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PANCE > Pulm > Flashcards

Pulm Flashcards

1
Q

Paratracheal lymphadenopathy
Elevated ACE levels

MC in african american

A

Sarcoidosis

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2
Q

Very aggressive lung cancer

median survival untreated is 6-18 weeks

A

small cell lung cancer

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3
Q

dilated thickened bronchi
tram-tracks
ring like markings

A

bronchiectasis

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4
Q

MC pathogen in pts with cystic fibrosis

A

pseudomonas

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5
Q

does a pulm effusion have decreased or increased tactile fremitus

A

decreased

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6
Q

DOC for pulmonary legionelliosis

A

azithromycin

(can also give FQs or tetracyclines)

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7
Q

______ most commonly presents as a solitary, peripheral lesion on chest radiograph. It is sometimes associated with an ipsilateral pleural effusion.

A

adenocarcinoma

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8
Q
  1. asthma
  2. nasal polyps
  3. ASA/NSAID allergy
A

Sumter’s triad

IgE mediated

*also associated w eczema

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9
Q

strongest predisposing factor for asthma

A

atopy

(atopic triad= wheeze, eczema, seasonal rhinitis)

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10
Q

with asthma, generally get and FEV1/FVC ratio of…

A

<75%

a greater than 10% increase FEV1 after bronchodilation therapy is supportive of diagnosis

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11
Q

symptoms <2 days a week

<2 monthly night symptoms a month

A

intermittent

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12
Q

>2 days a week

3-4 monthly night time symptoms

A

mild

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13
Q

daily symptoms

>1 night per week, but not nightly symptoms

A

moderate

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14
Q

continuous symptoms

almost nightly night time symptoms

A

severe

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15
Q

drug class:

salmeterol
formoterol

A

LABA

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16
Q

what do you need to monitor with leukotriene modifiers (ie montelukast)

A

LFTs

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17
Q

bronchodilator NOT to be used acutely

narrow therapeutic window: arrythmias, seizures

A

theophylline

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18
Q

bronchodilator

MOA: decreased Ca mediated smooth muscle contraction

*can also be used to prevent pre term labor

A

Magnesium

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19
Q

when do you give a COPD person supplemental O2

A

SpO2 < 88%

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20
Q

productive cough for greater or equal to 3 months for 2 consecutive years

A

chronic bronchitis

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21
Q

hyperresonance
resp alkalosis
mild hypoxemia

A

emphysema

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22
Q

rales, crackles, rhonchi
resp acidosis
increased Hct/RBCs
severe hypoxia and hypercapnia

A

chronic bronchitis

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23
Q

contraindications of anticholinergics (tiotropium, ipratropium)

A

BPH
glaucoma

24
Q

good antibiotic for acute COPD exacerbations

*anti-inflammatory properties in the lung

A

Azithromycin

25
Q

MC cause of bronchiectasis

A

cystic fibrosis

26
Q

DOC for bronchiectasis if suspected pseudomonas (ie in a CF patient)

A

fluoroquinolone
Zosyn
Aminoglycoside
Cephalosporin

27
Q

CF pt with…

daily chronic cough with thick, mucopurulent and foul smelling sputum

hemoptysis

persistent crackles

A

bronchiectasis

image of choice - CT

28
Q

CT showing:

tram tracks
signet ring sign

A

bronchiectasis

tx must cover psuedomonas if CF patient

29
Q 
meconium ileus
pancreatic insufficiency (exocrine dysfxn)
A

CF

30
Q

bilateral hilar LAD
R paratracheal LAD
ground glass appearance
+/- eggshell calcifications

*restrictive PFTs (increased or normal FEV1/FVC ratio)

A

sarcoidosis

tx= observe or steroids

31
Q

true or false…

MC mets for lung cancer are brain, bone, liver, lymph nodes, adrenals

A

true

32
Q

MC type of lung cancer

*locally spreads
*surgery is 1st line

can get pancoast syndrome

A

Non small cell

(88%)

33
Q

EARLY METS!! with ths lung cancer

often have mets at presentations

management-chemo and radiation

A

Small cell

34
Q

seen with non-small cell lung ca

  1. shoulder pain
  2. horners syndrome (miosis, ptosis, anhydrosis)
  3. atrophy of hands, arms
A

Pancoast syndrome

(horners syndrome due to compression of sympathetic)

35
Q

MC cause of transudative pleural effusions

A

CHF

also caused by: nephrotic syndrome, cirrhosis

36
Q

due to inflammation

protein > 0.5
LDH > 0.6 or > 2/3 upper limit norm

A

Exudative pleural effusion

37
Q

MC CXR= normal

but, may see:

Westermarks sign
Hamptons Hump

A

PE

38
Q

sinus tach
S1Q3T3

A

PE

39
Q

top 2 pathogens causing CAP

A
  1. s.pneumoniae
  2. H. influenzae
40
Q

MC pneumonia in alcoholics

A

klebsiella

41
Q

MC pneumonia in immunocompromised

A

pseudomonas

42
Q

which type of penumonia…

tx: macrolide or doxy

A

outpatient CAP

43
Q

which type of pneumonia…

tx= beta lactam (ceftriaxone) + macrolide or doxy
OR broad spectrum FQ (levo, moxi)

A

inpatient CAP

44
Q

tx for aspiration pneumonia

A

clinda or augmentin +/- flagyl

45
Q

what indurated PPD size is positive for:

HIV, immunocompromised
close contact to active TB patient
CXR showing old TB

A

5 mm

46
Q

what indurated PPD size is positive for:

recent immigrants
IV drug users
DM, CKD, silicosis
Kids under 4
health care workers

A

10 mm

47
Q

indurated PPD size for gen pop

A

15 mm

48
Q

RIPE treatment for TB

A
  • *R**ifampin
  • *I**NH
  • *P**yrazinamide
  • *E**thambutol
49
Q

SEs of:

rifampin
INH
pyrazinamide
ethambutol

A

rifamin- thrombocytopenia, orange

INH- hepatitis, peripheral neuropathy

pyrazinamide- hepatitis, hyperuricemia

ethambutol- optic neuritis

50
Q

true or false

streptomycin can be used for TB and has the SE of ototoxicity

A

true

51
Q

cyclic breathing in response to increased CO2

increases in resp plus gradual decreases in resp with a period of apnea 15-60 seconds

A

cheyne- stokes

52
Q

quick, shallow breaths of equal depth with irregular periods of apnea

A

biot’s

53
Q

deep, rapid, continuous respirations

result of metabolic acidosis

A

kussmauls

54
Q

disruption or obstruction of thoracic duct

*leakage of lymphatic fluid of intestinal origin

A

chylothorax

55
Q

high triglyceride content (>110)
turbid or milky white appearance

A

chylothorax

*chest, neck or abdominal surgery increases risk

56
Q

DOC for primary pulmonary HTN

A

CCBs

PANCE (10 decks)

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