Pulm & Critical Care

Question 1

what are the spirometry findings for interstitial lung disease (fibrosis)?

Answer 1

• decreased total lung capacity <80% of predicted value
• FEV1 <80% of predicted value
• FVC <80% of predicted value
• FEV1/FVC ratio normal or increased >80% of predicted value

Question 2

what are the spirometry findings for obstructive lung disease?

Answer 2

• decreased FEV1 <80% of predicted value
• normal FVC >80% of predicted value
• decreased FEV1/FVC ratio <80% of predicted value

Question 3

what are the findings of TB exudative plerual effusions?

Answer 3

• very elevated protein (always >4g/dL)
• lymphocytic leukocytosis
• low glucose levels (<60mg/dL)

Question 4

define chronic bronchitis?

Answer 4

chronic productive cough for at least 3 months for 2 successive years

Question 5

pt with persistent cough and weight loss presents with hyponatremia. what is this?

Answer 5

paraneoplastic ADH from small cell carcinoma

Question 6

initial treatment for someone who is euvolemic hyponatremic with SIADH from cancer?

Answer 6

fluid restriction

Question 7

gold standard diagnosis for PE? what if they have renal dysfunction or contrast allergy?

Answer 7

CT pulmonary angiography; V/Q scan

Question 8

what are the signs and sx of PE?

Answer 8

dyspnea, pleuritic chest pain, tachypnea, tachycardia.

chest Xray may be normal or abnormal; not a good imaging study for PE

Question 9

enzyme protease responsible for destruction of the lung parenchyma that can lead to COPD

Answer 9

elastase

Question 10

chest x-ray finding in pt with centrilobular emphysema (COPD)?

Answer 10

hyperlucency at the lung apices (think smoke rises)

Question 11

chest x-ray finding in pt with panacinar emphysema (alpha-1-antitrypsin deficiency)?

Answer 11

hyperlucency at the lung bases