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Pulmonary > Awesome Review > Flashcards

Awesome Review Flashcards

1
Q

First Step to determine obstructive or restrictive disease?

A

Total Lung Capacity

After maximal inhalation

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2
Q

PFT ratio to determine obstructive?

A

FEV1/FVC

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3
Q

Positive Broncodilator challenge to diagnose asthma?

A

Increase of FEV1 of 12% or increase of 200 mL

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4
Q

What causes fixed extra thoracic obstruction?
Draw it
Diagnosis

A

Tumor and Tracheal stenosis

Dx- Bronchoscopy

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5
Q

What causes dynamic extrathoracic obstruction?
Draw it
Diagnosis

A

Epiglottis and vocal cord dysfunction
Blunted inhalation, air coming in sucks
Dx- indirect laryngoscopy

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6
Q

What is DLCO in PE?

What is DLCO in CO poisoning?

A

Low

Normal

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7
Q

If you want to wean down ICS when treating asthma, what to give?

A

Leukotriene Modifiers

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8
Q

When to give Omalizumab?

A

Serum IgE 30-700
Evidence of allergies of perennial aeroallergen
Eosinophilia

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9
Q

What are new IL 5 antagonist monoclonal antibodies to treat eosinophilic asthma?

A

Reslizumab and Mepolizumab

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10
Q

Dx Allergic Bronchopulmonary Aspergillosis

A

+ skin test to Aspergillus
Increased IgE and peripheral eosinophilia
Brown mucus plugs
CXR- transient infiltrate, pleural thickening, atelectasis, proximal bronchiectasis

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11
Q

CXR difference btwn Chronic Eosinophilic PNA and Acute Eosinophilic PNA?

A

Chronic- peripheral infiltrate

Acute- center infiltrate/ground glass

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12
Q

Tx Alveolar Proteinosis

A

Whole Lung Lavage bc Shitty macrophages cause build up of surfactant in lung

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13
Q

If severe COPD on SABA, LABA, LA-anticholinergic, and pulm rehab, what’s next?

A

Roflumifast/Daliresp
Phosphodiesterase 4 inhibitor
Contraindicated in Liver Impairment

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14
Q

When do you need home oxygen in COPD?

A

PaO2 88%

Or Hct >55%

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15
Q

What can you do for upper lobe emphysema when FEV1 less than 50% but greater than 20%?
If less than 20%?

A

Lung Volume Reduction decreases mortality

Lung transplant if FEV1

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16
Q

Dx Dyskinetic Cilia Syndrome (aka Kartagener’s syndrome)

A

Screen- sperm motility

Confirm- testicular biopsy or biopsy of bronchi or sinus

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17
Q

Features of Dyskinetic Cilia Syndrome

A

Bronchiectasis
Sinusitis
Infertility!
Situs inversus

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18
Q

Leading bacteria that increases mortality in cystic fibrosis

A

Cepacia Burkholderia

Treat with Bactrim

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19
Q

Treat severe Bronchiectasis with bleed

A

Bronchial artery embolization

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20
Q

What is IgE and eosinophilia in hypersensitivity pneumonitis?

A

NORMAL

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21
Q

Does LABA change mortality in COPD?

A

NO

22
Q

What do you think of -Bilateral Basal Bullous Cyst

A

Thinks alpha 1 antitrypsin deficiency

Check Serum alpha 1 antitrypsin level

23
Q

What is DLCO in Broncholitis Obliterans?

A

NORMAL

24
Q

What is DLCO in Cryptogenic Organizing Pneumonia? What is treatment?

A

Decreased DLCO
Crackles everywhere!!
Steroids

25
Q

Treat Stage 1 Sarcoidosis

A

None, 60-90% will remit
Stage 1 only has hilar adenopathy
No lung involvement

26
Q

Features of Lymphangioleiomyatosis

A

Premenopausal
Spontaneous pneumothorax
Diffuse thin walled cysts
Tx- Sirolimus

27
Q

Features of Pulmonary Hypertension

A 
At rest- 25 mmHg
During exercise- 30 mmHg
Normal PCWP
Parasternal Heave
Large JVP
Widened/Split S2
RV failure
28
Q

Findings on Echo for Pulmonary Hypertension

A

Dilation and hyper trophy of right ventricle
Tricuspid regurgitation
Bulging of septum into left ventricle

29
Q

While diagnosing Pulmonary Hypertension with right heart cath and patient responds to vasodilator challenge? What do you do?

A

Treat with Nifedipine and Diltiazem

30
Q

Tx Pulmonary Arterial Hypertension

Mild Disease

A

PP5 inhibitors

Sildenafil and tadalafinil

31
Q

Txt Pulmonary Arterial Hypertension

Moderate disease with some limitation on physical activity

A

IV Epoprostenol

32
Q

Tx Pulmonary Arterial Hypertension

Severe and Hypotensive

A

Inhaled Iloprost

33
Q

Which types of Pulmonary Hypertension require anti coagulation?

A

Type 1 and 4

34
Q

How long do you anticoagulate after knee replacement, hip replacement, or acute orthopedic fracture?

A

4 weeks!!!

35
Q

Tx large DVT, like iliofemoral DVT

A

Thrombolytic!!

36
Q

If thrombus in popliteal vein, what’s next?

A

Follow up Doppler in 2 weeks to see if there is extension. If there is extension beyond knee- anticoagulate

37
Q

Patient on anticoagulation for DVT but started bleeding. Frack, now what?

A

ASA 325 mg

38
Q

MC of PNA in COPD and DM

A

Moraxella catarhalis

39
Q

Dx: post Tussive vomiting and subconjunctival hemorrhage

A

Bordatella pertussis

40
Q

Treat bacterial sinusitis

A

If fever, pain or sx >7 days

Augmentin

41
Q

Centor Criteria

A
  1. Fever
  2. Exudates
  3. Anterior cervical LAD
  4. No cough
    If you fulfill all 4 criteria, give Amoxicillin
42
Q 
Dx- Hot Potato Voice 
Dysphagia 
Drooling 
Tonsils touching each other 
Uvula deviated
A

Peritonsillar abscess

43
Q

Treatment of Lung Abscess

A

PCN & Clindamycin

44
Q

Severe Influenza treatment

A

IV Zanamivir

45
Q

If PPD + and negative CXR what’s next?

A

INH for 9 months

If unable to tolerate due to liver dysfunction, rifampin for 4 months

46
Q

Pleural Fluid finding in TB

A

Fluid adenosine deaminase test

47
Q

Dx Hepatopulmonary syndrome

A

TTE with micro bubble studies

48
Q

Dx Obesity Hypoventilation Syndrome

A

PaCO2 > 45

49
Q

Increased neutrophils in BAL

A

Idiopathic Pulmonary Fibrosis

50
Q

Increased Lymphocytes in BAL

  1. CD 4 > CD8
  2. CD 8 > CD 4
A

Sarcoidosis is more CD4

Hypersensitivity Pneumonitis is more CD 8

Pulmonary (2 decks)

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