Pulminology Flashcards
What are the main side effects of isoniazid?
Hepatitis and peripheral neuropathy
What two lung cancers are typically found centrally on CXR?
Small cell lung cancer and squamous cell
What is the treatment for epiglottitis?
2nd or 3rd generation cephalosporins (Ceftriaxone). Erythromycin is another possible choice.
What is the best test to diagnose bronchiectasis?
CT
If you see a question with an alcoholic with pneumonia be sure to conider this organism?
Klebsiella pneumoniae
Ghon or Ranke complexes on CXR should make you think of what diagnosis?
TB
What is the initial treatment for active TB?
INH+RIF+PZA+EMB x 2 months followed by INH+RIF x 4 months
A thin looking heart and flattened diaphragm on CXR should make you think of what diagnosis?
Emphysema
Caseating granulomas should make you think of what diagnosis?
TB
List 4 medications which may cause asthma.
Beta blockers, NSAIDS, ACEI, ASA
Honeycombing and tram tracks on the CXR should make you think of what diagnosis?
Bronchiectasis and idopathic Pulmonary fibrosis
At what size induration would a PPD be positive for an HIV patient?
5mm
What is the gold standard for the diagnosis of cystic fibrosis?
Sweat chloride test
Will evidence of TB be seen more frequently in the upper or lower lung lobes on CXR?
Upper
Paradoxical pulses may be found in what pulmonary disorder?
Asthma
A noncaseating granuloma should make you think of what diagnosis?
Sarcoidosis
Parenchymal metastasis and blebs on CXR should make you think of what diagnosis?
Emphysema
Hampton’s hump on CXR should make you think of what diagnosis?
Pulmonary embolism
What two lung cancers are typically found diagonsison CXR?
Adenocarcinoma and Large cell
When you step up the diagnosis from intermittent asthma to mild persistent asthma what medication should you add?
An inhaled steroid like fluticasone
What occupations are associated with berylliosis?
Aerospace and nuclear plant workers
A pearl formation on CXR should make you think of what diagnosis?
Squamous cell lung cancer
Nodular opacities in the upper lung fields should make you think of what diagnosis?
Silicosis
How long after administering a PPD should it be read?
48-72hrs
A barrel chest should make you think of what diagnosis?
Emphysema
When performing a decompression for a tension pneumothorax where do you put the needle?
2nd intercostal space at the midclavicular line
Hyperinflation on a CXR as well as eosinophilia on CBC should make you think of what diagnosis?
Asthma
What is erythema nodosum?
Tender red nodules usually found on the shins
A very sick patient with diffuse infiltrates that spare the costophrenic angles should make you think of what diagnosis?
ARDS
Does FEV1 go up or down with asthma?
It goes down
Eggshell opacities on the CXR should make you think of what diagnosis?
silicosis
Currant jelly sputum should make you think of what diagnosis?
Klebsiella pneumoniae
A college students presents with pneumonia. What two organisms should you be thining of?
Chlamydia and Mycoplasma
Are the lungs noisy or quiet in COPD?
Quite
Post tussive rales should make you think of what diagnosis?
TB
What are the three most common cancers to metastasize to the lungs?
Breast, Liver, colon
List the three most commonly used medical treatments for COPD?
Oxygen, ipratropium, albuterol
Oseltamivir (Tamiflu) may be given to children above what age?
1 year old
Does total lung capacity go up or down in COPD?
It goes up
Any question about rabbits and pneumonia should make you think of what diagnosis?
Tularemia
If you come across a question where the patient has erythema nodosum and an enlarged parotid gland what diagnosis should you be thinking of?
Sarcoidosis
Zanamivir (Relenza) may be give to children above what age?
7 years old
A patient administering spleen is no longer working is more susceptible to what type of organisms?
Encapsulated organisms most commonly Strep pneumoniae and H. Flu
List the four most common places for metastasis from lung cancer?
Bone, brain, adrenals, liver
A contralateral mediastinal shift should make you think of what diagnosis?
Tension pneumothorax
What CXR finding might make you think of berylliosis?
Diffuse infiltrates with hilar adenopathy
What CXR finding might make you think of mesothelioma?
Pleural thickening. Remember 80% are found in the pleura lining
Young child presents to ER and you see him in tripod position. What diagnosis should you be thinking of?
Epiglottitis
An older patient presents with pneumonia and diarrhea. What diagnosis should you be thinking of?
Legionella pneumonia
What is the most common organism causing pneumonia in COPD patients?
Haemophilus influenzae
At what age should vaccinations for pneumococcal pneumonia begin?
65 years old
What is the most common cause of pneumonia in child less than 1 year old?
RSV
What is the most common cause of pneumonia in a patient with cystic fibrosis?
Pseudomonas
What happens to total lung capacity in sarcoidosis?
It goes down
What is the gold standard for diagnosis of a pleural effusion?
Thoracocentesis
Patient has pneumonia with rust colored sputum. What diagnosis should you be thinking of?
Strep pneumonia
Ethambutol has what two major side effects?
Optic neuritis, red green vision loss
HIV patient with ground glass appearance on CXR should make you think of what diagnosis?
PCP now known as pneumocystis jiroveci
You are treating a patient for TB. He has noticed that his body fluids now have an orange tint. What drug is most likely causing this?
Rifampin
What is the most common cause of bronchiectasis?
Cystic Fibrosis
What will the likely findings be on a CXR of a patient with asbestosis?
Linear opacities at the bases with pleural plaques
Pertussis is most commonly treated with what antibiotic?
Erythromycin
A Westermark sign on CXR should make you think of what diagnosis?
Pulmonary embolism
Blue bloater refers to the physical exam findings of what disease?
Chronic bronchitis
What is the most common patient complaint with emphysema?
Shortness of breath
If you see a question with anything to do with rats and the patient has pneumonia what organism should you be thinking of?
Yersinia pestis
List four indications for the flu vaccine.
Child 6-59 months, pregnant female, healthcare worker, older than 50
Coal miners lung often shows nodular opacities in what lung fields?
Upper lung fields
At what size induration would a PPD be positive for a healthcare worker?
10mm
What is the most common location of Pott’s disease?
Pott’s disease is TB outside of the lung which is most commonly found in the thoracic spine
What is the treatment for PCP?
Bactrim
List six extrapulmonary complications of lung cancer.
SPHERE - SVC syndrome, Pancoast tumor, Horner’s syndrome, Endocrine problems, Recurrent laryngeal symptoms, Effusions (exudative)
If you suspect a pneumothorax how should you order the CXR?
End expiratory CXR looking for visceral pleural air
Transudative pleural effusions should make you think of what diagnosis?
CHF
Mesothelioma is most commonly found in what lung location?
80% are found in the pleural lining
Thumbprint sign on x-ray should make you think of what two diagnoses?
Lateral C-spine = epiglottitis, abdominal = intestinal ischemia
An exudative pleural effusion should make you think of what diagnosis?
TB, Lung cancer
Where is a Pancoast tumor found on chest x-ray?
At the apex of either the right or left lung
Prolonged expiration (low FEV1) should make you think of what diagnosis?
Asthma or COPD
