ACCP SEEK 23 SET 2

Question 1

PFT SAFETY

Answer 1

DELAY PFT TILL 1 MONTH AFTER MYOCARDIAL INFARCTION

NO SMOKING WITHIN 1 HOUR OF TESTING
NO EXERCISE WITHIN 30 MINUTES OF TESTING

Question 2

FIBROSING MEDIASTINITIS

Answer 2

SVC SYNDROME MOST COMMON SERIOUS COMPLICATION

NONMALIGNANT BUT OFTEN PROGRESSIVE
USUALLY DUE TO HISTOPLASMOSIS
AG TEST IS USUALLY NEG.

SOMETIMES SARCOID, TB,

Question 3

ASPIRATION PNEUMONIA

Answer 3

IF POOR DENTITION AND ASPIRATION USE
AUGMENTIN,
COVER ANAEROBES AND BETA LACTAMASE PRODUCING ORGANISMS

Question 4

ACUTE CHEST SYNDROME

Answer 4

SCD, CAN BE MILD, MODERATE, SEVERE

SEVERE : EXCHANGE TRANSFUSION FOR SEVERE
MODERATE: SIMPLE TRANSFUSION

GOAL IS TO REDUCE HB S < 30%.

OTHER TX: FLUIDS , O2, OPIATES

NO ROLE FOR PLASMAPHERESIS OR STEROIDS

Question 5

THYMOMA

Answer 5

MOST COMMON ANTERIOR MEDIASTINAL 
ROUND OR OVOID
OFTEN ASX
55% ARE BENIGN
MALIGNANT HAVE POOR PX

Question 6

OTHER ANTERIOR MEDIASTINAL MASSES

Answer 6

LYMPHOMAS, INTRATHORACIC THYROID TISSUE, LIPOMAS,

LESS LIKELY BRONCHOGENIC CARCINOMA

Question 7

DIFFUSE ALVEOLAR HEMORRHAGE

Answer 7

BRONCH WITH INCREASINGLY BLOODY RETURNS
IDIOPATHIC PULMONARY HEMOSIDEROSIS IF
NEGATIVE FOR CTD, VASCULITIS

TREATMENT: SUPPORTIVE

Question 8

DIFFERENTIAL OF IDIOPATHIC PULMONARY HEMOSIDEROSIS

Answer 8

VASCULITIDES, CTD, IMMUNE COMPLEX DEPOSITION DISORDERS, MPA

Question 9

SEPTIC PULMONARY EMBOLI

Answer 9

PERIPHERAL NODULES
FEEDING VESSEL SIGN
BOTH GRAM POSITIVE AND GRAM NEGATIVE

Question 10

PULMONARY KS QUESTION 68

Answer 10

LOW CD4 COUNT < 150
BILATERAL HILAR DENSITIES
PERIBRONCHOVASCULAR DISTRIBUTION

Question 11

CF AND ANCA

Answer 11

ANCA IS COMMON IN CF
< 40% IN PATIENTS
HAVE IGG AND IGA AB TO BACTERICIDAL PROTEIN

Question 12

YELLOW NAIL SYNDROME QUESTION 71

Answer 12

YELLOW NAIL SYNDROME
LYMPHEDEMA, RECURRENT PLEURAL EFFUSION, AND YELLOW DISCOLORATION OF NAILS

40% OF PTS : BRONCHIECTASIS
LYMPHANGIOGRAPHY CAN IDENTIFY ABNORMAL LYMPHATIC CHANNELS IN PELVIS OR EXTREMITIES