Other

Question 1

Pleural Effusion physical exam

Answer 1

1. Dullness to percussion
2. Decreased tactile fremitus
3. Decreased breath sounds

Question 2

If you suspected pleural effusion. what do you order?

Answer 2

CXR- PA/lateral
Lateral decubitus films ***

Confirmed: Thoracentesis

Question 3

Lights Crtieria exclusive to

Answer 3

Exudates

Question 4

MC cause for transudative pleural effusion

Answer 4

CHF

Question 5

Pneumothorax pathophysiology and etiology

Answer 5

Increasingly positive pleural pressure causing collapse of lung

1. Spontaenous
2. Traumatic
3. Tension

Question 6

Poaisitve air pressure pushes lung, trachea, and heart to contralateral side

Answer 6

Tension pneumothorax

Question 7

Increased JVP, pulsus paradoxus, and hypotension

Answer 7

Tension pneumothorax

Question 8

PE for pneumothroax

Answer 8

1. Hyperresonance to percussion
2. decreased fremitus
3. decreased breath sounds

Question 9

Management of pneumothorax

Answer 9

Chest tube or 1. needle aspiration if tension followed by chest tube in 2nd intercostal space

Question 10

Most common type of pneumonia in HIV patients? Treatment?

Answer 10

Bactrim

Question 11

MC cause of pneumonia in general population

Answer 11

Strep

Question 12

MC type of orgaism for pneumonia

Answer 12

Strep

Question 13

MC type of pneumonia in HIV population and tx

Answer 13

Pneumocystis -treat with Bactrim

Question 14

Acute dyspnea, cyanosis, and tachypnea . Refractory hypoxemia

Answer 14

Acute respiratory distress syndrome

Question 15

Treatment for TB

Answer 15

Rifampin
Isoniazid
Pyrazinamide
Ethambutol

Question 16

Pleuritic chest pain worse with inspiration, coughing, and certain movements

Answer 16

Costochondritis

Question 17

Pt comes in with dyspnea, plleuritic chest pain, and hemoptysis. CXR is normal. Suspect?

Answer 17

PE- do helical CT

pulmonary angiography is gold standard

Question 18

ECG findings of PE

Answer 18

1. Sinus tachycardia

2. S1Q3T3–> deep s in lead I, q wave and t wave inversion in lead 3

Question 19

What criteria should you consider when trying to rule on PE

Answer 19

PERC
Age <50 y/o
O2 sat >95%
HR <100
no prior PE, no recent trauma, no hemoptysis, no use of estrogen, no unilateral leg swelling

Question 20

What criteria does someone with latent TB have and what should the tx regimen be?

Answer 20

1. Asymptomatic
2. Positive PPD
3. No evidence active infection on xray

Treat with INH and Pyridoxine for 9 months

Question 21

Pt presents with mother for cough x2 weeks stating pt usually throws up post coughing. What do you order? What pathogen do you suspect?

Answer 21

Obtain nasopharyngeal swab for bordetella pertussis

TX is mainly supportive with Erythromycin if caught within 1st 7 days

Question 22

Lack of breastfeeding, born premature, and infants less than 2 y/o are risk factors for what

Answer 22

Acute bronchiolitis secondary to RSV

Question 23

Tx for RSV

Answer 23

O2 mainstay of treatment, but can given Rabavirin if immunosuppressed patients

Question 24

3-6 y/o pt comes in with dysphagia, drooling. Exam reveals inspiratory stridor . You suspect it is induced by H. influenzae type b. What do you order?

Answer 24

1. Laryngoscopy-definitive diagnosis showing cherry red epiglottis
2. Cervical xray showing thrumb print signs

Question 25

Management of someone with acute epiglottitis

Answer 25

1. Airway support keeping child in comfortable position, dexamethasone, and intubate
2. Given Rocephin

Question 26

PT comes in with barking cough, stidor, and hoarseness, dyspnea worse at night. What do you suspect is cause? Xray findings? and Tx?

Answer 26

Croup caused by parainfluenza. CXR will show steeple sign.

Tx with humidifier, dexamethasone