Pulm Exam

Question 1

Atypical PNA in a 20 yo. Most likely organism?

Answer 1

Mycoplasma PNA

Question 2

Most common symptom of undiagnosed lung CA?

Answer 2

Cough

Question 3

US preventative criteria to screen for lung CA?

Answer 3

60 yo with a 30 yr pack history and a current smoker (or quit w/in last 15 yrs)

Question 4

Governing criteria for asthma severity?

Answer 4

Bronchospasm

Question 5

5yo w/ asthma using SABA every day, waking up every night and severe affect on daily activities. Put him on what?

Answer 5

LABA and oral steroid

Question 6

Old guy was treated for the flu. Now he’s back with signs of infection. What does he most likely have?

Answer 6

Secondary bacterial PNA

Question 7

Risk factor for HCAP?

Answer 7

Abx w/in past 90 days

Question 8

How do you treat a pt with PNA who has a history of heart Dz?

Answer 8

Beta-lactam and fluoroquinolone

Question 9

A CF pt has PNA. What is the most likely organism?

Answer 9

Pseudomonas

Question 10

What do you have to keep in mind when reading an AP view CXR?

Answer 10

Heart appears bigger than it is

Question 11

What is the advantage of a lateral view CXR?

Answer 11

See retrocardial space

Question 12

Explain the histology of idiopathic pulmonary fibrosis

Answer 12

Repeated damage from an unknown cause resulting in progressive scarring

Question 13

How do you treat a pt with a large pleural effusion?

Answer 13

Drain it

Question 14

An HIV pt presents with PNA symptoms. How do you treat them?

Answer 14

Bactrim

Question 15

How do you treat sarcoidosis?

Answer 15

Steroids

Question 16

What is a positive PPD reading?

Answer 16

Healthy pt, 20mm at 48 hrs and indurated

Question 17

How do you diagnose acute bronchitis?

Answer 17

Rapid influenza test

Question 18

What preventative measures do you do for a pt w/ pneumoconiosis?

Answer 18

Flu and PPV vaccines

Question 19

How do you assess lung function in an 8yo?

Answer 19

Spirometry (can’t do if < 4 yo)

Question 20

A pt presents with obstructive disease and a 60 yr pack history. What do you expect to see on spirometry?

Answer 20

Decreased FEV1/FVC ratio

Question 21

What doesn’t help with classifying or initiating treatment in asthma?

Answer 21

Smoking history

Question 22

How do you treat a child with RSV?

Answer 22

Send home w/ saline drops and O2

Question 23

How do you treat pleuritis?

Answer 23

NSAIDs

Question 24

What is the most likely cause of a low-protein pleural effusion?

Answer 24

Transudative pleural effusion d/t CHF

Question 25

How do you treat a tension PTX?

Answer 25

Immediate needle decompression

Question 26

What diagnostic test should you do if you have a pt with a family Hx of PEs?

Answer 26

Check factor V Leiden

Question 27

What diagnostic test should you perform for a patient with a family history of emphysema (no Hx of smoking)?

Answer 27

a-1 antitrypsin

Question 28

How do you diagnose a PE?

Answer 28

CT w/ contrast

Question 29

A 2 yo presents with a barking cough. Most likely diagnosis?

Answer 29

Croup

Question 30

How do you treat pertussis?

Answer 30

Macrolide

Question 31

What is the pathology causing a pt to have barrel chest?

Answer 31

Hyperinflation of lung tissue

Question 32

Classify the stage of COPD: FEV1/FVC is 55%.

Answer 32

Stage II (moderate)

Question 33

Mainstay Tx for COPD?

Answer 33

Bronchodilators

Question 34

Pt in LA presents with dyspnea. What should you ask?

Answer 34

Occupational Hx, exposure Hx, etc.

Question 35

What do you have to do before you can treat pulmonary HTN?

Answer 35

Right sided catheter

Question 36

What is the MC cause of cor pulmonale?

Answer 36

Pulmonary HTN

Question 37

What is the hallmark of sarcoidosis?

Answer 37

Non-caseating granulomas

Question 38

20 yo granite worker with difficulty breathing. What is the MC cause?

Answer 38

Silica

Question 39

Baby born at 26 weeks with difficulty breathing. What Tx should you initiate?

Answer 39

Immediate surfactant replacement therapy

Question 40

How do you test a child that you suspect has CF?

Answer 40

Sweat test

Question 41

What is inadequate expansion of air spaces which results in inadequately oxygenated blood (hypoxia)?

Answer 41

Atelectasis

Question 42

What doesn't assess ventilation?

Answer 42

Pulse ox

Question 43

What is the etiology of CF?

Answer 43

Distrupted CFTR gene

Question 44

What helps with CF?

Answer 44

Directed cough, exercise, PEP mask

Question 45

How do you treat a pt with a PE?

Answer 45

Heparin