Pulmo. Hemoptysis + clubbing + nitrofurantoin 10-28 (1)

Question 1

Hemoptysis. Pulmonary? 3

Answer 1

bronchitis
lung cancer
bronchiectasis

Question 2

Hemoptysis. cardiac? 2

Answer 2

mitral stenosis
acute pulmonary edema (nu jie abu kinda susije)

Question 3

Hemoptysis. infectious? 4

Answer 3

TBC
lung abscess
bacterial pneumonia
aspergillosis

Question 4

Hemoptysis. hematologic? 1

Answer 4

coagulopathy

Question 5

Hemoptysis. vascular? 2

Answer 5

PE
arteriovenous malformation

Question 6

Hemoptysis. systemic? 2

Answer 6

Granulomatosis with polyangiitis

Goodpasture syndrome

Question 7

Hemoptysis. other? 2

Answer 7

Trauma
Cocaine use (inhalation)

Question 8

Nitrofurantoin. what injury short term?

Answer 8

Acute hypersensitivity pneumonitis

Question 9

Nitrofurantoin. what injury long term?

Answer 9

Interstitial lung disease

Question 10

Nitrofurantoin. du komponentai (gal tokie kaip simptomai sakyciau) kurie define pulmonary injury

Answer 10

Lung findings + eosinophilia after 3-9 days of nitrofurantoin

Question 11

Nitrofurantoin. ACUTE DISEASE.
when occurs?

Answer 11

3-9 days after medication initiation

Question 12

Nitrofurantoin. ACUTE DISEASE.
labs?

Answer 12

EOSINOPHILIA
leukocytosis

Question 12

Nitrofurantoin. ACUTE DISEASE. examination?

Answer 12

wet, basilar crackles
erythematous, maculopapular rash

Question 13

Nitrofurantoin. ACUTE DISEASE.
imaging?

Answer 13

bilateral, basilar reticular opacities
Pleural effusions can also occur, but are unilateral

Question 14

Nitrofurantoin. ACUTE DISEASE. treatment?

Answer 14

cessation of nitrofurantoin. improvement occurs within 1-2days of cessation

Question 15

Clubbing. definition.

Answer 15

Clubbing is bulbous enlargement and broadening of the fingertips due to connective tissue proliferation at the nail bed and distal phalanx.

Question 16

Clubbing. angle?

Answer 16

Angle between nail fold and nail plate >180 degree (Lovibond angle).

normal angle 160

Question 17

Clubbing. pathophysiology?

Answer 17

● Pathophysiology: megakaryocytes that skip the normal route of fragmentation within pulmonary circulation to enter systemic circulation. Megakaryocytes become entrapped in the distal fingertips due to their large size and release PDGF and VEGF. PDGF and VEGF stimulate connective tissue hypertrophy and capillary permeability
and vascularity.

Question 18

Clubbing. assoc conditions. intrathoracic neoplasms?

Answer 18

Bronchogenic carcinoma
Metastatic cancers
Mezothelioma
Lymphoma

Question 19

Clubbing. assoc conditions. intrathoracic suppurative diseases?

Answer 19

Lung abscess
empyema
bronchiectasis
CF
chronic cavitary infections (funal, mycobacteria)

Question 20

Clubbing. assoc conditions. lung disease?

Answer 20

idiopathic pulmonary fibrosis
asbestosis
pulmonary arterio-venous malformation

Question 21

Clubbing. assoc conditions. cardiovascular?

Answer 21

cyanotic congenital heart disease

Question 22

Clubbing. the most common secondary causes? 3

Answer 22

lung malignancies
CF
right-to-left cardiac shunts

Question 23

Clubbing. presentation joints?

Answer 23

It can occur by itself or associated with hypertrophic osteoarthropathy, which presents with:
i. Painful joint enlargement
ii. Periostosis of long bones
iii. Synovial effusions