Pulmo, Harrison

Question 1

Condition in which venous thrombi dislodge from their site of formation and emboli to pulmonary arterial circulation

Answer 1

PE

Question 2

PE in the setting of normal right heart function and normal systemic arterial pressure

Answer 2

Small to moderate PE

Question 3

PE in the setting of RV hypokinesis but normal systemic arterial pressure

Answer 3

Moderate to large PE

Question 4

PE in the setting of arterial hypotension and anatomically widespread TE

Answer 4

Massive PE

Question 5

PE: Gender predominance

Answer 5

F

Question 6

PE: Acquired risk factor that has a greater risk of fatal PE

Answer 6

Cancer

Question 7

PE: Non-DVT specific risk factor that has a greater risk of fatal PE

Answer 7

Cerebrovascular disease

Question 8

50% of DVT is due to (2)

Answer 8

1) Pelvic vein thrombosis

2) Proximal leg DVT

Question 9

Vein thrombi that poses a lower risk of PE

Answer 9

Isolated calf vein thrombi

Question 10

PE: First step in outpatient or ER setting with non-high clinical likelihood

Answer 10

D-dimer

Question 11

PE: Elevated D-dimer, next step is

Answer 11

Imaging

Question 12

PE: First step for inpatients or with high likelihood

Answer 12

1) Chest CT with contrast

2) Lung scan if with renal insufficiency or renal contrast allergy

Question 13

COPD: Major risk factor

Answer 13

Cigarette smoking

Question 14

COPD, normal vs slightly reduced, vs markedly reduced levels of α1 antitrypsin: M allele

Answer 14

Normal

Question 15

COPD, normal vs slightly reduced, vs markedly reduced levels of α1 antitrypsin: S allele

Answer 15

Slightly reduced

Question 16

COPD, normal vs slightly reduced, vs markedly reduced levels of α1 antitrypsin: Z allele

Answer 16

Markedly reduced

Question 17

COPD, normal vs slightly reduced, vs markedly reduced levels of α1 antitrypsin: Null allele

Answer 17

Absence

Question 18

COPD: Most common cause of exacerbation

Answer 18

Viral infections

Question 19

3 most common symptoms of COPD

Answer 19

1) Cough
2) Sputum production
3) Exertional dyspnea, frequently of long duration

Question 20

COPD: Pursed lip breathing

Answer 20

Emphysema

Question 21

Tripod position is in order to

Answer 21

Facilitate actions of SCM, scalene, and intercostal muscles

Question 22

Sign associated with paradoxical breathing

Answer 22

Hoover sign (inward movement of rib cage)

Question 23

Signs of cor pulmonale (6)

Answer 23

1) Peripheral edema
2) Ascites
3) Hepatic congestion
4) Elevated JVP
5) RV heave
6) 3rd heart sound

Question 24

T/F Chronic bronchitis without chronic airflow obstruction is not COPD

Answer 24

T

Question 25

T/F Asthma patients can also develop chronic (not fully reversible) airflow obstruction

Answer 25

T

Question 26

T/F Clubbing of fingers is not a sign of COPD

Answer 26

T

Question 27

In patients with COPD, newly developed clubbing is most likely explained by

Answer 27

Lung CA

Question 28

Hospitalization in COPD is recommended for (4)

Answer 28

1) Respiratory acidosis and hypercarbia
2) Significant hypoxemia
3) Severe underlying disease
4) Living situation not conducive to careful observation and delivery of prescribed treatment

Question 29

2 interventions demonstrated to influence the natural history of COPD

Answer 29

1) Smoking cessation

2) O2 therapy

Question 30

The only therapy demonstrated to decrease mortality in COPD

Answer 30

Supplemental O2

Question 31

COPD: Arterial pH allows classification of ventilatory failure, which is defined as

Answer 31

pCO2 >45mmHg

Question 32

Principal determinant of morbidity in COPD

Answer 32

Degree of airway obstruction

Question 33

COPD: Patients who continue to smoke cigarettes experience an annual decline in FEV1 of

Answer 33

80-100mL

Question 34

COPD: Patients who quit smoking experience an annual decrease inFEC1 of

Answer 34

30mL

Question 35

COPD: Median survival for severe disease

Answer 35

4 years

Question 36

COPD: Severe disease is defined as

Answer 36

FEV1 less than 1L