Pop lock and scholom lecture

Question 1

indications for supplemental O2

Answer 1

PaO2 less than 55 mmhg or SpO2 under 89%

Question 2

mild disease asthma treatment

Answer 2

SABA or SAMA (ipratroprium) prn

Question 3

moderate asthma treatment

Answer 3

LABA or LAMA (tiatroprium)

Question 4

severe asthma treatment

Answer 4

ICS + LABA + LAMA

with or without roflumilast or theophylline

Question 5

very severe asthma treatment

Answer 5

ICS + LABAB or
ICS + LAMA or
ICS + LAMA + LABA

with or without roflumilast or theophylline

Question 6

pulmonary rehab for pts with COPD treats what

Answer 6

symptoms more than the disease

Question 7

inducible laryngeal obstruction associated conditions

Answer 7

asthma
gerd
chronic rinosinusitis

Question 8

initial treament with person with COPD

Answer 8

LABA and LAMA

Question 9

inducible laryngeal obstruction vs asthma

ILO

Answer 9

ILO- upper airways, rapid, can leave abruptly

monophnic inspiratory stridor and prolonged inspiratory phase

Question 10

ILO treatment

Answer 10

primarily speech therapy

avoidance of irritant substances

Question 11

oxygen content equation

Answer 11

Hb X % saturation X 1.34

Question 12

O2 transport equation

Answer 12

O2 content X CO

Question 13

prototypic ILD presentation

Answer 13

dyspnea
cough
crackles at bases
digital clubbing
exercise indcued hypoeemia
reduced FRC, TLC normal, low DLCO

Question 14

scleroderma and lungs

Answer 14

pulmonary fibrosis (most lethal)
pulmonary hypertension
aspiritaion (esophagus becomes stiff tube with no motion, aspirate chronically)

Question 15

SLE assocaitions

Answer 15

PIPE

pleural disease
interstitial lung disease
pulmonary HTN
extra pulmonary restriction

if sudden onset then probably not likely SLE

Question 16

antibiotic commonly used for UTI that can cause lung disease

Answer 16

nitrofuratoin

Question 17

treatment for hypersenstivie pneumonitis

Answer 17

put on prednisone for acute form

chronic form does not respond to prednisone as well

Question 18

ILD of COPD has more rapid decline

Answer 18

ILD

Question 19

ILD and cough

Answer 19

non productive

Question 20

treatment of ILD

Answer 20

corticosteroids except IPF

Question 21

treatment for IPF

Answer 21

pirfenidone

nintedanib

Question 22

what is Dohls sign

Answer 22

microhem on legs from leaning on knees so much with COPD

Question 23

heart size and COPD

Answer 23

smaller

Question 24

treatment for sarcoid

Answer 24

prednisone

Question 25

sudden collapse of young lady recently prescribed birth control

Answer 25

increased hypercoag, so PE leading to syncope | can occur with thrombophlebitis

Question 26

superficial thrombophlebitis vs erythema nodosum

Answer 26

superficial thrombo is tracts along the vein erythema nodsum is bunched up red marks

Question 27

what kind of tumors increase chance of getting clot

Answer 27

mucin producing adenocarcinoma of the lung

Question 28

pulmonary hypertension xray

Answer 28

opacity in vasculature of the lung fields in the periphery bc it has been narrowed down. big knuclkes in pulm artery

Question 29

treatment of PHTN

Answer 29

treat underlying cause

Question 30

pulmonary HTN classification

Answer 30

I HLP Others ``` Group 1- idiopathic and CTD Group 2- heart Group 3- lung Group 4- pulmonary emboli Group 5- all others ```

Question 31

what has an increased 2nd heart sound, PHTN or ischemic heart disease

Answer 31

pulmonary hypertension

Question 32

woman with SOB, most common causes

Answer 32

Smoking Postnasal drip GERD asthma also ILO

Question 33

causes of bronchiectasis

Answer 33

post infectious A1AT idiopathic inflammatory disorders like CTD and sarcoid Inhalation injury/obstruction

Question 34

initial tests in bronchiectasis looking for

Answer 34

mycobacterium and NTM

Question 35

managment of bronchiectassis

Answer 35

tracheobronchial clearance technique mucus mobilizing method anti inflamm airway manag anti aspiration methods

Question 36

key for seeing pneumothorax in xray

Answer 36

looking for pleural line which is white line with dark air on either side

Question 37

tension pneumothorax can cause what

Answer 37

decrease venous return and mediastinal shift | true emergency

Question 38

similarity of pneumothorax and pleural effusion on exam

Answer 38

absetnt or diminished breath sounds

Question 39

diff of pneumothorax and pleural effusion on exam

Answer 39

hyper resonant on pneumothoraX dull in effusion change in position may help effusion for breath sounds

Question 40

exudate exists with what

Answer 40

pleural protein/serum protein above 0.5 pleural ldh/serum ldh above 0.6 pleaural fluid above 2/3 upper limit of serum level in lab doing measurement

Question 41

heart failure leads to transudate or exudate

Answer 41

transudate

Question 42

atypical pneumonias are almost always associated with what

Answer 42

bronchiectasis or cystic lung disease

Question 43

what is the DLCO

Answer 43

effective alveolar capillary blood volume

Question 44

what can decrease DLCO

Answer 44

emphysema pulmonary fibrosis/interstitial lung disease pulmonary vascular disease

Question 45

MRC breathlessness: only with streneous exercise

Answer 45

grade 1

Question 46

MRC breathlessness: slower than other people their same age

Answer 46

grade 3

Question 47

MRC breathlessness: too breathless to leave house or while undressing

Answer 47

grade 5

Question 48

MRC breathlessness: hurrying on level ground or walking up a slight hill

Answer 48

grade 2

Question 49

MRC breathlessness: stops after 100 yards or a few minutes on level ground

Answer 49

grade 4