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HELP CAMPUS > PULM > Flashcards

PULM Flashcards

1
Q

What is pneumoconiosis?

A

inflammation of the lungs d/t inhaled dust particles

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2
Q

Which pneumoconiosis causes diffuse infiltrates and hilar lymphadenopathy?

A

berylliosis

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3
Q

Which pneumoconiosis has upper lobe opacities in CXR?

A

Coal workers

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4
Q

Which pneumoconiosis has egg shell calcifications on CXR?

A

silicosis

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5
Q

How do you differentiate between lofgrens syndrome and sarcoid?

A

lofgren is short term and acute; sacroid is chronic

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6
Q

What DVT area can commonly lead to PE?

A

ABOVE knee

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7
Q

What disorder should be considered in YA (20-30yo) with severe emphysema?

A

alpha 1 antitrypsin deficiency

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8
Q

Diffuse ground glass but no pulmonary nodules on CXR?

A

interstitial lung disease

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9
Q

Diffuse ground glass with pulmonary nodule on CXR?

A

lung CA

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10
Q

What type of pneumonia should be considered with a patient exposed to bat/bird droppings in Mississippi?

A

histoplasmosis

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11
Q

What drug classes can be used to tx klebsiella pneumonia?

A

cephalosporin, aminoglycoside, fluoroquinolone

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12
Q

What drug classes can be used to tx legionella pneumonia?

A

fluuroquinolone and macrolides

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13
Q

What hx wold be indicative for legionella pnuemonia?

A

traveling with mist environment (cruise ships, AC)

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14
Q

What hx would be indicative for klebsiella pneumonia?

A

alcoholics, DM, severe COPD

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15
Q

What other bacterial pneumonia could a patient with pseudomonas pneumonia have?

A

s. aureus pneumonia

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16
Q

How many and what types of abx should be used for pseudomonas pneumonia?

A

at least 2 abx; anti-pseudomonal beta-lactam + anti-psuedomonal quinolone/aminogylcoside OR anti-quinolone +anti aminoglycoside

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17
Q

How should MRSA pneumonia be tx’d?

A

cipro OR levofloxin + vancomycin

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18
Q

How should a patient in ICU be treated with s. pneumonia or non MRSA?

A

beta lactum + macrolide OR fluoroquinolone

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19
Q

How should a patient in non ICU be treated with s. pneumonia or non MRSA?

A

beta lactum + macrolide

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20
Q

How should a patient in outpatient with comorbidites be treated with s. pneumonia or non MRSA?

A

beta lactum + macrolide OR fluroquinolone doxycycline

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21
Q

How should a patient in outpatient that is healthy should be treated with s. pneumonia or non MRSA?

A

macrolide OR fluoroquinolone doxycyline

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22
Q

What to suspect with young patient who has been exposed to rodent feces who presents with CHF-like sx?

A

hantavirus

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23
Q

What factors pre-dispose children from IRDS type 2?

A

c section, DM mothers

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24
Q

What type of IRDS can occur in full term babies?

A

type 2

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25
Q

What type of IRDS can occur in premature babies?

A

type 1

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26
Q

Incomplete lung development d/t congenital malformation?

A

pulmonary hypoplasia

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27
Q

Long term inflammation that leads to scarring d/t severe resp distress or mechanical ventilation?

A

broncho-pulmonary dysplasia

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28
Q

What abx is strongly associated with hypertrophic pyloric stenosis?

A

macrolides, esp clarithomyocin

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29
Q

Where does the CA associated with absetosis like to grow?

A

base of the lungs

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30
Q

CXR looks like CHF but pulm wedge pressure is normal?

A

ARDS

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31
Q

Patient has SOB and works at radiation plant?

A

berylliosis

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32
Q

What labs are elevated in sarcoidosis?

A

4x ACE levels; ESR

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33
Q

1wk postpartum and now has SOB + tachycardic?

A

PE

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34
Q

Class 5 pulmonary HTN cause?

A

sarcoidosis

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35
Q

Class 4 pulmonary HTN cause?

A

PE

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36
Q

Class 3 pulmonary HTN cause?

A

COPD

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37
Q

Class 2 pulmonary HTN cause?

A

L heart probs: mitral stenosis, mitral rergug, LVH

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38
Q

Class 1 pulmonary HTN cause?

A

congenital defect: VSD, ASD, PDA

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39
Q

R HF d/t long COPD?

A

cor pulmonale

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40
Q

Only med that improves morbidity and mortality in COPD?

A

O2

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41
Q

Bloody pleural effusion is concerning for?

A

CA

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42
Q

Med of choice for COPD exacerbation?

A

ipratropium

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43
Q

What is the most aggressive lung CA?

A

small cell

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44
Q

What is the common CA in non-smokers?

A

adenocarcinoma

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45
Q

“Cinnamon breath” is associated with what infxn?

A

TB

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46
Q

Ethambutal has what ADR?

A

optic neuritis

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47
Q

What is given to patient to prevent neuropathy from isoniazid?

A

B6

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48
Q

Older lesions from old TB will show at which part of the lung?

A

lower lobes

49
Q

What lab is elevated in PJP pneumonia?

A

LDH

50
Q

What do you expect in a young patient who does IV drug use, CXR with diffuse infiltrates + hypoxia?

A

PJP pneumonia

51
Q

What pneumonia do you expect from a patient who has been exposed to AC vents and spas?

A

Legionella

52
Q

Most common bacterial infection associated with ventilators?

A

Psuedomonas

53
Q

Bacterial pneumonia that is caused after a flu?

A

S. aureus

54
Q

What pneumonia is associated with diarrhea and low Na?

A

legionella

55
Q

First episode of wheezing in children?

A

bronchiolitis

56
Q

Wet cough and foul smelling sputum in child?

A

bronchiectasis

57
Q

Flu can be treated with oseltamivir within what window period?

A

48hrs

58
Q

Tx for berylliosis?

A

chronic steroids

59
Q

How high does pulmonary pressure need to be to dx pulmonary HTN?

A

25 at rest

60
Q

What CA is a patient at risk with abstesosis?

A

mesothelioma

61
Q

Chronic dry cough dyspnea fatigue and clubbing; CXR shows fibrosis and CT shows honeycombing?

A

idiopathic pulmonary fibrosis

62
Q

CXR shows bilateral adenopathy and non caseating granulomas?

A

sarcoidosis

63
Q

Gold standard for pulm HTN?

A

R heart cath

64
Q

CXR with ARDS?

A

b/l infiltrates; like CHF

65
Q

Patients with asthma, FEV1 to FVC will be?

A
66
Q

R sided pleural effusion is associated with?

A

CHF or cirrhosis

67
Q

3 types of non small cell CA?

A

adenocarcinoma, squamous, large cell

68
Q

What is recommened for first time positive PPD for healthcare workers?

A

isoniazid for 6months

69
Q

Tx for histomplasmosis?

A

amphoterin B

70
Q

Tx for fungal pneumonia in immunocompressed patient?

A

fluconazole or itraconazole

71
Q

CXR shows RUL consolidation, organism most likely?

A

klebsiella

72
Q

What pneumonia is associated with ‘red currant jelly’?

A

klebsiella

73
Q

What virus can lead to pneumonia after URI and associated with GI and diarrhea?

A

adenovirus

74
Q

Rusty colored sputum?

A

strep pneumonia

75
Q

Pink/salmon colored sputum?

A

staph aurues

76
Q

Atypical pneumonia?

A

chlamydia, mycoplasma, legionella

77
Q

Most common viral pneumonia?

A

influenza

78
Q

Percussion over normal lungs sound like..?

A

resonance

79
Q

How to prevent hyaline membrane dz in children?

A

antenatal steroids

80
Q

Bug that causes whooping cough?

A

bordetella pertusiss

81
Q

Steeple sign on CXR?

A

croup

82
Q

How to tx croup?

A

azithormycin or clarithomycin

83
Q

Bug that causes croup?

A

parainfluenzae type 1

84
Q

Child with barking cough?

A

croup

85
Q

Child has resp. distress, dyphagia, drooling; what to expect on CXR and dz?

A

CXR: thumbprint sign; dz - epiglottitis

86
Q

Common cause of bronchiolitis?

A

RSV

87
Q

Which pneumoconiosis has higher rate of getting TB?

A

silicosis

88
Q

Where does mesothelioma present on CXR?

A

base of pleura

89
Q

What is the normal blood pressure in the lungs?

A

15/5

90
Q

ARDS CXR would look like?

A

CHF

91
Q

Pt in a MVA has a tension pneumothorax, which way does the trachea deviate?

A

good lung

92
Q

What is the diagnostic test of choice to dx cor pulmonale?

A

R heart cath

93
Q

Most common cause of ARDS?

A

sepsis

94
Q

What are the 3 types of COPD?

A

asthma, emphysema, chronic bronchitis

95
Q

In addition to O2, ipratropium, what else should be given to all COPD exacerbations?

A

abx

96
Q

Which lung CA is tx with chemotherapy only (no surgery)?

A

small cell

97
Q

During lung exam, you can hear clearly when patient whispers?

A

consolidation

98
Q

Which fungal pneumonia is likely to turn into meningitis in immunocompressed patients?

A

cryptococcal

99
Q

If HIV pt is allergic to sulfa drugs?

A

pentamidine

100
Q

Which pneumonia is associated with positive cold aggluntins?

A

mycoplasma aka walking pneumonia

101
Q

Outbreak of the flu with diarrhea and nausea in boot camp is caused by what bug?

A

adenovirus

102
Q

18yo male presents to office after flu like sx with productive sputum and CXR has large infiltrate, bug that caused this?

A

s. aureus

103
Q

Common pneumonia after splenectomy?

A

strep pneumonia

104
Q

Gold standard to dx pertussis?

A

cx

105
Q

Premature baby is treated with corticosteroids and surfactant to prevent what?

A

infant respiratory distress syndrome

106
Q

Bug for epiglottitis?

A

H. influenzae type B

107
Q

14mo has runny nose, fever and wheezing, now with SOB, what is the bug?

A

RSV

108
Q

A previously healthy 12-year-old boy presents to the emergency department with a three week history of a progressively worsening cough. He does not appear extremely ill. Oral temperature is 99.4 degrees F. Pulse oximetry results are 99% on room air. Physical exam is significant for a injected, bulging left eardrum, injection of the pharyngeal mucosa without exudates, and rales at the left posterior lung base. CXR shows a small area of patchy infiltrate but no evidence of effusion. Which of the following is the most appropriate therapy?

A

Outpatient treatment with oral doxycycline (Doryx)

109
Q

A 77-year-old man who has been on ventilator assistance for 2 weeks now has an extensive right lower lobe pneumonia. Which of the following is the most likely organism causing the pneumonia?

A

Pseudomonas aeruginosa

110
Q

A 77-year-old man who worked with asbestos in shipbuilding is at greatest risk of developing which of the following?

A

Mesothelioma

111
Q

A 51-year-old man has hypercortisolism caused by ectopic ACTH production from a small cell carcinoma of the lung. Which of the following is the most likely abnormal laboratory value to be noted?

A

Hypokalemia

112
Q

Which of the following statements is true concerning the physiologic difference between a freshwater drowning versus a salt water drowning?

A

Fresh water in the lungs is rapidly absorbed, diluting the plasma, and causing intravascular hemolysis and cardiac arrhythmia

113
Q

When evaluating arterial blood gas results, which of the following test results is the best indicator that your patient is hyperventilating?

A

Decreased pCO2

114
Q

Ipratropium therapy is initiated in a 71-year-old woman who has chronic obstructive lung disease. Which of the following is the pharmacologic action of this medication?

A

Anticholinergic

115
Q

A 60-year-old man has a 2 week history of progressive weakness without nausea or vomiting. Serum sodium concentration is 124 mEq/L. Chest radiography shows a hilar mass with mediastinal adenopathy. Which of the following is the most likely diagnosis?

A

Small cell carcinoma

116
Q

Which of the following are the organisms most likely to produce epiglottitis in children under the age of three years?

A

H influenza b and s. Pneumonia

117
Q

A 14-year-old asymptomatic boy has recently immigrated from a country known to have a high incidence of tuberculosis. After evaluation, latent tuberculous infection is diagnosed for which isoniazid therapy is initiated. The patient and parents should be advised that which of the following are the most likely symptoms to represent and adverse effect of the isoniazid?

A

Anorexia, dark urine, nausea

118
Q

A 45-year-old male presents with a 40 pack year smoking history complaints of a chronic cough productive of mucopurulent sputum. The cough has been present for the past 3 years, but he attributed it to a “smoker’s cough”. He has been coughing up a lot of sputum lasting all winter long for the past 2 years. He denies any hemoptysis, weight loss or chest pain. Physical examination reveals a moderately obese male in no acute respiratory distress. Lung fields reveal presence of scattered rhonchi and wheezes. There is 1+ peripheral edema. Which of the following is the most likely diagnosis?

A

Chronic bronchitis

119
Q

A 14-year-old girl has asthma that is triggered by exposure to certain pollens. Which of the following is the mechanism of action of cromolyn sodium?

A

Mast cell stabilizer

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