Pulm

Question 1

Rapid, deep labored breathing

Answer 1

Kussmaul breathing - DKA, metabolic acidosis

Question 2

Deep breathing alternating w/ apnea

Answer 2

Cheyne-stokes breathing - heart failure, brain damage

Question 3

Crackles or rales

Answer 3

Pneumonia, heart failure, etc…

Question 4

Apical infiltrates, F, C, dry cough

Answer 4

TB

Question 5

Eggshell pattern on CXR

Answer 5

Silicosis (sandblasters)

Question 6

Ground glass appearance on CXR

Answer 6

Asbestosis (shipbuilders, building demolition)

Question 7

Dyspnea after surgery, travel (airplane), LE Fx, May have c/o calf pain also.

Answer 7

DVT/PE

Question 8

Venous stasis, vessel wall injury, hypercoagulability

Answer 8

DVT/PE (virchow’s triad)

Question 9

Pediatric with barking cough, stridor

Answer 9

viral croup (laryngitracheobronchitis); tx w/ racemic epi and glucocorticoids if stridor at rest

Question 10

Drooling, sniffing position, tripod, toxic

Answer 10

Epiglottitis

Question 11

Inspiratory stridor

Answer 11

FB, viral croup (laryngotracheobronchitis)

Question 12

Smoker, chronic productive cough. NO hemoptysis, wt. loss

Answer 12

Bronchitis (COPD)

Question 13

Smoker, DOE, cough

Answer 13

COPD

Question 14

Hyperinflation on CXR, tear drop heart

Answer 14

emphysema

Question 15

Airway edema with eosinophils, neutrophils, lymphocytes

Answer 15

Asthma

Question 16

Fever, cough, sputum. Crackles, decreased breath sounds, dullness to percussion, +egophony, pectoriloquy. CXR - infiltrates or consolidation

Answer 16

Pneumonia

Question 17

> 35yo with PNA. Rusty colored or yellow-green sputum. Acute onset F/C

Answer 17

Strep. pneumonia

Question 18

<35yo, college students. Fever, cough, +/- sputum, chills, muscle aches

Answer 18

mycoplasma pneumonia

Question 19

PNA w/ DM, immunocompromised, EtOH. Currant color sputum

Answer 19

Klebsiella

Question 20

PNA w/ water, late summer, construction site. Diarrhea, toxic looking

Answer 20

Legionella

Question 21

Pediatric with Hx recurrent lung infections, pancreatitis, reproductive problems, FTT

Answer 21

cystic fibrosis (staph and pseudomonal infections usually cause of death)

Question 22

Sweat chloride test

Answer 22

cystic fibrosis

Question 23

<2 days post-op with fever

Answer 23

atelectasis

Question 24

Stab wound, hyperresonance to percussion, decreased breath sounds, tympany

Answer 24

Pneumothorax

Question 25

Stab wound, dullness to percussion, decreased breath sounds

Answer 25

hemothorax

Question 26

Tall, skinny, male, band student, acute onset one-sided chest pain, dyspnea

Answer 26

spontaneous PTX

Question 27

Stab wound to chest. Hypotension, tracheal shift

Answer 27

Tension PTX

Question 28

Poor sleeping, obese, daytime fatigue and drowsy, snoring, HTN, PM wakening

Answer 28

Obstructive sleep apnea

Question 29

s/p thoracic trauma. Multiple rib fractures. Chest wall moves in with inspiration, out with expiration.

Answer 29

Flail chest (pain control, incentive spirometry, pulmonary toilet, intubation)

Question 30

Horner’s syndrome

Answer 30

Ptosis, miosis, anhidrosis
Pancoast tumor - apex of lung

Question 31

EKG S1Q3T3

Answer 31

Pulmonary emboli

Question 32

aFEV1 less than 80% suggests

Answer 32

obstructive lung disease

Question 33

Types of pleural effusions

Answer 33

Exudative verses transudative

Question 34

Exudative pleural effusion

Answer 34

Neoplastic, infection

Question 35

Transudative pleural effusion

Answer 35

CHF, cirrhosis

Question 36

Funnel chest

Answer 36

pectus excavatum

Question 37

Hypotension, JVD, tracheal shift to the right

Answer 37

Left tension pneumothorax

Question 38

Fever, night sweats, wt loss with cough, pleuritic chest pain, hemoptysis

Answer 38

TB

Question 39

Emboli seen following long bone fracture

Answer 39

Fat emboli