by pleural fluid pH under $7.2$ and low glucose.

Hemoptysis Features

Expectorated frothy, bright red, alkaline fluid; differentiated from hematemesis, requiring imaging in smokers over $40$.

Tuberculosis Pathophysiology

Airborne infection caused by Mycobacterium tuberculosis walled off by macrophages in caseating granulomas; latent is asymptomatic/non-contagious, while active disease reactivates in upper lobes with immunosuppression.

Tuberculin Skin Test (TST) Cutoffs

Induration read at $48\text{--}$ to $72\text{--}$ hours: $5\text{--}$ mm positive for HIV, close contacts, immunosuppressed; $10\text{--}$ mm for recent immigrants, health workers, children under $4$; $15\text{--}$ mm for no risk.

RIPE Therapy

Treatment regimen for active tuberculosis: rifampin (orange secretions, CYP inducer), isoniazid (neuropathy, give vitamin B6), pyrazinamide (hyperuricemia), and ethambutol (optic neuritis, red-green color loss).

Pertussis Stages and Symptoms

Infection caused by Bordetella pertussis toxin presenting in catarrhal (most contagious), paroxysmal, and convalescent stages; characterized by paroxysmal cough, inspiratory whoop, post-tussive vomiting, and lymphocytosis.

Pertussis Vaccination Schedule

DTaP administered at $2\text{--}$, $4\text{--}$, $6\text{--}$, $15\text{--}$ to $18\text{--}$ months, and $4\text{--}$ to $6\text{--}$ years; Tdap given at $11\text{--}$ to $12\text{--}$ years and during each pregnancy at $27\text{--}$ to $36\text{--}$ weeks.

Croup

Subglottic edema caused by parainfluenza virus in children aged $6\text{--}$ months to $3\text{--}$ years; presents with barking cough, inspiratory stridor, hoarseness, and a steeple sign on neck X-ray.

Epiglottitis Clinical Signs

Airway emergency presenting with drooling, tripod position, and a toxic look; examination of the throat is strictly prohibited.

Croup Pharmacology

Treatment consisting of a single dose of dexamethasone and nebulized racemic epinephrine for stridor at rest, followed by observation for rebound.