Hubbard Review

Question 1

What is the clinical presentation of obstructive sleep apnea?

Answer 1

impaired daytime attention 
difficult with memory 
daytime sleepiness 
snoring 
witnessed apnea 
altered modd

Question 2

What type of patients should be screened for OSA

Answer 2

obese patients with depression

Question 3

OSA clinical findings?

Answer 3

obesity 
large neck 
nasal obstruction 
enlarged tonsils 
narrow oropharynx

Question 4

What is the management goal of OSA?

Answer 4

improve daytime sleepiness and cognitive performance

Question 5

How to treat OSA?

Answer 5

primarily - lose weight
avoid alcohol
nasal decongestants

Question 6

What do you give if symptoms of OSA persist after lifestyle modifications ?

Answer 6

nocturnal CPAP

Question 7

If OSA patients don’t respond to CPAP, then what?

Answer 7

bi-PAP

Question 8

If biPAP doesn’t work, then what?

Answer 8

UPPP - uvulopalatopharnygeoplasty

Question 9

What is pickwinian syndrome also known as? What disease does it mimic?

Answer 9

obesity-hypoventilation syndrome. can mimic COPD, but PFTs demonstrate a restrictive defect rather than obstructive.

Question 10

What are some causes of cough? 4

Answer 10

infection
malignancy
medications (ACEI)
GERD

Question 11

What are the causes of dyspnea?

Answer 11

CHF, CAD, perciardial disease
COPD, ILD, malignancy, chronic infection
CKD (anemia), acid base disorders

Question 12

What is the differentiation between chronic cough and acute cough?

Answer 12

chronic cough = greater than 2 months

acute cough = less than 3 weeks

Question 13

What is the differentiation between acute and chronic dyspnea?

Answer 13

Chronic dyspnea is longer than 1 month

acute dyspnea develops rapidly

Question 14

What are the causes of wheezing in children?

Answer 14

asthma, bronchiolitis, atypical infection, bacterial tracheitis
foreign body aspiration

Question 15

What are the causes of wheezing in adults?

Answer 15

asthma 
bronchiolitis 
atypical infection 
bacterial trachieitis 
foreign body aspiration 
esophageal foreign body 
upper airway tumors 
lower respiratory tract tumors 
anaphylaxis 
pneumonia 
pulmonary edema

Question 16

What is the first thing you do for a tension pneumothorax?

Answer 16

needle thoracotomy

Question 17

What do you see in a tension pneumothorax?

Answer 17

decreased chest movement on affected side
mediastinal shift
diaphragm not symmetrical

Question 18

causes of a pneumothorax ?

Answer 18

spontaneous - young men
traumatic - post procedural, direct trauma
disease related - numerous diseases

Question 19

What does an exudate fluid contain?

Answer 19

pleural protein/serum protein > 0.5

pleural LDH/serum LDH >0.6

pleural fluid LDH >2/3 upper limits of serum LDH in lab doing the measurement

Question 20

What cause transudate effusions?

Answer 20

LVH, CHF

Misplaced central line

Question 21

if you see increased eosinophils in effusion, what are you thinking?

Answer 21

increased air in pleural space

Question 22

If you see lymphocytic cells in effusion, what are you thinking?

Answer 22

malignancy, tuberculosis

Question 23

How do you manage a chronic pleural effusion?

Answer 23

PleurX Cathater

Question 24

What is the most common cause of horners syndrome?

Answer 24

lung cancer/pancoast tumor

Question 25

Who is at risk for silicosis?

Answer 25

spelunkers, occupations that are exposed to silicosis

Question 26

What are two main causes of dramatic weight loss?

Answer 26

Malignancy

Tuberculosis

Question 27

What is the term for the increase in risk of cancer in people who smoke and drink?

Answer 27

synergistic effect

Question 28

hemoptysis is either ___ or ____ until you prove otherwise

Answer 28

tuberculosis, lung cancer

Question 29

Not all that wheezes is asthma. What else could it be?

Answer 29

Look at ankles, think about fluid retention, think aspiration (idk he didn’t say much here)

Question 30

What is the only reliable measure of dyspnea?

Answer 30

patient self reporting