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IFOM > 1.4 Pulmunology > Flashcards

1.4 Pulmunology Flashcards

1
Q

what does the PFT in asthma show

A

↓ FEV1/FVC (both decrease)

↑ TLC

↑ RV

Reversibility with albuterol: ↑ FEV1 > 12%

Bronchial hyperresposiveness: ↓ FEV1 >20% (methacoline)

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2
Q

what diagnostic tool do you use ot test for asthma in a patient that is asymptomatic?

A

methocoline bronquial hyperresponsiveness

↓ FEV1 >20%

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3
Q

adverse effect of ICS

A

dysphonia

oral candidiasis

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4
Q

adverse effects of zafirlukast

A

hepatotoxicity

Chrug-Strauss Syndrome

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5
Q

what vaccines are given in all asthma and COPD patients?

A

influenza

pneumococcal

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6
Q

severe asthma exacerbation (LAB)

A

PEF: decreased

ABG: increased A-a

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7
Q

when is magnesium used in an acute asthma flare?

A

after several rounds of albuterol do not work (waiting for the corticosteroids to begin to work)

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8
Q

shortness of breath, young, non-smoker

most likely cause?

A

anpha-1 antitrypsin deficiency

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9
Q

treatment of COPS that decreases mortality

when to use them

A
  1. smoking cessation
  2. oxygen therapy
  • pO2 <55 / sat <88%
  • pO2 <60 / sat <90%
    • pulm HTN
    • High HCT
    • cardiomyopathy
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10
Q

Most common/resistant organisms that infect CF patients?

A

nontypable H. influenzae

Pseudomonas aerruginosa

Staph. aureus

Burkhorlderia capacia

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11
Q

pneumonia that is accompanied by a dry (nonproductive) cough

A
  1. virus
  2. pneumocystis
  3. mycoplasma
  4. coxiella
  5. chlamydia
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12
Q

what is the best initial test for all respiratory infections?

A

chest x-ray

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13
Q

organisms that cause atypical pneumonia

A

mycoplasma

chalmydophila

legionella

coxiella

viruses

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14
Q

criteria for empyema

A

LDH >60% of serum

Protein >50% of serum

WBC >1000

pH <7.2

+ gram stain/culture / frank pus

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15
Q

🌟 reasons to hospitalize a patient with pnemonia

A

CURB 65

Confusion

Uremia

Respiratory distress

BP low

Age > 65

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16
Q

empiric therapy for CAP

A

macrolides

comorbidities or ATB in past 3 months: flouroquinolones

inpatient treatment: IV flouroquinolones

/ ceftriaxone+ azithromycin

17
Q

empiric therapy for HAP

A

antipseudomonal drugs (gram-eg bacilli)

cefepime, ceftazidime

piperaciline/tazobactam

imipenem, meropenem

18
Q

why can’t you use daptomycin in the lung

A

inactivated by surfactant

19
Q

adverse effect of imipenem

A

at toxicity levels can cause seizures

excreted by kidney, kidney failure = toxicity

20
Q

risks for large-volume aspiration

A

stroke with loss of gag reflex

seizures

intoxication

endotracheal intubation

21
Q

in what part of the lungs does aspiration pneumonia happen

A

upper lobe when lying flat

22
Q

🚩 pt with AIDS presenting dyspnea, dry couch and fever

A

pneumocystis pneumonia

P. jiroveci

23
Q

most common adverse effects of TMP/SMP

A

rash

bone marrow supression

24
Q

🚩 bite cells

what drug is contraindicated

A

G6PDH deficiency

primaquine, dapsone

25
Q

TB risk factors

A

immigrants (past 5 yrs)

healthcare provider

prisoners

close contacts with TB

alcoholics

HIV

hematologic malignancy

DM

26
Q

in what cases is the tx for tuberculosis extended >6m?

A
  1. osteomyelitis
  2. miliary tb
  3. meningitis
  4. pregnancy
  5. cavitary lesions
27
Q

what drugs are contraindicated for a pregnant woman with TB?

A

pyrazinamide and streptomycin

28
Q

lunch cancer screening indications

A

30 pack-year tobacco history

age >55

chest CT

29
Q

🚩 velcro sounding crackles

A

interstitial lung disease (pulm. fibrosis)

30
Q

🚩 hiliar adenopathy on chest x-ray in a healthy african american woman

A

Sarcoidosis

31
Q

🚩 Dyspnea, normal chest x-ray, hypoxia with respiratory alkalosis

A

pulmonary embolism

32
Q

when should you treat PE with IVC filter

A
  1. contraindication to the use of anticoagulants
  2. recurrent emboli (while on therapy)
  3. right ventricular dysfunction
33
Q

when should you tret a patient with PE with thrombolytics

A
  1. hemodynamically unstable
  2. acute right ventricle dysfunction
34
Q

what is the treatment in a patient with PE that has heparin-induced thrombocytopenia?

A

fondaparinux

35
Q
A

IFOM (11 decks)

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