Lungs

Question 1

Indication for empiric antibiotics in COPD exacerbation

Answer 1

2 or more cardinal symptoms (increased dyspnea, increased cough, or sputum change)
Or
Mechanical ventilation requirement

Collection of sputum cx NOT recommended due to difficulty of isolating single organism

Question 2

empiric anticoagulation in DVT vs PE

Answer 2

Start anticoagulation in PE if clinically convincing

But not for DVT (need doppler first to confirm)

Question 3

Trauma pt
ABG shows hypoxemia
CT shows patchy, irregular (nonlobular) alveolar infiltrate

Answer 3

Pulmonary contusion

Question 4

Location of mediastinal masses

Answer 4

Anterior: thymoma, teratoma, retrosternal thyroid

Middle: bronchogenic cysts, tracheal tumors, pericardial cysts, lymphoma…

Posterior: neurogenic tumors

Question 5

tactile fremitus in consolidation vs pleural effusion

Answer 5

consolidation: tactile fremitus increased

pleural effusion: tactile fremitus decreased
(if fluid or air is present OUTSIDE the lung in the thoracic cavity- eg pneumothorax too– then sounds and vibrations from lung will be insulated!!)

Question 6

What is ABPA

Answer 6

Allergic bronchopulmonary aspergillosis

Hypersensitivity pneumonitis toward aspergillus spores usually in patients with asthma

Question 7

Spontaneous PTX

Answer 7

primary: young men, sometimes +tracheal deviation
secondary: COPD, CF, no trachea deviation

Question 8

CF vs primary ciliary dyskinesia

Answer 8

Both have sinus infections, nasal polyps, bronchiectasis, digital clubbing, infertility

CF: pancreatic insufficiency, failure to thrive
PCD: situs inversus, Normal growth