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Diagnostic testing for DVT?Ascending venogram, D-Dimer, Compression USG, MRI, Wells Score, Peripheral Vascular Disease Differentials:arterial-5P’s (pain, pallor, pulseless, paralysis, paresthesia, shiny ski, hair thinning, thick toenails (Keep legs down for blood flow)venous- venous pooling, edema, discoloration, pain (Keep legs up for blood return)DVT- warm, erythema, pain, red streakingVaricosities- engorged vessels, visible veins, “spider veins”Obstructive Vs Restrictive Pulm DiseasesFVC < than 80%-restrictive disease; FVC < 70% obstructive-COPD, emphysema, Bronchitis, asthmaASTHMA: FEV1 Classification: Normal FEV1/FVC: 8-19 yr 85% 20-39 yr 80% 40-59 yr 75% 60-80 yr 70%Intermittent- pulmonary function may be normal, symptoms less than 2 days per weekMild- wake up few times/month and use rescue inhaler 3-4x per week, minor limits on activityMod persistent- wake up once/week use rescue inhaler daily, some limitation of activitySevere persistent- wake up from sleep often use rescue inhaler multiple times/day, 7x per week usage of inhaler and extremely limiting their activitiesSigns and Symptoms: Emphysema- cough, hemoptysis, smoker, hyperventilationBronchitis-cough, sputum, dyspneaPneumonia- fevers, chills, sputum production, myalgias, chest pain, possible crackles Asthma- I/E wheezing, accessory muscle use, stridor, tachypnea, tachycardia, SOBCOPD-dyspnea, cough, barrel chest, crackles, JVD, fatigue distant Breath Sounds, wheezingCURB65-confusion, BUN >19, RR >30, BP: sys<90, dys <60, age >65 0.1 home, 0-2 short Outpatient, 3-5 inpatient, possible ICU admittance
Common organism associated with CAP- S pneumoniae, Hemophilus Influenzae, Mycoplasma Pneumoniae, Chlamydophilia Pneumoniae, Viral Infections.Stages of COPD-1. mild FEV>80%, 2. Mod FEV50-79% 3. Severe FEV1 30-39% 4. Very severe <30%(pg362)Contributing factors to obstructive sleep apnea, PT EDUCATION-