PULM

Question 1

Risk factor for DVT

Answer 1

stasis, endothelial injury, hypercoagulability (Virchow!)

Question 2

Criteria for exudative effusion

Answer 2

plerual/serum protein>0.5, pleural/serum LDH>0.6

Question 3

causes of exudative effusion

Answer 3

leaky capillaries, malignancy, TB, bacterial or viral infection, PE w/ infarct, pancreatitis

Question 4

Transudative effusion causes

Answer 4

intact capillaries = CHF, liver or kidney dz, protein losing enteropathy

Question 5

normalizing PCO2 in pt having an asthma attack indicates what?

Answer 5

respiratory muscle fatigue and impending resp failure

Question 6

Sarcoidosis sx and labs

Answer 6

dyspnea, lateral hilar adenopathy on CXR, noncaseating granulomas, increased ACE and hypercalcemia

Question 7

PFT of obstructive dz

Answer 7

Decreased FEV/FVC

Question 8

PFTof restrictive dz

Answer 8

Increased FEV/FVC, decreased TLC

Question 9

Honeycomb pattern on CXR? Tx?

Answer 9

diffuse IPF, steroids may help but mainly give supportive care

Question 10

Tx for SVC syndrome

Answer 10

radiation

Question 11

Tx for mild persistent asthma

Answer 11

Inhaled B-Agonists and inhaled corticosteroids

Question 12

Tx for COPD exacerbation

Answer 12

O2, bronchodilators, corticosteroids w taper, smoking cessation

Question 13

Tx for chronic COPD

Answer 13

smoking cessation, home O2, beta agonists, anticholinergics, systemic inhaled corticosteroids, flu and pneumovax

Question 14

Acid base disorder in PE

Answer 14

resp alkalosis w/ hypoxia and hypocarbia

Question 15

Non small cell lung CA associated w/ hypercalcemia

Answer 15

squamous cell carcinoma

Question 16

lung CA associated w SIADH

Answer 16

small cell lung CA

Question 17

Tall caucasian man presents w acute shortness of breath. Dx?

Tx?

Answer 17

Spontaneous pneumothorax

Spontaneously regresses but supplmental O2 may help

Question 18

Tx of tension pneumo

Answer 18

immediate needle thoracostomy

Question 19

Characteristics favoring carcinoma in isolated pulmonary nodule

Answer 19

Age >45-50, lesions new or larger in comparison to old films, absence of calcifications or irregular calcifications, size >2cm, irregular margins

Question 20

ARDS

Answer 20

Hypoxemia and pulmonary edema w/ normal pulmonary capillary wedge pressure

Question 21

SEquelae of asbestos exposure

Answer 21

pulmonary fibrosis, pleural placques, bronchogenic carcinoma (mass in lung field), mesothelioma (pleural mass)

Question 22

Increased risk of what infection w/ silicosis?

Answer 22

Mycobacterium TB

Question 23

Causes of hypoxemia

Answer 23

R to L shunt, hypoventilation, low inspired O2 (altitude), tension, diffusion defect, V/Q mismatch

Question 24

Classic CXR finding for pulmonary edema

Answer 24

cardiomegaly, prominent pulmonary vessels, Kerley B lines, bat wing appearance on CXR, perivacular/peribronchial cuffing

Question 25

Westermark’s sign and Hampton’s hump

Answer 25

CXR findings suggestive of PE