Pulm reverse

Question 1

Kussmaul breathing - DKA, metabolic acidosis

Answer 1

Rapid, deep labored breathing

Question 2

Cheyne-stokes breathing - heart failure, brain damage

Answer 2

Deep breathing alternating with apnea

Question 3

Pneumonia, heart failure, etc.

Answer 3

crackles or rales

Question 4

TB

Answer 4

Apical infiltrates, F, C, dry cough

Question 5

Silicosis (sandblasters)

Answer 5

Eggshell pattern on CXR

Question 6

DVT/PE

Answer 6

Dyspnea after surgery, travel (airplane), LE Fx. May have c/o calf pain also

Question 7

DVT/PE (Virchow’s triad)

Answer 7

Venous stasis, vessel wall injury, hypercoagulability

Question 8

Viral croup (laryngotracheobronchitis); Tx w/ racemic epi and glucocorticosteroids if stridor at rest

Answer 8

pediatric with barking cough, stridor

Question 9

Epiglottitis

Answer 9

drooling, sniffing position, tripod, toxic

Question 10

FB, viral croup
(laryngotrachobronchitis)

Answer 10

Inspiratory stridor

Question 11

Bronchitis (COPD)

Answer 11

Smoker, chronic productive cough. No hemoptysis, wt. loss

Question 12

COPD

Answer 12

smoker, DOE, cough

Question 13

Emphysema

Answer 13

Hyperinflation on CXR, tear drop heart

Question 14

Asthma

Answer 14

Airway edema with eosinophils, neutrophils, lymphocytes

Question 15

Pneumonia

Answer 15

Fever, cough, sputum. Crackles, decreased breath sounds, dullness to percussion, +egophony, pectoriloquy. CXR - infiltrates or consolidation

Question 16

Strep. pneumonia

Answer 16

> 35 yo with PNA. Rusty colored or yellow-green sputum. Acute onset F/C

Question 17

Mycoplasma pneumonia

Answer 17

<35 yo, college students. Fever, cough, +/- sputum, chills, muscle aches

Question 18

Klebsiella

Answer 18

PNA with DM, immunocompromised, EtOH. Currant color sputum

Question 19

Legionella

Answer 19

PNA w/ water, late summer, construction site. Diarrhea, toxic looking

Question 20

Cystic fibrosis (staph and pseudomonal infections usually cause of death)

Answer 20

Pediatric with hx recurrent lung infections, pancreatitis, reproductive problems, FTT

Question 21

Cystic fibrosis

Answer 21

sweat chloride test

Question 22

Atelectasis

Answer 22

< 2 days post-op with fever

Question 23

Pneumothorax

Answer 23

Stab wound, hyperresonance to percussion, decreased breath sounds, tympany

Question 24

Hemothorax

Answer 24

Stab wound, dullness to percussion, decreased breath sounds.

Question 25

Spontaneous PTX

Answer 25

Tall, skinny, male, band student, acute onset one-sided chest pain, dyspnea

Question 26

Tension PTX

Answer 26

Stab wound to chest. hypotension, tracheal shift

Question 27

Obstructive sleep apnea

Answer 27

Poor sleeping, obese, daytime fatigue and drowsy, snoring, HTN, PM wakening

Question 28

Flail chest (pain control, incentive spirometry, pulmonary toilet, intubation)

Answer 28

S/p thoracic trauma. multiple rib fractures. Chest wall moves in with inspiration, out with expiration

Question 29

Ptosis, miosis, anhidrosis
Pancoast tumor - apex of lung

Answer 29

Horner’s syndrome

Question 30

Pulmonary emboli

Answer 30

EKG S1Q3T3

Question 31

Obstructive lung disease

Answer 31

FEV1 less than 80% suggests

Question 32

Exudative vs transudative

Answer 32

types of pleural effusions

Question 33

Neoplastic, infection

Answer 33

Exudative pleural effusion

Question 34

CHF, cirrhosis

Answer 34

transudative pleural effusion

Question 35

Pectus excavatum

Answer 35

Funnel chest

Question 36

Left tension pneumothorax

Answer 36

Hypotension, JVD, tracheal shift to the right

Question 37

TB

Answer 37

fever, night sweats, wt loss with cough, pleuritic chest pain, hemoptysis

Question 38

Fat emboli

Answer 38

emboli seen following long bone fracture

Question 39

Asbestosis (shipbuilders, building demolition)

Answer 39

Ground glass appearance on CXR