Deck 4

Question 1

pH of exudative effusion

Answer 1

pH < 7.3- 7.45

Question 2

Pleural fluid analysis in PE:

Answer 2

unilateral, bloody with normal glucose values and negative cytology

Question 3

Ligation of which artery is recommended for refractory epistaxis

Answer 3

Sphenopalatine artery

Question 4

Management for post-drowning with SpO2 of 90% despite using O2

Answer 4

Endotracheal intubation

Question 5

signs of SVC syndrome

Answer 5

• headache that worsens when leaning forward
• engorged veins over chest
• swelling of head, neck and upper extremities

Question 6

Management of penetrating trauma **hemo. unstable **

Answer 6

exploratory laparotomy

Question 7

Features of foreign body aspiration

Answer 7

• **unilateral wheezing **
• acute cough
• sob

Question 8

Managements of open pneumothorax (will have bubbling of blood)

Answer 8

• temporary: partially occlusive dressings
• permanent: chest tube

Question 9

What to do if suspected asthma in pt is not improving with inhaler?

Answer 9

try a trial of PPI since cough can be caused by GERD

Question 10

Tx for CAP with no comorbidities and no risk factors for drug-resitant bugs

Answer 10

• amoxicillin
• doxycycline
• macrolide (azithro)

Question 11

next step in management of suspected **acute tonsilitis **

Answer 11

confirm before tx –> obtain throat culture

Question 12

When to perform tracheostomy

Answer 12

• long term mechanical ventilation
• upper airway obstruction (mass in neck)

Question 13

CURB-65

Answer 13

• C- confusion
• U- uremia (> 7)
• R- resp rate > 30
• B- BP of < 90 / < 60
• 65- > 65y/o

Question 14

tx for CAP with >2 in curb-65

Answer 14

macrolide + cefotaxime

Question 15

Marker of granulomatosis w. polyangitis

Answer 15

c-ANCA titers

Question 16

what systems are involved in granulomatosis w. polyangiitis (GPA)

Answer 16

• vasculitis (palpable purpura)
• respiratory infections (sinusitis, nasal ulcers, hemoptysis)
• glomerulonephritis (RBC casts)

Question 17

Tx of CAP in pregnancy

Answer 17

inpatient tx with azithromycin + ampicillin-sulbactam

Question 18

How to know if viral sinusitis became a bacterial superinfection

Answer 18

watery nasal discharge becomes mucopurulent (yellowish) over the course of days

Question 19

Tx of bacterial rhinosinusitis

Answer 19

amoxi-clav

Question 20

what would happen if pt with left-sided pneumonia is turned to the left

Answer 20

increased perfusion of nonventilated alveoli –> increased A-a gradient

Question 21

How is the A-a gradient in asbestosis?

Answer 21

Increased

Question 22

Silicosis increases the risk of what infection?

Answer 22

M. tuberculosis (primary TB)

Question 23

Galactomannan antigen is suggestive of:

Answer 23

Aspergillosis

Question 24

MC bug for postviral bacterial pneumonia

Answer 24

Strep. pneumo

Question 25

MC lung injury after trauma to chest

Answer 25

pulmonary contusion

Question 26

How to determine if pt has pulmonary contusion?

Answer 26

pt respiratory distress worsens after being given fluids

Question 27

What does deepening of costophrenic angle means in a intubated pt?

Answer 27

pt developed pneumothorax

Question 28

Findings in asthma:
1. chest excursion
2. breath sounds
3. chest percussion
4. tactile frenitus

Answer 28

1. chest excursion: symmetric
2. breath sounds: decreased
3. chest percussion: hyperresonant
4. tactile frenitus: decreased