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UWorld Step 2 > IM Pulm - Rd 2 > Flashcards

IM Pulm - Rd 2 Flashcards

1
Q

Pt that has rheumatologic condition that presents w/cough, fever, hemoptysis, and Hg drop has what?

Often assoc w/what?

A

Diffuse alveolar hemorrhage

Drugs

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2
Q

What are the PE findings of pts w/Cor pulmonale?

A 
Peripheral edema
Inc JVP
Loud S2
Pulsatile liver from congestion
TR
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3
Q

Exudative pleural effusions occur d/t what physiology?

A

Increase capillary permeability d/t cytokines release during inflammation

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4
Q

What can cause a small pleural effusion in a pt with sudden onset chest pain, dyspnea, and tachycardia?

A

PE

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5
Q

PCP in HIV pts can cause what additional problem?

A

SIADH

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7
Q

What can cause abrupt increases in RA pressure to > 10 mmHg and PA pressure to > 40 mmHg?

Can lead to what?

A

Massive PE

Dec CO, HoTN, Obstructive shock

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8
Q

According to uWorld, when should long-term supplemental home oxygen be given?

A

PaO2 = 55 or SaO2 = 88% on room air
OR
PaO2 = 59 or SaO2 = 89% in pts w/Cor pulmonale, RHF or Hct > 55%

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9
Q

Lung biopsy in a pt w/pulmonary arterial HTN demonstrates what?

A

Arterial intimal hyperplasia

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10
Q

What makes the Dx for chronic pulmonary aspergillosis?

Who is at increased risk?

A

> 3 months of B sx
Cavitary lesion
+ aspergillus IgG serology

Immunocompromised pt —> had TB in the past

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11
Q

How much should the TV be in pt when setting the ventilation controls?

A

6 mL/kg of IBW

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12
Q

What is ASA-exacerbated respiratory disease?

Presents in whom?

Presents how?

A

Pseudoallergic reaction to NSAIDs, NOT IgE mediated

Pts w/asthma, chronic rhinosinutitis w/nasal polyps

Bronchospasm and nasal congestion following ASA ingestion

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13
Q

JVD and RBBB on EKG indicate what?

A

Right heart strain

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13
Q

How is the DLCO effected in interstitial fibrosis?

A

Decreased capacity

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14
Q

How are the following effected in pleural effusion?
Breath sounds?

Tactile fremitus?

Percussion?

A

Dec (fluid insulates sounds and vibrations originating in the lung, making it quiet)

Dec

Dull

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15
Q

What things cause a high A-a gradient?

A

V/Q mismatch (PE)
R—>L shunt
Pulmonary fibrosis

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17
Q

Pt that has PNA in the left lobe and lies on left side, what will happen physiologically?

Why?

A

R—>L intrapulmonary shunting and V/Q mismatch

Gravity increases blood flow to left lung, but there is markedly decrease V d/t alveolar consolidation —> worse V/Q shunt

17
Q

Diphragmatic flattening in COPD is d/t what?

A

Increased work of breathing

19
Q

What improves mortality in ARDS pts?

A

Preventing alveolar overdistention

20
Q

Aspergillosis appears in what settings?

A

TB, sarcoidosis, bronchial cyst, neoplasm

20
Q

CT scan that shows pulmonary nodules w/surrounding ground-glass opacities is what?

Seen in what?

A

Halo sign

Invasive aspergillosis

21
Q

What is CREST syndrome?

A 
Calcinosis
Raynaud’s
Esophageal dysmotility
Sclerodactyly 
Telangiectasia
21
Q

Normal diffusion capacity of the lung (DLCO) is seen in what obstructive diseases?

Restrictive?

A

Chronic bronchitis, asthma

MSK deformity, Neuromuscular disease

23
Q

What lung infection presents w/subacute fever, chills, malaise, HA, myalgia, dry cough with CXR showing Hilary LAD w/focal, reticulonodular infiltrates?

Biopsy shows what?

A

Histoplasmosis

Granulomas w/narrow-based budding yeasts

24
Q

Pt that comes in with RECURRENT episodes of LARGE amounts of productive sputum production with hemoptysis and dyspnea, what is the most likely Dx?

Dx how?

A

Bronchiectasis

High Res CT

25
Q

What tumor presents w/elevated bHCG and AFP?

A

Nonseminomatous germ cell tumor

25
Q

Wedge shaped infarct is called what?

Seen in what condition?

A

Hampton hump

PE

26
Q

Pt that may be developing ARDS, what is the goal PaO2?
This corresponds to what O2 Sat?

What should the FiO2 be immediately following intubation?
Prolonged FiO2 can cause what?

A

55-80
88-95%

> 60% then weaned down
Oxygen toxicity d/t O2 free radicals

27
Q

What features help diagnose a pulmonary contusion?

A

Rales/dec breath sounds

CXR shows patchy, alveolar infiltrate

29
Q

ABG shows hypoxia, hypocapnia, and respiratory alkalosis indicates what pathology?

A

CHF

30
Q

Panacinar emphysema seen in what condition?

Centriacinar?

A

A1AT

Smoking (Senter - Smoking)

32
Q

Why do COPD pts have relatively normal pH in their blood and not more acidosis?

A

Renal tubular compensation via increased bicarbonate retention

36
Q

What do the PFTs look like in a pt w/Ankylosing spondylitis?

A

Dec VC and dec TLC
Normal FEV1/FVC
FRC 110% of predicted d/t fixation of the rib cage in an inspiratory position

UWorld Step 2 (17 decks)

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