Block 56: Lung

Question 1

Bronchiectasis

Answer 1

bronchial thickening and dilation to due to a recurrent cycle of bacterial infection, inflammation and tissue damage

Question 2

In young patient, most common underlying etiology for bronchiectasis is

Answer 2

cystic fibrosis

Question 3

where in the lung is bronchiectasis due to cystic fibrosis located

Answer 3

upper lung lobe

Question 4

common side effect of systemic glucocorticoids seen in labs

Answer 4

leukocytosis with neutrophilic predominance

Question 5

what lab value is expected for hypersensitivity reaction

Answer 5

eosinophilia

Question 6

MOA of ACE

Answer 6

metabolism of kinins and substanceP

Question 7

destruction and permanent damage of the conducting airway occurs in

Answer 7

bronchiectasis

Question 8

pt with COPD and acute-onset shortness of breath, hypoxia and unilaterally decreased breath sounds likely has? most common cause?

Answer 8

secondary spontaneous pneumothorax

- alveolar blebs

Question 9

risk factors for obstructive atelectasis

Answer 9

• foreign body aspiration
• malignancy
• severe pneumonia ( mucus plug)

Question 10

pts develop what after a fat embolsm

Answer 10

• respiratory distress
• neurological abnormalities
• petechial rash

Question 11

acute dyspnea and hypoxia after motor vehicle collision likely has what

Answer 11

pulmonary contusion

- he was prone to blunt thoracic trauma

Question 12

clinical feature of pulmonary contusion

Answer 12

intra-alveolar hemorrhage and edema

Question 13

some clinical features to look for in pulmonary embolism

Answer 13

• pleuritic chest pain
• tachypnea
• atrial fibrillation

Question 14

triad for cardiac tamponade

Answer 14

• distant heart sounds
• hypotension
• jugular venous distension

Question 15

pleuritic chest pain

Answer 15

pain when you breathe, cough and sneeze

Question 16

Peak airway pressure equation

Answer 16

Airway resistance + plateau pressure

Question 17

plateau pressure equation

Answer 17

elastic pressure + positive end-expiratory pressure (PEEP)

Question 18

How is PEEP calculated

Answer 18

end-expiratory hold maneuver

Question 19

lung compliance

Answer 19

ability to expand

Question 20

how does pneumonia cause hypoxemia

Answer 20

right-to-left intrapulmonary shunting

V/Q mismatch

Question 21

how is theophylline meabolized

Answer 21

cytochrome oxidase in liver

Question 22

antibiotic known to decrease theophylline clearance

Answer 22

ciprofloxacin

Question 23

patient with acute presentation of dyspnea, chest pain, tachycardia, hypoxia, and clear lung sounds has

Answer 23

PE

Question 24

most common cause of community-acquired pneumonia

Answer 24

strept. pneumoniae

Question 25

on the vent, what influences O2? which one are you more likely to reduce to decrease O2

Answer 25

FiO2 (this one) and PEEP

Question 26

on vent what, influences CO2

Answer 26

RR and TV

Question 27

what tumor produced both alpha fetoprotein and human chorionic gonadotropin tumor marker

Answer 27

Nonseminomatous germ cell tumors

Question 28

3 most common causes of chronic cough a

Answer 28

1. postnasal drip
2. asthma
3. GERD

Question 29

MOA of Chlorpheniramine

Answer 29

H1 Antihistamine receptor blocker

Question 30

asthma patient that has sore throat, morning hoarsness, worsening cough only at night, and increased need for her albuteral inhaler following meals also has what

Answer 30

GERD

Question 31

when are antibiotics given in COPD patient

Answer 31

• moderate to severe exacerbation of COPD

- pts needing mechanical ventilation

Question 32

what causes clubbing

Answer 32

magakaryotcytes are not broken down in lungs, and then get stuck in fingers
- hypoxia does not cause clubbing

Question 33

what does CT show for pulmonary embolism

Answer 33

wedge-shaped infarction

Question 34

development of clubbing and sudden-onset joint artropathy in chronic smoker suggests? what can cause this

Answer 34

hypertrophic osteoarthropathy

- any lung cancer

Question 35

Name 2 ways you can increase oxygenation on a vent? which one would you increase in ARDS patient and why?

Answer 35

FiO2 and PEEP

- PEEP: prevent alveolar collapse during respiratory cycles and my also reopen some alveoli

Question 36

If high levels (greater than 60%) of FiO2 is required to maintain oxygen, how do you increase the amount of oxygen a patient gets on the vent

Answer 36

PEEP

Question 37

Aspirin-exacerbated respiratory disease is most often seen in patient with a history of

Answer 37

asthma or chronic rhino-sinusitis with nasal polyposis

Question 38

clinical symptoms of aspirin-exacerbated respiratory disease

Answer 38

bronchospasm
nasal congestion
following aspirin ingeston

Question 39

what type of reaction is aspirin-exacerbated respiratory disease

Answer 39

non-IgE mediated

psuedoallergic drug reaction

Question 40

where are bronchogenic cysts located

Answer 40

middle mediastinum

Question 41

where are thymoma’s found

Answer 41

anterior mediastinum

Question 42

where are all neurogenic tumors located in the mediastinum

Answer 42

posterior mediastinum

Question 43

PE for lung consolidation

Answer 43

dullness to percussion
increased intensity of breath sounds
increased tactile fremitus

Question 44

percent predicted obstructive pattern FEV1/FVC

Answer 44

less than 70%

Question 45

predicted restrictive pattern FEV1/FEV

Answer 45

greater than 70%

Question 46

what organs are involved in granulomatosis with polyangiitis

Answer 46

• upper and lower respiratory tract infection
• renal involvement
• glomerulonephritis