MKSAP Flashcards
Define heat stroke and what are the two types with risk factors
Temp >104 and encephalopathy
- Exertional: athletes with hot and humid weather
- Non exertional: old patients wuth anticholinergic or diuretics use
TG level of pleural fluid in chylothorax
110
Hallmark PE finding of DPLD
Normal pulse ox with rest and >4% drop in O2 sat with ambulation
Two antifovrotic agents for IPF
Nintedanib and perfinidone
What is HAPE
High altitude pulmonary edema —> develops due to rapid ascent above 2500 ft —> causes intense vasoconstriction and leads to pulmonary HTN and fluid leak into alveoli —> pneumonia
Treatment of HAPE
Low altitude descent, O2 supplementation
Medication used for HAPE prophylaxis
Acetazolamide
What is the size cutoff to call it a pulmonary nodule upper limit
3 cm
Size above which a pulmonary nodule is called a lung mass
3 can
What is the first question to ask in evaluation of pulmonary nodules
Solid or sub solid?
Solid pulmonary nodule <6mm follow up
None
Solid pulm nodule 6-8 mm
CT at 6-12 months —> CT 1.5-2 years
Solid pulm nodule >8 mm. Next step?
Evaluate risk of malignancy and obtain CT in 3 months, PET/tissue sampling
Subsolid nodules are —- likely to be malignant
More
I hat are the two types of subsolid nodules
GGO only and GGO with solid component
A subsolid nodule with GGO developed solid component. Next step?
It is malignant
Pure GGO nodule <6 mm. Follow up?
None
Pure GGO >6mm
CT at 6-12 months —-> every 2 years for 5 years
Part solid module <6mm
No follow up
Part solid nodule >6 mm
CT 3-6 months —-> I’d stable —-> annual CT
How do you differentiate between a complicated and uncomplicated para pneumonic effusion?
Ph <7.20 or evidence of microorganism on culture —> complicated
Patient with anaphylaxis develops recurrent episode. Rx?
Epinephrine drip maybe required
Side effect of monteluekast FDA black box warning
Depression and suicide
What is Reynolds’s Pentad
Fever jaundice RUQ pain hypotension AMS
What is the temp cut off for hyperthermic emergencies
> 104
What are the typical symptoms of hyperthermic emergencies
AMS, seizures
Muscle rigidity and rhabdomyolysis
ARDS
Kidney dysfunction
DIC
Which symptom differentiates serotonin syndrome
Myoclonus and hyper reflexia
Rx of NMS
Benzo, bromocriptine.
Rx of serotonin syndrome
Benzodiazepine —> fails cypriheptadine
I hen should we start parenetrral nutrition in ICU patients
Failed enteral nutrition - inability to achieve 60% of requirements in 7-10 days
I’m Medical conditions assoicted with central sleep apnea
Heart failure and pain
Indications of antibiotics in COPD exacerbation. Name 5
- Increase sputum volume
- Increased purulent
- Increased DOE
- Non invasive vent
- Invasive vent
Mesothelioma is linked to — exposure
Asbestos
Pleural effusion from mesothelioma is —- in cytology and —— is neede d for diagnosis
Negative; transthoracic vidoscopic pleural biopsy
3 DDx for exudative effusions
- Infection
- Malignancy
- CTD
Respirator indices s/o NM associated respiratory failure
Decrease in FVC of >20% in while supine compared to upright position and >50% decline in MIP/MEP
Normal NIF
-100 to -150
A patient with true aspiration pneumonitis rapidly improves within — hours and antibiotics can be —-
24; discontinued
Empiric Rx of bronchiectasis exacerbation antibiotic
Ciprofloxacin x 14 days
