Pulm

Question 1

Lung CA screening

(a) Age cutoff
(b) Amount of smoking cutoff

Answer 1

Low-dose CT chest for lung CA screening

(a) 55-74 (to 80 by other guidelines) every year
(b) in ppl who have smoked more than 30 pack years and currently smoke or quit w/in 15 years

Question 2

Mechanism by which supplemental O2 in COPD reduces mortality

Answer 2

By reducing risk of R heart failure (cor pulmonale)

Question 3

Lofgren Syndrome

Answer 3

Lofgren Sydnrome = specific presentation of Sarcoidosis

• erythema nodosum
• hilar adenopathy
• migratory polyarthralgia
• fever

Question 4

ABG cutoff numbers for permissive hypercapnia in ARDS

Answer 4

Permissive hypercapnia

pH 7.3 - 7.45
pO2 55-80
peak pressures under 30

Question 5

What has mortality benefit in ARDS?

Answer 5

Mortality benefit

1. 6 cc/kg
2. Proning
3. Neuromuscular blockade

No mortality benefit

• alveolar recruitment maneuvers
• IV glucocorticoids
• inhaled NO

Question 6

TRALI

(a) Mechanism
(b) Highest risk with what products

Answer 6

Transfusion-related lung injury

a) Neutrophil mediated cytokine reaction
(b) FFP and platelets (higher than RBCs

Question 7

Timecourse for TRALI

Answer 7

Typically b/l infiltrates w/in 4 hrs of transfusion of products

Question 8

Ideal location for CVL placement

Answer 8

R IJ (right internal jugular)
Lowest rate PTX
Slightly higher rate of infection and arterial puncture than subclavian

Question 9

CXR findings expected in alpha-1 antitrypsin

Answer 9

Blackening of lower lobes = lower lobe predominant emphysema

Question 10

Age of onset- pulmonary symptoms in alpha-1 antitrypsin

Answer 10

Typically in 40s, but earlier in smokers