Lung step 3

Question 1

best test to confirm endotracheal obstruction / best next step management

Answer 1

• flexible bronchoscopy

- ct

Question 2

features of allergic bronchopulmonary aspergillosis

Answer 2

history of asthma or CF
infiltrates or central bronchiecasis
diagnosis: skin test + for asperg, eosinoph, specific IgG or IgE

Question 3

diagnosis of PE in patients with high creatinine

Answer 3

ventilation-perfusion scan

Question 4

hemoptysis - first step

Answer 4

chest x-ray

Question 5

COPD exacerbation - signs / management

Answer 5

1. increased sputum purulence
2. increased sputum volume
3. increased dyspnea
   try antibiotics

Question 6

fat embolism symptoms

Answer 6

1. resp distress
2. comfusion
3. petechial rash

Question 7

lung contusion - treatment

Answer 7

supportive care

Question 8

Post intensive care syndrome - RF / pathophys

Answer 8

ICU delirium, ARDS, prolonged ventilation

- cns hypoxia, neuroinflammation + metabolic disruption

Question 9

Post intensive care syndrome - clinical features

Answer 9

psychiatirc, neurocognitive, physical

Question 10

Post intensive care syndrome - managment

Answer 10

early therapy (pt/ot)
multidisciplinary post ICU

Question 11

Post intensive care syndrome - prognosis

Answer 11

most require additional home care and nevere return to work

Question 12

Refeeding syndrome

Answer 12

hypoP after initiation of total parental nutrition
potentially fatal shifts in fluids and electrolytes that may occur in malnourished patients receiving artificial refeeding (whether enterally or parenterally5). These shifts result from hormonal and metabolic changes and may cause serious clinical complications.

Question 13

allergic bronchopulmonary aspergillosis - treatment

Answer 13

systemic steroids +/- intraconazole or voriconazole

Question 14

small cell - paraneoplastic

Answer 14

ACTH, SIADHM Lambert eaton

Question 15

SCC - paraneoplastic

Answer 15

PTHrp

Question 16

SIADH hyponatremia - first line treatment

Answer 16

water restriction

Question 17

clinical signs predictions of 30 day mortality in PE

Answer 17

hypotension, tachycardia, tachypnea, hypoxemia, mental status, history of cancer, age more than 80

Question 18

radiological signs predictions of 30 day mortality in PE

Answer 18

right ventricular dysfunction

Question 19

laboratory signs predictions of 30 day mortality in PE

Answer 19

troponin

bnp

Question 20

PE - heparin

Answer 20

all patients unsless contrindication

Question 21

pe - IVC filter

Answer 21

contraindication of anticoagulation

low cardiopulm reseve

Question 22

PE - thrombolysis

Answer 22

PE with hypotension AND low risk bleeding

Question 23

PE - embolectomy

Answer 23

shock likley to cause death or failed thrombolysis

Question 24

most reliable method to verify endotracheal tube placement in the tracha

Answer 24

capnography

Question 25

unstable patient with PE suspected - next step

Answer 25

bedside echo

Question 26

snoring in a patient without other indications of OSA (eg hyprtension, excessive daytime sleep etc)

Answer 26

stop alcohol or smoking

Question 27

primary goal of managing a brain-dead organ donor is to

Answer 27

maintain euvolemic, normotensive and normothermic

Question 28

cough-varian asthma

Answer 28

chronic nonproductive cough

• worse at night and triggered by exericse, force expiration and allergen
• lack classic asthma symptoms (wheezing, sob etc)

Question 29

lung cancer screening - age

Answer 29

50-80

Question 30

COPD home oxygen

Answer 30

-p02 less than 55 or sat less than 88
- less than 60 and 90 + cor pulmonale or elevated hematoc
DECREASES MORTALITY

Question 31

factors increasing malignant probability

Answer 31

1. large size (more than 2 cm)
2. advanced age
3. female
4. smoker or previous
5. fh of lung ca
6. upper lobe
7. spiculated radiographic appearamce