Pulm

Question 1

MC pathogen to cause pneumonia in alcoholics

Answer 1

Klebsiella pneum

Question 2

MC pathogen to cause pneumonia in COPD

Answer 2

Haemophilus pneumo

Question 3

MC pathogen to cause pneumonia in CF

Answer 3

pseudomonas

Question 4

MC pathogen to cause pneumonia in young athletes, college

Answer 4

Mycoplasma pneumo

Chlamydia pneumo

Question 5

MC pathogen to cause pneumonia in AC/aerosolized water

Answer 5

Legionella pneumo

Question 6

MC pathogen to cause pneumonia in postsplenectomy

Answer 6

Encapsulated organisms
Strep pneumo
Haemophilus pneumo

Question 7

MC pathogen to cause pneumonia in leukemia, lymphoma

Answer 7

fungus

Question 8

MC pathogen to cause pneumonia in children <1 y

Answer 8

RSV

Question 9

MC pathogen to cause pneumonia in <2 y

Answer 9

Parainfluenza virus

Question 10

Acute bronchitis etiology

Answer 10

MC = viral & after URI (Adenovirus, influenza, parainfluenza, coronavirus, rhinovirus, coxsackie, RSV)

Bacterial → S. pneumo, H. influenzae, M. catarrhalis, Mycoplasma

Question 11

Acute bronchitis tx

Answer 11

Symptomatic = ToC (MC viral)

Fluids, Rest, Antipyretic/pain reliever (acetaminophen)

Productive cough → cough expectorant (Guaifenesin- Mucinex)

Non-productive cough → cough suppressants in adults (Dextromethorphan - Robitussin/DayQuil)

+/- Bronchodilators (Albuterol)

Question 12

tram track

Answer 12

bronchiectasis

Question 13

MC cause of bronchiectasis

Answer 13

CF (usu d/t pseudomonas)

Question 14

bronchiectasis tx

Answer 14

ABXs
Pseudomonas (CF) → Fluoroquinolone, Zosyn, Aminoglycoside, Cephalosporin
Aspergillus → CCS + Itraconazole
MAC → Clarithromycin + Ethambutol

↓ inflammation → Bronchodilators (Beta agonists, Anticholinergics), Inhaled Steroids (Fluticasone)

Improve Bronchial Hygiene → Chest Physiotherapy

Severe/complicated cases → surgery (resection/transplant)

Question 15

MC site of carcinoid tumors

Answer 15

GI tract

2nd MC =lungs

Question 16

Carcinoid tumor tx

Answer 16

Definitive = Surg excision (often resis to radiation & chemo)
↓ Sxs/secretion of hormones→ Octreotide

Question 17

MC chronic cause of Cor pulmonale

MC acute cause

Answer 17

chronic-COPD

acute-PE

Question 18

Peaked P waves

Answer 18

cor pulmonale

Question 19

honeycombing and ground glass opacities

Answer 19

Idiopathic Pulmonary Fibrosis

Question 20

Idiopathic Pulmonary Fibrosis tx

Answer 20

lung transplant is only cute

somking cessation + corticosteroids for exacerbations

Question 21

coal workers

Answer 21

Pneumoconiosis

Question 22

MC org Typical PNA

Answer 22

s. pnuemo

Question 23

MC org Atypical PNA

Answer 23

mycoplasma pneumo

Question 24

MC org Hosp acquired PNA

Answer 24

pseudomonas, MRSA

Question 25

MC org aspiration PNA

Answer 25

Strep, staph, anaerobes

Question 26

currant jelly sputum

Answer 26

klebsiella

Question 27

rusty blood tinged sputum

Answer 27

strep pneumo

Question 28

green sputum

Answer 28

pseudomonas

Question 29

CAP tx

Answer 29

macrolides outpt

inpt or underlying chronic dz fluoroquin or B lactam + macrolide

Question 30

Atypical CAP tx

Answer 30

M. pneumo and Legionella → erythromycin or doxy

Viral → supportive tx

Chlamydia → tetracycline

Question 31

hosp acq PNA tx

Answer 31

Antipseudomonal β-lactam + antipseudomonal FQ

Suspect MRSA: Add Vanco or Linezolid

Suspect Legionella: Add Levofloxacin or Azithromycin

Suspect PJP: Add Bactrim +/- corticosteroids

Question 32

asp PNA tx

Answer 32

Clindamycin or Amoxicillin/clavulanic acid

Question 33

MC cause of PNA in adults

Answer 33

influenz

Question 34

MC cause of PNA in infants/children

Answer 34

RSV

Question 35

bird/bat droppings

Answer 35

Histoplasma

Question 36

Define Pulmonary HTN

Answer 36

Mean pulmonary arterial press ≥ 25 at rest or 30 mmHg w/exercise

Question 37

Pulmonary HTN tx

Answer 37

Primary → Vasoreactivity trial w/ inhaled NO, IV Adenosine or CCB
Vasoreactive: CCBs = 1st line

Definitive = Heart-lung transplant

Secondary → Tx underlying dz (Type III → O2 ↓ mortality; Type IV → anticoagulation = 1st line)

Question 38

Small, round/coin/oval shaped, well circumscribed lesion < 3 cm (mass: > 3 cm)

Answer 38

Pulmonary Nodules

Question 39

Pulmonary Neoplasms + gynecomastia

Answer 39

adenocarcinoma

Question 40

Pulmonary Neoplasms + cavitary lesions, hypercalcemia and pancoast syn

Answer 40

SCC

Question 41

Pulmonary Neoplasms + SIADH/hyponat, cushings, lambert-eation

Answer 41

Small/Oat cell

Question 42

Horner’s Syn

Answer 42

Mitosis, Ptosis, Anhydrosis d/t cervical cranial symp paralysis)

Question 43

Trousseau’s Syn

Answer 43

Venous thrombosis a/w metastatic CA

Question 44

Lambert-Eaton Syn

Answer 44

Abs vs Ca gated chan at NMJ → weakness like MG (but improves w/use)

Question 45

Upper Lung Fibrosis locations

Answer 45

“CHARTS”

CWP, Histiocytosis/HSN Pneumonitis, Ankylosing Spondylitis, Radiation, TB, Silicosis

Question 46

Lower Lung Fibrosis locations

Answer 46

“I SOAR”

IPF (Idiopathic Pulm Fibrosis), Systemic Sclerosis, Others (drug induced), Asbestosis, RA

Question 47

non-caseating granuloma

Answer 47

Sarcoidosis

Question 48

Sarcoidosis tx

Answer 48

Observation→ most have spontaneous remission in 2 years
Oral corticosteroids
MTX
Hydroxychloroquine

Question 49

bilat hilar lymphadenopathy + noncaseating granulomas

Answer 49

sarcoidosis

Question 50

CAP CURB-65

Answer 50

Confusion
Urea >7 mmol/L
RR >30
B SBP <90 or DBP <60
Age >65

1 pt for each 3 or more admit to ICU, 2 prob admit vs out pt, 1 or less outpt

Question 51

airway dilation ang thickening

tram track

Answer 51

bronchiectasis

Question 52

honeycombing of lung parenchyma

Answer 52

idiopathic pulm fibrosis