Pulm Qs Flashcards
radiation pneumonitis present with? when? CT shows?
cough and/or dyspnea approximately 6 weeks after the exposure. CT imaging typically shows hazy opacities with ground-glass attenuation.
idiopathic pulmonary fibrosis - CT findings? PE findings?
Notable missing feature?
bilateral peripheral and lower lobe–predominant interstitial thickening with honeycombing
Clubbing
not associated with mediastinal and hilar lymphadenopathy.
Lambert-Eaton myasthenic syndrome has a strong association with this cancer?
SCLC
Small cell lung cancer typically presents on imaging as?
a large hilar mass with bulky mediastinal lymphadenopathy.
Absolute contraindications to lung transplantation?
malignancy within the last 2 years, HBV/HCV with histologic evidence of significant liver damage, active or recent smoking, drug or alcohol abuse, severe psychiatric illness, documented nonadherence with medical care, and absence of social support.
Mild persistant asthma? recommended treatment options?
more than 2 days per week but not daily with an FEV1 of greater than or equal to 80% of predicted.
A leukotriene agonist or low-dose inhaled glucocorticoid
Chronic eosinophilic pneumonia is associated with? improve with?
peripheral and upper lobe–predominant areas of consolidation
Steroids
Vocal Cord Dysfunction - gold standard for diagnosis? Treatment?
laryngoscopy
speech pathology
Omalizumab is indicated in patients with?
moderate to severe persistent asthma +
(1) symptoms inadequately controlled with inhaled glucocorticoids,
(2) evidence of allergies to perennial aeroallergens, and
(3) serum IgE levels between 30 and 700
Next step in a patient with cough or unexplained dyspnea but with normal spirometry?
bronchial challenge testing (such as with methacholine)
When is in-flight supplemental oxygen is usually recommended?
O2 sat<92
out-of-center sleep testing is appropriate for?
high pretest probability of uncomplicated moderate to severe obstructive sleep apnea (ie NOT for patients with HF, pulm disease, or cenral sleep apnea)
Breakdown product effects of methanol? ethylene glycol?
Formic acid, which is toxic to the retina of the eye
oxalic acid, which crystalizes in renal tubules and causes kidney injury
hen suspicion for pleural malignancy is high but pleural fluid cytology is negative?
repeat fluid cytology
preferred and most sensitive diagnostic imaging study for chronic thromboembolic pulmonary hypertension?
VQ scanning
CCBs are beneficial in PAH only if? Otherwise, use?
positive vasoreactivity test
phosphodiesterase-5 inhibitors (sildenafil, tadalafil) or endothelin receptor antagonists (bosentan, ambrisentan)
Anticentromere antibody is associated with?
limited cutaneous systemic sclerosis and the risk of developing pulmonary hypertension.
characteristic of severe tricyclic antidepressant overdose?
progressive somnolence, hypotension, widening of the QRS interval, seizure, and anticholinergic signs (fever, tachycardia, mydriasis, reduced bowel sounds)
Why not use this med to treat Aortic dissection?
Hydral - increase aortic wall shear stress and are more difficult to use in predictably controlling blood pressure
Non-pulmonary findings in cystic fibrosis?
recurrent pancreatitis, male infertility
Burkholderia cepacia - think>
sputum culture in cystic fibrosis
timecourse for radiation pneumonitis v radiation fibrosis?
<3 months after treatment
v occurs 6 to 24 months after
Lymphangioleiomyomatosis - affects (molecullarly)? What develops in the lungs? Presentation?
Molecular marker?
Treatment?
mTOR
thin-walled cysts
Pneumothorax
elevated levels of vascular endothelial growth factor-D (VEGF-D)
Sirolimus
When should PCV13 be given before PPSV23?
functional or anatomic asplenia, cochlear implants, persistent cerebrospinal fluid leak, and significant immunocompromising conditions.
Treatment of high-altitude pulmonary edema?
adjunctive treatment?
supplemental oxygen, rest, and consideration of descent from altitude
vasodilators such as nifedipine
