Pulm

Question 1

Initial management of pulmonary htn due to lv dysfunction

Answer 1

Loops and aceis

Question 2

Management of idiopathic pulm htn

Answer 2

Endothelin receptor antagonists (bosentan), phosphodiesterase inhibitors eg sildenafil, and or prostanoids (epoprostenol)

Question 3

In osa you have ___ hematocrit and epo levels

Answer 3

Increased

Question 4

How do you screen for lung cancer

Answer 4

Chest ct (not X-ray!)

Question 5

When and how do you screen for lung cancer in smokers?

Answer 5

Annual low dose chest ct in pts 55-80 with a >30 pack year smoking history who are currently smoking or quit within the last 15 years

Question 6

Three common causes of secondary clubbing

Answer 6

Lung malignancies
Cystic fibrosis
Right to left cardiac shunts

Question 7

Does copd present with digital clubbing

Answer 7

No

Question 8

Can you have a pleural effusion with a pe

Answer 8

Yes

Question 9

Etiology of infectious/inflammatory pleural exudative effusion

Answer 9

Increase in capillary permeability

Question 10

What is lights criteria

Answer 10

Is pleural effusion transudative or exudative

Exudate if any of these are true

1. PF ldh/serum ldh > 0.6
2. PF protein/serum protein > 0.5
3. PF ldh > 2/3 The upper limit of normal

Question 11

Cause of biphasic stridor/wheezing/dysphagia, more prominent during expiration, improves with neck extension in a baby under one

Answer 11

Vascular ring

Question 12

Laryngomalacia is __ when supine

Answer 12

Worse

Question 13

Laryngomalacia is ___ with inspiration because ___

Answer 13

Worse

Collapse of supraglottic structures

Question 14

Sudden loss of vision, onset of floaters, fundus hard to visualize in a diabetic

Answer 14

Vitreous hemorrhage

Question 15

Asthma, chronic sinusitis, nasal polyps, congestion following ingestion of aspirin or NSAIDs
What am I

Answer 15

Aspirin exacerbated resp disease

Question 16

Vulvar pain, malaise, dysuria, painful labial ulcers, inguinal lymphadenopathy, what am I

Answer 16

Genital herpes

Question 17

Symptom management in copd

Answer 17

Ipratropium (anti muscarinic, anti cholinergic) plus short acting beta agonist

Question 18

Transudative effusions are marked by ___ protein

Answer 18

Low (<3g/dL)

Question 19

In pulmonary fibrosis, total lung capacity is ___, functional residual capacity is ___, and residual volume is ___

Answer 19

Tlc is low
Frc is low
Residual capacity is low

Question 20

In pulmonary fibrosis, dlco is ___ and alveolar-arterial gradient is ___

Answer 20

Dlco is reduced

Alveolar-arterial gradient is high

Question 21

Progressive dyspnea and productive cough are more associated with copd or angina?

Answer 21

Copd

Question 22

Dead space ventilation refers to

Answer 22

Ventilation of areas of lung that are not perfused with blood (eg pe)

Question 23

Normal pleural fluid ph

Answer 23

7.6

Question 24

Normal pleural fluid ph in transudative pf

Answer 24

7.4-7.55

Question 25

Normal pleural fluid ph in exudative pleural fluid

Answer 25

7.3-7.45

Question 26

Pleural fluid ph <7.3 is usually due to

Answer 26

Empyema, pleuritis, pleural fibrosis

Question 27

Pulmonary arterial hypertension causes what heart exam findings?

Answer 27

Rv heave

Question 28

Dlco is asthma and chronic bronchitis

Answer 28

Normal

Question 29

Dlco in emphysema

Answer 29

Low