Pulm

Question 1

CHF, cirrhosis, nephrotic syndrome cause this type of pleural effusion

Answer 1

Transudative

Question 2

Local infx/ inflammation causes this type of pleural effusion

Answer 2

Exudative

Question 3

Lights criteria for exudative pleural effusion:

Answer 3

Pleural fluid protein : serum protein > 0.5

Pleural fluid LDH : serum LDH > 0.6

Or

Pleural fluid LDH > 2/3 the upper limit of normal LDH

Question 4

Other findings with exudative effusion:

Answer 4

Glucose < 60
Protein >3
WBC < 1000
LDH > 200

Question 5

Findings with transudative effusion :

Answer 5

Glucose > 60
Protein < 3
WBC < 1000
LDH < 200

Question 6

MC sx of pleural effusion
What do you hear on heart/lung PE
What do you see on XR

Answer 6

Pleuritic CP
Dec breath sounds, dull to percussion, friction rub
+ menisci, blunting of costophrenic angles

Question 7

Best XR for pleural effusion

Answer 7

Lat decubitus

Question 8

Gold standard tx for pleural effusion

Answer 8

Thoracentesis

Question 9

Where do you place a chest tube

Answer 9

2nd ICS at MCL

Question 10

Typical pneumonia organisms X4

Answer 10

S pneumo
H inf
Klebsiella
S aureus

Question 11

Atypical pneumonia organisms X4

Answer 11

Mycoplasma (assoc w ear infx)
Chlamydia
Legionella
Viral

Question 12

Rusty blood sputum

Answer 12

S pneumo

Question 13

Currant jelly sputum

Answer 13

Klebsiella

Question 14

Green sputum

Answer 14

H inf, pseudomonas

Question 15

Foul sputum

Answer 15

Anaerobes

Question 16

Outpatient tx of CAP

Answer 16

Macrolide or doxy

Question 17

Inpatient tx of CAP

Answer 17

Macrolide or doxy
+
B-lactam

OR

FQ

Question 18

ICU tx of CAP

Answer 18

Macrolide
+
B-lactam

OR

Macrolide
+
FQ

Question 19

5 Blactams with pseudomonal coverage (*use if hospital acquired pneumonia)

Answer 19

Cefepime
Imipenem 
Meropenem 
Piper/tazo 
Piperacillin

Question 20

2 other classes for pseudo tx?

Answer 20

FQ

AG

Question 21

How to treat aspiration pneumonia

Think: anaerobes usually

Answer 21

Clinda or augmentin

+- flagyl

Question 22

TB treatment course in depth

Answer 22

4 drugs x 2 months
Then
2 drugs x 4 months

RIF + INH + PZA + ETH/STM
then
RIF + INH

Question 23

Decreased platelets
Orange secretions
S/E of

Answer 23

Rifampin

Question 24

Hepatitis, neuropathy

S/e of

Answer 24

Isoniazid

Question 25

What vitamin do you give with isoniazid

Answer 25

B6

Question 26

Hepatitis, gout, GI sx, sun rash

S/e of

Answer 26

Pyrazinamide

Question 27

Optic neuritis

S/e of

Answer 27

Ethambutol

Question 28

Ototoxic
Nephrotoxic
S/e of

Answer 28

Streptomycin

Question 29

What is the tx for latent TB

Answer 29

INH + PZA x 9-12 mos

Question 30

What sort of a patient would you treat for latent TB

Answer 30

No sx
PPD+
CXR -

Question 31

TB skin test mm with no risks

Answer 31

15mm

Question 32

PPD is >5mm induration. In what populations is that +

Answer 32

HIV+
Recent contact with TB
Evidence of TB on cxr
Immunecompromised on steroids

Question 33

> 10mm PPD is positive with??

Answer 33

Immigrants
IVDU
Lab personnel/HCP
Group settings/prisons
Certain med conditions or <4yo