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ABIM Pulmonary > CHEST SEEK Questions > Flashcards

CHEST SEEK Questions Flashcards

1
Q

What is bovine pegylated carboxyhemoglobin used for? What is the brand name?

A

Bovine soured oxygen carrier. Replaced PRBCs for Jehovah’s Wittnesses. Brand name is Sanguinate. Available through expanded access program.

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2
Q

Parkinson’s Disease is associated with what sleep disorder?

A

REM sleep behavior disorder

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3
Q

What is the difference between defining airflow obstruction with FEV1/FVC < 0.7 as opposed to LLN?

A

The “< 0.7” method is more accurate for defining hospitalizations and mortality.

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4
Q

What is the FDG activity pattern of sarcoidosis?

A
  • (+) in 2/3 of patients with stage II and III

- (-) in stage I and IV

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5
Q

Histology of silicosis?

A

ANodular perilymphatic fibrosis that tend to have the greatest profusion in the upper lung zones

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6
Q

What is Samter’s Triad?

A

(NSAID)-exacerbated respiratory disease (NERD)

  • Asthma / chronic sinusitis
  • Nasal polyps
  • Exacerbated by NSAIDs or aspirin
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7
Q

Sentinel symptoms prior to GBS (Guillain-Barre Syndrome)?

A

Autonomic dysfunction

Lumbar muscle spasm/pain

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8
Q

Common causes of GBS (Guillain-Barre Syndrome)?

A
  • Campylobacter Jejuni diarrhea (MC)
  • Cytomegalovirus, Epstein-Barr virus, human immunodeficiency virus, and Zika virus
  • Immunization, surgery, trauma, medications, or bone-marrow transplantation
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9
Q

Treatment of Periodic Limb Movement Disorder?

A
  • Check ferritin
  • Gabapentin +/- enacarbil
  • Pramipexole, ropinerole
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10
Q

Symptoms & epidemiology of DIPNECH (Diffuse Idiopathic Pulmonary Neuro-Endocrine Cell Hyperplasia)?

A
  • Middle-aged, female, nonsmokers
  • Cough, dyspnea, wheezing
  • Flushing, watery diarreha
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11
Q

PFTs of DIPNECH (Diffuse Idiopathic Pulmonary Neuro-Endocrine Cell Hyperplasia)?

A

-Obstructed, DLCO decreased. Not restricted

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12
Q

Histology of DIPNECH (Diffuse Idiopathic Pulmonary Neuro-Endocrine Cell Hyperplasia)?

A

-Peribronchioloar fibrosis & small airway obliteration, leading to Obliterative Bronchiolitis

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13
Q

Treatment of DIPNECH (Diffuse Idiopathic Pulmonary Neuro-Endocrine Cell Hyperplasia)?

A
  • Steroids, immunosuppressants
  • Somatostatin analogs
  • Transplant
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14
Q

Histology of follicular bronchiolitis?

A

-Multiple reactive lymphoid follicles with germinal centers, focused around bronchi and bronchioles. This leads to narrowing of airway.

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15
Q

Treatment of follicular bronchiolotis?

A
  • Treat underlying infectious, inflammatory or immunodeficiency disease.
  • Immunosuppression, prednisone, maybe azithromycin.
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16
Q

Symptoms of hydrogen sulfide (H2S) inhalation?

A

-Loss of consciousness due to displacement of iar
-Rotten eggs smell
-neurologic, cardiovascular, renal, hepatic, hematologic
(From ‘sour’ crude oil)

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17
Q

Symptoms of carbon monoxide inhalation?

A

-Vomiting, confusion, collapse, death.

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18
Q

Symptoms of Toluene Diisocynate (TDI) toxicity?

A

-asthma, skin reactions

from polyurethane and consumer production

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19
Q

Symptoms of cadmium poisoning?

A

-long-term exposure leads to cancer, multiple organ system failure if chronic.

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20
Q

Treatment of pulmonary AVM?

A

Embolization, especially when feeding artery is <2-3mm.

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21
Q

What disease and what gene account for most pulmonary AVMs?

A
  • Hereditary Hemorrhagic Telangiectasia (HHT)

- Endoglin gene (ENG) and Activin-Like-Receptor-Kinase-1 (ACVLR1)

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22
Q

Treatment of PAH due to Sickle Cell?

A

Endothelin Receptor Antagonists. Epoprostanil is 2nd line. Avoid sildenafil.

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23
Q

Name of new cephalosporin that targets everything?

A

Cefiderocol (Fetroja). Not affected by ESBL or carbanapem-ase.

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24
Q

Buzzword: “foamy macrophages on BAL”

A

Amio-induced interstitial pneumonitis

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25
Q

3 differentials of calcification of entire tracheobronchial tree?

A
  • Warfarin use
  • ESRD
  • Advanced age
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26
Q

Initial and maintenance therapy for DAH?

A
  • Induce with steroids & cyclophosphamide

- Maintenance with azathioprine

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27
Q

Treatment for malignancy-related VTE:

  • While inpatient & discharged?
  • 2nd line?
A
  • Initial hospitalization: LMWH, not UFH.

- On discharge, LMWH. If refusing parenteral, Edoxaban is DoC.

28
Q

Treatment for airway surgical dehiscence after lung transplant?

A
  • Chest tube for PTX
  • Antibiotics
  • Minimize steroids
  • Bronchoscopy with fibrin patch, blood patch, or stenting.
  • Last resort is surgical exploration.
29
Q

Histology of cocciodomycosis?

A

Large spherules seen on low power

30
Q

Histology of histoplasmosis?

A

Small, round cells. (Significantly smaller than the surrounding cells)

31
Q

Histology of blastomycosis?

A

Larger bud with thick capsule and distinctive daughter bud on broad base.

32
Q

Histology of sporothrix?

A

Small, cigar-shaped.

33
Q

Treatment for Guillain-Barre?

A

-IVIG or plasmapharesis

steroids don’t work

34
Q

Best test to diagnose Guillain-Barre?

A

CSF with increased protein but normal WBC.

35
Q

Blood test for Pulmonary Alveolar Proteinosis (PAP)?

A

Anti-GM-CSF

36
Q

CT findings of Pulmonary Alveolar Proteinosis (PAP)?

A

“crazy paving” sign

37
Q

Bronchoscopy findings of Pulmonary Alveolar Proteinosis (PAP)?

A
  • BAL fluid is milky-white, and positive for PAS (Periodic-Acid-Shiff)
  • TBBx shows intra-alveolar deposits of lipoproteinaceous material
38
Q

Pulse oximetry readings for methemoglobinemia?

A

Initially high, then hover around 85% as toxicity increases

39
Q

Common inciting drugs for methemoglobinemia?

A

Chloroquine
Dapsone
Trimethoprim
Sulfonamides
Local anesthetics (benzocaine, lidocaine)
Nitrates (nitroglycerin, nitroprusside, nitric oxide).

40
Q

Best test for pulmonary hypertrophic osteoarthropathy?

A

99m-TC bone scan

41
Q

What is “Good Syndrome”?

A

Hypogammaglobulinemia, as paraneoplastic syndrome resulting from thymoma.

42
Q

Treatment for pertussis?

A

Azithromycin (within 4 weeks)

43
Q

Relative risk reduction from flu vaccine?

A

50%

44
Q

Size of renal abscess that means it needs drainage instead of antibiotics alone?

A

0.5cm

45
Q

Treatment options for LTBI?

A
  • Rifampin daily for 4 months
  • INH + Rifampin daily for 3 months
  • INH + Rifampetine injections weekly for 3 months
46
Q

Medicine shown to improve CPAP compliance?

A

Eszopiclone (Lunesta)

47
Q

Echocardiographic findings of tamponade?

A

-diastolic collapse of RV
-IVC dilation and loss of respiratory dilation
-respiratory increase of ventricular interdependence
Doppler
->25% respiratory variation of mitral or tricuspid flow.
Possible: swinging heart, RA collapse.

48
Q

PAH medications OK for pregnancy?

A

Prostacycline, sildenafil.

49
Q

Initial therapy for CF?

A

If 1 or 2 delF508 mutations, use triple modulator therapy: Elexacaftor/tezacaftor/ivacaftor.

50
Q

Criteria for (+) bronchoprovocation testing for asthma?

A
  • 20% for direct stimuli (methacholine, histamine)

- 15% for indirect stimuli (mannitol)

51
Q

Follow up after lung cancer treatment?

A

CT every 6 months for 2 years, then annually through year 5.

52
Q

Criteria for Hypoglossal Nerve Stimulator for OSAS, besides failed CPAP?

A
  • 22yo +
  • AHI 20-65
  • BMI <=32
53
Q

MCID for 6MWT distance?

A

30m

54
Q

Treatment for AIDS w/ tuberculous meningitis?

A
  • Start RIPE now.
  • Start steroids, taper over 6-8 weeks.
  • Hold cART for 8 weeks
55
Q

Treatment for AIDS with pulmonary tuberculosis?

A
  • Start RIPE now
  • Start steroids within 2 weeks to Ppx(IRIS)
  • Start cART within 2 weeks if CD4<50, and in weeks 8-12 for CD4>50
56
Q

Treatment for cryptococcal meningits?

A
  • Induction phase with Liposomal Amphotericin + Flucytosine (2 weeks from negative CSF)
  • Consolidation phase with high-dose fluconazole
  • 1yr (or lifetime if immunosupporessed) fluconazole
57
Q

Bronchial fistulae should raise suspicion for what infectious organism?

A

Actinomyces

58
Q

What is Mounier-Kuhn syndrome?

A

-Dilated tracheobronchial tree, with impaired mucociliary clearance, leading to recurrent infections & bronchiectasis.

59
Q

Most common myositis-specific auto-antibody?

A

Antisynthetase antibodies

60
Q

Antibodies present in ILD prior to clinical myositis?

-IPAF = Interstitial Pneumonitis with AI features.

A
  • Anti-Jo-1
  • Anti-MDA5
  • Anti-PL-12
61
Q

Antibodies with myositis overlap syndromes?

A

Anti-Ku

62
Q

What is “buffalo chest”? What patient population is it seen in?

A

Bilateral pleural spaces communicate, like a Buffalo.

-Seen in s/p bilateral lung transplant patients. Mediastinum is disrupted in surgery.

63
Q

Positive score on STOP-BANG?

A

5

64
Q

Buzzword: “safety-pin appearance of bacteria”

A

Y. Pestis

65
Q

Treatment for Babesia?

A

Atovaquone & Azithromycin

66
Q

CT findings of pulmonary Kaposi Sarcoma?

A

bilateral, ill-defined, interstitial or alveolar opacities in a peribronchovascular distribution (“flame-shaped” infiltrates)

ABIM Pulmonary (37 decks)

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