ACCP SEEK 23 SET 5

Question 1

DAD DUE TO EGFR TYROSINE KINASE INHIBITORS

QUESTION 37

Answer 1

DISCONTINUE EGFR TYROSINE KINASE INHIBITORS

Question 2

INDWELLING PLEURAL CATHETERS

Answer 2

HOSPITALIZATION DURING IPC PLACEMENT IS SIGNIFICANTLY DECREASED COMPARED TO PLEURODESIS
SPONTANEOUS RESOLUTION IN 47%
NO SIGNIFICANT DIFFERENCES IN CHEST PAIN OR QOL
INFECTION HAPPENS LATE > 50 DAYS

Question 3

TREATMENT OF STABLE LOW RISK COPD

Answer 3

SHORT ACTING BETA AGONIST

Question 4

CMV PNEUMONIA QUESTION 34

Answer 4

FOLLOWS BMT
WITHIN 100 DAYS
INCIDENCE IS 10-40%
RISKS: ALLOGENEIC TRANSPLANT, AGE, VIRUS TITER
BEST WAY TO DX: ANTGEN TESTS
HALLMARK: LARGE OWLS EYE INCLUSION BODIES
CMV INFECTION IS ASSOCIATED WITH BRONCHIOLITIS OBLITERANS

Question 5

METHOTREXATE LUNG

Answer 5

ALVEOLITIS, EOSINOPHILIC INFILTRATES

Question 6

VTE IN CANCER

Answer 6

PREDICTOR OF INCREASED MORTALITY
SHOULD BE ON LMWH AND NOT CONVERTED TO WARFARIN
>= 3 MONTHS

Question 7

QUINOLONES AND TB

Answer 7

SHORT TERM QUINOLONE USE IS NOT ASSOCIATED WITH RESISTANCE IN TB

Question 8

AMMONIA GAS EXPOSURE

Answer 8

AMMONIA IS WATER SOLUBLE
LOW DOSE: OBSERVE FOR 12 HOURS.
HIGH EXPOSURE: SEVERE ARIWAY IRRITATION, EDEMA AND BRONCHOSPASM CAN OCCUR AND AIRWAY PROTECTION IS ESSENTIAL

Question 9

BLASTOMYCOSIS QUESTION 32

Answer 9

ITRACONAZOLE FOR MILD DISEASE
IF PT HAS NO MENINGITIS, BUT LUNG INVOLVEMENT, SKIN INVOLVEMENT AND NOT RESP FAILURE
24 WEEKS OF TREATMENT 
AMPHOTERICIN FOR SEVERE DISEASE:
ARDS OR MENINGITIS

Question 10

TREATMENT FOR ACTINOMYCES

Answer 10

PCN G

Question 11

POST TRANSPLANT LYMPHOPROLIFERATIVE DISORDER

QUESTION 33

Answer 11

OCCURS IN LUNG TRANSPLANTS MORE THAN OTHER ORGANS
B CELL NHL IS MOST COMMON. ASSOCIATED WITH EBV
RADIOGRAPHIC: SOLITARY OR MULTIPLE NODULES
TREATMENT: REDUCE IMMUNOSUPPRESION AND RITUXIMAB, ANTI-CD20 MONOCLONAL ANTIBODY

Question 12

ACUTE REJECTION

Answer 12

OCCURS IN FIRST YEAR FOLLOWiNG TRANSPLANT
PATHOLOGY: LYMPHOCYTIC VASCULITIS
TREATMENT: INCREASE IMMUNOSUPPRESION
ALSO FOR CHRONIC REJECITON: BO

Question 13

ARDS DEFINITION

Answer 13

BILATERAL OPACITIES CONSISTENT WITH PULMONARY EDEMA MUST BE PRESENT
PO2/FIO2 CAN BE AS HIGH AS 300

Question 14

A1AT DEFICIENCY

Answer 14

CANNOT GIVE AUGMENTATION IF PT IS STILL SMOKING