Inpatient EOR - Pulm

Question 1

asthma dx

Answer 1

FEV1/FEV <0.7, imrpove w/ bronchodilator

Question 2

asthma stepwise tx

Answer 2

1. saba prn
2. low-med ICS
3. med-high ICS+LABA
4. high ICS+LABA+oral steroid

Question 3

daily chronic cough with smelly discharge/hemoptysis - dx and tx

Answer 3

brochectasis (dx on CT)

tx
FQ, zosyn for psuedomonas
CCS+itraconazole for aspergillus
clarith+ethambutol for MAC

flu and prevnar vax
beta agonist, fluctiasone

Question 4

signet ring sign

Answer 4

for brocnhectasis, a pulm artery with dilaeted bronchus

Question 5

localized wheeze and a hormone being secreted (resulting in cushings, SIAD)

Answer 5

carcinoid tumor- neuroendocrine, made of enterochromaffin cells

Question 6

carcinoid tumor tx

Answer 6

excision, octreotide reduces hormones screted

Question 7

copd tx

Answer 7

ipratoprim and albuterol

Question 8

MC acute cause of cor pulmonale

Answer 8

PE

Question 9

EKG finding cor pulmonale

Answer 9

peaked P waves

Question 10

hilar LAD, dry cough, erythema nodosum dx

Answer 10

sarcoid

Question 11

MC Ca death in both sexes

Answer 11

lung ca

Question 12

lambert-eaton syn

Answer 12

weakness like MG that imrpoves with use, a/w small cell carcnoma

Question 13

pancoast syndrome

Answer 13

shoulder pain, horner syn, atrophy of hands/arm, a/w suamous cell cacrinoma

Question 14

what type of lung ca is best a/w hemoptysis

Answer 14

small/oat cell

Question 15

what type of lung ca is peripheral as opposed to central (in terms of loc)

Answer 15

adenocarcinoma (MC type in smokers and overall in non-smokes)

Question 16

what type of lung Ca is a/w gyncomastia

Answer 16

adenocarcinom

Question 17

who should be screened for lung Ca

Answer 17

55+ with 30 pack yr hx, quit <15 y ago

Question 18

a small lesion in lung <3cm is called a ___ ; what are it’s possibly etiologies

Answer 18

nodule.

infxn: TB, histo, coccidio
tumor: thymoma, benign, malig
inflam: RA, sarcoid

Question 19

XR finding and PFT finding for pulm fibrosis

Answer 19

honeycombing, ground glass opacity

normal or increased FEV1/FVC

Question 20

3 abcess forming PNA organiams

Answer 20

kleb, anarobes, S.aureus

Question 21

rusty sputum

Answer 21

strep pnuemo PNA

Question 22

tx: typical PNA

Answer 22

MC: S. pneumo

inpt: FQ + macrolide
outpt: macrolide or doxy

Question 23

tx: atypical PNA

Answer 23

could be viral - no tx

M. pnuemo: erthromycin or doxy
(erythro for the ear)

Chylamydia: tetracycline

Question 24

tx: aspiration PNA

Answer 24

clinda or Zosyn

Question 25

tx: hospital PNA

Answer 25

pseudomonas or MRSA
FQ + betalactam

+ vanc if suspect MRSA
+ levoflox/azithro if sus legionella
+bactrim & CCS is sus PJP

Question 26

what kind of PNA is a/w elevated LFT

Answer 26

Legionella

Question 27

where in lung would you expect to see a consolidation for anarobic PNA

Answer 27

RLL

Question 28

pulmonary arterial pressure qualification for dx of pulm HTN

Answer 28

> 25 at rest, 30 with exercise

Question 29

CBC lab with pulm HTN

Answer 29

polycythemia

Question 30

pulm HTN tx - if vasoreactive

Answer 30

CCB

Question 31

pulm HTN tx - not vasoreactive

Answer 31

prostacyclin (epoprostenol, iloprost), PDE51, O2

Question 32

define primary and secondary pulm htn

Answer 32

primary-idiopathic (BMPR2)

2ndary- LHF, COPD/PE (arterioles shunt away and ^HTN)