Pulm Flashcards
What is the most common cause of community-acquired pneumonia?
Strep pneumoniae
What antibiotic is appropriate for outpatient treatment of community acquired pneumonia?
Macrolide (not erythromycin) or doxycycline
Who is the pneumococcal polysaccharide vaccine recommended for?
Young / old, sick, sickle cell (functional asplenia), smokers, liver disease, asplenics
What are two buzzwords that go with Mycoplasma Pneumoniae?
Bullous myringitis and cold agglutinins
What are two buzzwords with Pneumocystis Jiroveci?
elevated LDH and hyper-hypoxia
What is a buzzword for pneumococcal pneumonia (strep pneumonia)?
rust-colored sputum
Buzzwords for Kelbsiella pneumonia?
ETOH abuse and currant jelly sputum
Most likely bug that causes pneumonia in an ETOH abuser?
Klebsiella
Most likely bug that causes pneumonia in COPD patient?
Haemophilus
Most likely bug with causes pneumonia in a cystic fibrosis patient?
Pseudomonas
Bug most likely to cause pneumonia in young adults?
Mycoplasma / Chlamydia
Bug most likely to cause pneumonia with exposure to aerosolized water?
Legionella
Bug most likely to cause pneumonia in children <1yr old?
RSV
Bug most likely to cause pneumonia in children <2yrs old?
Parainfluenza
What is the most common hospital acquired infection?
UTI
Most likely pathogen for ICU-acquired pneumonia?
Pseudomonas
What is the most common opportunistic infection in patients with HIV?
Pneumocystis jiroveci
What are the classic symptoms of TB?
fever, night sweats, weight loss
What are Ghon complexes (that represent healed infections)?
calcified primary focus in the lungs
What is the historical landmark of TB?
caseating granuloma (aka necrotizing granuloma)
What are the side effects of INH?
B6 deficiency, hepatitis, neuropathy
Side effects of rifampin?
orange skin discoloration and hepatitis
What is NOT predictive of bacterial bronchitis?
sputum color
What is leading cause of cancer death?
bronchogenic carcinoma
What radiographic finding is diagnostic for epiglottitis?
thumbprint sign
What radiographic finding is diagnostic for croup?
steeple sign
What is the most common cause of bronchogenic cancer?
adenocarcinoma
What is the treatment of choice for non-small cell cancer?
surgery
Three components of asthma?
airflow obstruction, hyper-reactivity and inflammation
What change in FEV1 after bronchodilation is supportive of the diagnosis of asthma?
10%
Most effective anti-inflammatory for chronic asthma?
inhaled steroids
Most contributing cause of COPD?
smoking
What deficiency leads to COPD?
alpha-1 antitrypsin deficiency
What is the single most important intervention to help COPD?
stopping smoking
What is superior to beta-agonists in achieving bronchodilation?
anticholinergics (ipratropium or tiotropium)
What therapy is the only therapy that can alter the course of COPD?
supplemental oxygen
What are the main symptoms of cystic fibrosis?
cough excessive sputum sinusitis steatorrhea abdominal pain
What is the gold standard for identifying a pleural effusion?
thoracentesis
Most common irritants used for pleurodesis?
doxycycline and talc
What type of radiology reveals pneumothorax?
expiratory CXR
What are risk factors for DVT / PE?
Virchow’s Triad:
- endothelial damage
- hypercoagulable state
- venous stasis
Most common hypercoagulable states?
- high estrogen
- cancer
- genetics
Inital method for diagnosis of PE?
spiral CT
When is a negative D-dimer helpful in ruling out PE?
with low pre-test probability
What is the definitive test for PE?
Pulmonary Angiogram
What physical findings are suggestive of Pulmonary HTN?
- systolic ejection click
- splitting / accentuation of S2
What causes pneumoconiosis?
- coal dust
- silicate
- other inert dusts
What is used to relieve chronic alveolitis in silicosis?
Steroids
What CXR findings are seen in asbestosis?
pleural-based plaques
What is the number one complication of asbestosis?
mesothelioma
What disease is a multiorgan disease of idiopathic cause characterized by non-caseating granulomatous inflammation in affected organs?
sarcoidosis
What is the main presentation of an aspirated foreign body?
choking, coughing or unexplained wheezing or hemoptysis
What is the most common cause of respiratory disease in a pre-term infant?
hyaline membrane disease
What can be used as a prophylaxis or rescue in a patient with established hyaline membrane disease?
exogenous surfactant
