Pulm Exam Flashcards
Atypical PNA in a 20 yo. Most likely organism?
Mycoplasma PNA
Most common symptom of undiagnosed lung CA?
Cough
US preventative criteria to screen for lung CA?
60 yo with a 30 yr pack history and a current smoker (or quit w/in last 15 yrs)
Governing criteria for asthma severity?
Bronchospasm
5yo w/ asthma using SABA every day, waking up every night and severe affect on daily activities. Put him on what?
LABA and oral steroid
Old guy was treated for the flu. Now he’s back with signs of infection. What does he most likely have?
Secondary bacterial PNA
Risk factor for HCAP?
Abx w/in past 90 days
How do you treat a pt with PNA who has a history of heart Dz?
Beta-lactam and fluoroquinolone
A CF pt has PNA. What is the most likely organism?
Pseudomonas
What do you have to keep in mind when reading an AP view CXR?
Heart appears bigger than it is
What is the advantage of a lateral view CXR?
See retrocardial space
Explain the histology of idiopathic pulmonary fibrosis
Repeated damage from an unknown cause resulting in progressive scarring
How do you treat a pt with a large pleural effusion?
Drain it
An HIV pt presents with PNA symptoms. How do you treat them?
Bactrim
How do you treat sarcoidosis?
Steroids
What is a positive PPD reading?
Healthy pt, 20mm at 48 hrs and indurated
How do you diagnose acute bronchitis?
Rapid influenza test
What preventative measures do you do for a pt w/ pneumoconiosis?
Flu and PPV vaccines
How do you assess lung function in an 8yo?
Spirometry (can’t do if < 4 yo)
A pt presents with obstructive disease and a 60 yr pack history. What do you expect to see on spirometry?
Decreased FEV1/FVC ratio
What doesn’t help with classifying or initiating treatment in asthma?
Smoking history
How do you treat a child with RSV?
Send home w/ saline drops and O2
How do you treat pleuritis?
NSAIDs
What is the most likely cause of a low-protein pleural effusion?
Transudative pleural effusion d/t CHF
How do you treat a tension PTX?
Immediate needle decompression
What diagnostic test should you do if you have a pt with a family Hx of PEs?
Check factor V Leiden
What diagnostic test should you perform for a patient with a family history of emphysema (no Hx of smoking)?
a-1 antitrypsin
How do you diagnose a PE?
CT w/ contrast
A 2 yo presents with a barking cough. Most likely diagnosis?
Croup
How do you treat pertussis?
Macrolide
What is the pathology causing a pt to have barrel chest?
Hyperinflation of lung tissue
Classify the stage of COPD: FEV1/FVC is 55%.
Stage II (moderate)
Mainstay Tx for COPD?
Bronchodilators
Pt in LA presents with dyspnea. What should you ask?
Occupational Hx, exposure Hx, etc.
What do you have to do before you can treat pulmonary HTN?
Right sided catheter
What is the MC cause of cor pulmonale?
Pulmonary HTN
What is the hallmark of sarcoidosis?
Non-caseating granulomas
20 yo granite worker with difficulty breathing. What is the MC cause?
Silica
Baby born at 26 weeks with difficulty breathing. What Tx should you initiate?
Immediate surfactant replacement therapy
How do you test a child that you suspect has CF?
Sweat test
What is inadequate expansion of air spaces which results in inadequately oxygenated blood (hypoxia)?
Atelectasis
What doesn’t assess ventilation?
Pulse ox
What is the etiology of CF?
Distrupted CFTR gene
What helps with CF?
Directed cough, exercise, PEP mask
How do you treat a pt with a PE?
Heparin
