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AANP Exam > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

Pertussis treatment

A

Macrolide- azythromycin

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2
Q

Older adults with CAP, sicker- what pathogen? How would you treat?

A

Strep pneumo
B-lactam ie amoxicillin or doxycycline

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3
Q

Younger patients with community acquired pneumo- what pathogen and how to treat?

A

-Atypical pathogens ie. mycoplasma pneumo or chlamydiphilia pneumo
- macrolide ie. azythromycin or doxy

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4
Q

Patients with CAP and other comorbid conditions- what pathogen?
Treatement?
If pregnant or CI?

A

Drug resistant strep pneumo
Resp quinalone- ie. moxi/levofloxacin
Preg- macrolide + beta lactam ie. azythromycin + amoxicillin

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5
Q

Three meds used to treat CAP

A

Macrolide- azythromycin
Resp qinalones- moxi/levo
Beta lactams- amoxicillin +/- clav

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6
Q

Diagnostic criteria COPD spiro?

A

FEV1/FVC <0.7

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7
Q

Stages of COPD

A

4 stages

1- FEV1 > 80%
4- FEV1 < 30%

4 = worst

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8
Q

SABA onset and duration

A

Onset 10 mins- duration 4-6h

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9
Q

LABA onset and duration

A

10-20 mins
Last 12h

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10
Q

Steroid treatment of COPD exacerbation

A

Prednisone 40mg PO OD x 5 d

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11
Q

Side effects of anti cholinergics saying-

A

Oh this drug it makes me pink
Sometimes I can’t think, or even blink
I can’t see
I can’t pee
I can’t spit
I can’t shit

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12
Q

What COPD meds do you avoid in ppl with BPH

A

Antocholinergics ie SAMA/ LAMA

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13
Q

Long term side effects of inhaled steroids x2

A

Increased risk of cataracts - annual eye exams
Increased r/o Osteopenia

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14
Q

Normal upper and lower lobe breathe sounds

A

Upper- vesicular- soft and low
Lower- bronchial- louder

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15
Q

Name the condition-
Increased breathe sounds
Increased tactile Fremitus
Percussion- dull

A

Consolidation ie. lobar pneumonia

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16
Q

Name the condition-
Decreased/ absent breathe sounds
Decreased tactile fremitus
Percussion- dull

A

Pleural effusion
Mediastinal shift away from effusion (if large)

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17
Q

Name the condition-
Decreased or absent breathe sounds
Decreased tact frem.
Hyper resonance- percuss

A

Pneumothorax
Mediastinal shift aware from the tension pneumo

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18
Q

Name the condition-
Decreased or absent breathe sounds
Decreased tat frem.
Dullness on percuss

A

Atelectasis ie. mucus plugging
Mediastinal shift towards the atelctasis.

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19
Q

Who qualifies for lung cancer screening?
What is the screening test?

A

Low dose CT of chest.

Ppl aged 50-80
> / = 20 pack year history and current smoker/ quit within 15 yrs

Stop screening if have quit for >15 yrs

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20
Q

Chronic bronchitis definition

A

Coughing with excessive mucus for > 3 months for 2 consecutive yrs

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21
Q

Treatment step wise approach for COPD x 4

A

SABA +/- SAMA prn
LAMA
LAMA + LABA
LAMA + LABA + ICS

22
Q

Albuterol med class

A

SABA

23
Q

Salmetrol med class

A

LABA

24
Q

Formoterol Med Class

A

LABA

25
Q

Levalbuterol med class

A

SABA

26
Q

Vilanterol med class

A

LABA

27
Q

Ipratropium med class

A

SAMA

28
Q

Tiotropium med class

A

LAMA

29
Q

Umeclidinium pwder med class

A

LAMA

30
Q

COPD pt failing on SABA- what do you add?

A

SAMA

31
Q

COPD pt failing on SABA + SAMA- what’s next?

A

LABA or LAMA
Then combo them for next step
Keep PRN SABA

32
Q

Rescue med inhaler class?

A

SABA

33
Q

Gold standard definitive test for CAP?

A

X-ray- repeat in 6 weeks to document clearing

34
Q

If treating a pt with CAP who has antibiotics within last 3 months- treat with what?

A

Doxycycline or levofloxacin

35
Q

Young person with CAP- treatment?

A

Think atypical pathogen
and treat with azythromycin or doxycycline

36
Q

Older person with CAP- treatment?

A

Think S.Pneumo - treat with beta-lactam or doxycycline

37
Q

If DRSP CAP is suspected- treatment is?

A

Resp Quinalonee ie. moxifloxi or levofloxi

38
Q

CURB 65 ?

A

Confusion
BUN elevated
Resp > 30
BP <90/60
65 yrs or older
Score >1 == hospitalize

39
Q

Top 2 bacteria in CAP

A

S. Pneumo
H. Influenza

40
Q

2 Top bacteria in Atypical Pneumonia

A

Mycoplasma pneumo
Chlamydia pneumo

41
Q

Suspect pertussis after pt experiences what?

A

Coughing for >2-3 weeks
Or failed on abx and is getting worse

42
Q

Duration and treatment of common cold?

A

Duration of symptoms 4-10 days
Treatment is supportive care

43
Q

CXR shows cavitations and adenopathy and granule as in the hill of the lungs—-?

A

Reactive TB

44
Q

Present in younger children and elderly
-milia seed on CXR

A

Military TB

45
Q

Quad therapy- rifampin + ethambutol + pyrazinamide + INH
Treatment of what disease?
How long for?

A

TB
2 months of intensive treatment
18 weeks continuation phase treatment

46
Q

Positive PPD TB test

A

< 10mm
Induration at site

47
Q

ICS + LABA Combo names x 2

A

Advair- fluticasone + salmeterol

Symbicourt- budesonide + formoterol

48
Q

Step 3 Asthma criteria
Treatment-

A

FEV1 60-80%
Nightly awakenings 1/wk (not nightly)
Tx- low-dose ICS + LABA

49
Q

1st line treatment for severe asthma exacerbation

A

Epinephrine injection

50
Q

Two medications that cause interstitial lung disease

A

Amiodarone and methotrexate

AANP Exam (11 decks)

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