pulm

Question 1

tram track

Answer 1

bronchiectasis

Question 2

honeycombing

Answer 2

IPF (but really also any dz that has interstitial lung fibrosis)

Question 3

mining, quarry rocks, sandblasting –> what lung dz

Answer 3

silicosis

Question 4

coal –> what lung dz

Answer 4

coal miners lung/black lung

Question 5

aerospace engineering –> what lung dz

Answer 5

berylliosis

Question 6

work exposure + nodules in upper lung fields

Answer 6

silicosis
berylliosis
also coal workers

Question 7

work exposure + nodules in lower lung fields

Answer 7

asbestosis

Question 8

just in case… cotton/textile worker can develop what lung dz

Answer 8

byssinosis

Question 9

4 characteristic of malignant lung nodules:
shape
growth
calcium deposition
cavitary

Answer 9

shape: irregular, spiculated
growth: rapid, may double in 4mo
ca: no calcifications
cavitary: seen in both, but has thickened walls here

Question 10

what is 1st line tx for non small cell carcinoma

Answer 10

surgery

Question 11

4 types of non small cell carcinoma

Answer 11

adeno
squamous cell
large cell (anaplastic)
bronchoalveolar — rare

Question 12

what is the 1st line tx for small cell carcinoma (oat cell)

Answer 12

chemo +/- radiation

Question 13

which lung CA are central

Answer 13

squamous cell

small cell

Question 14

which lung CA are peripheral

Answer 14

adeno
large cell (anaplastic)

Question 15

which lung CA is assoc with cavitary lesions, hypercalcemia and pancoast syndrome

Answer 15

squamous cell

Question 16

lung neuroendocrine tumors that secrete serotonin, acth, etc.

Answer 16

bronchial carcinoid tumor

Question 17

“pink to purple well vascularized central tumor”

Answer 17

bronchial carcinoid tumor

Question 18

light’s criteria for pleural effusions:

Answer 18

exudative if:
a) pleural protein:serum protein > 0.5
b) pleural LDH:serum LDH > 0.6
OR
b) pleural LDH > 2/3 upper limit of normal

Question 19

what is the max you can remove during 1 thoracentesis

Answer 19

1.5L

Question 20

what % is considered a “small” ptx that only needs observation and O2

Answer 20

<20%

Question 21

in a PE you see avascular markings distal o the area of the embolus. what is this sign

Answer 21

westermarks sign

Question 22

if a PE you see a wedge shaped infarction in the lung. what is this sign

Answer 22

hamptons hump

Question 23

other than nothing, what are the ekg findings of a PE

Answer 23

R heart strain - s1q3t3
wide deep S in lead 1
q wave in lead 3
TWI in lead 3

Question 24

mgmt of heme stable PE

Answer 24

iv or subq heparin + po warfarin for 5-7 days then switch to po warfarin alone

Question 25

mgmt of heme unstable PE

Answer 25

thrombolysis; embolectomy if C/I

proceed once heme stable

Question 26

which heparin do you need to do PTT monitoring

Answer 26

unfractioned

do not need to for LMWH

Question 27

what is a normal PTT when someone is on UFH

Answer 27

1.5-2.5x above normal

Question 28

what is the heparin toxicity antidote

Answer 28

protamine sulfate

Question 29

s/e of rifampin

Answer 29

orange secretions

thrombocytopenia

Question 30

s/e of isoniazid

Answer 30

hepatitis

neuropathy

Question 31

s/e of pyrazinamide

Answer 31

hepatitis

gout

Question 32

s/e of ethambutol

Answer 32

optic neuritis

Question 33

at what weeks does an infant produce surfactant

Answer 33

24-28 weeks

Question 34

at what weeks does the fetus have enough surfactant to survive on its own

Answer 34

35+

Question 35

how can you prevent infant respiratory distress syndrome/hyaline membrane disease

Answer 35

give mom steroids between 24-36 weeks pregnancy

Question 36

ARDS doesn’t ever respond to 100% O2. What should you give them?

Answer 36

mechanical ventilation (cpap, peep)

Question 37

how do you make a definitive dx of pulm htn

Answer 37

right sided heart cath

Question 38

what is the mgmt for pulm htn

Answer 38

vasodilators (1st line ccb***, also PDE-5 inhibitors)

O2 and anticoag