Pulmonary

Question 1

MCC atypical Pneumonia

Answer 1

Mycoplasma

Question 2

MCC Pneumonia in alcoholics

Answer 2

Klebsiella

Question 3

MCC interstitial Pneumonia in bird handlers

Answer 3

Chlamydia pscitissi

Question 4

MCC Pneumonia in pts exposed to bats

Answer 4

Histoplasma capsulatum

Question 5

MCC Pneumonia in pt that has recently traveled to New Mexico /Arizona

Answer 5

Coccidiomycosis

Question 6

What organism is associated with current jelly sputum

Answer 6

Klebsiella

Question 7

Organism responsible for Q fever in livestock handlers

Answer 7

Coxiella burnetti

Question 8

Pneumonia associated with air conditioners

Answer 8

Legionella

Question 9

MCC pneumonia in kids

Answer 9

RSV

Question 10

MCC pneumonia in neonates

Answer 10

GBS and E. Coli

Question 11

MCC pneumonia in kids and young adults

Answer 11

Mycoplasma

Question 12

MCC of pneumonia in pts with other health problems

Answer 12

Klebsiella

Question 13

MCC viral Pneumonia

Answer 13

RSV and influenza

Question 14

Organism responsible for wool sorters disease

Answer 14

Bacillus anthracis

Question 15

Common organism responsible for COPD exacerbation

Answer 15

H. Influenza

Question 16

MCC Pneumonia in ventilated pt and in cystic fibrosis

Answer 16

Pseudomonas

Question 17

Organism responsible for Pontiac fever

Answer 17

Legionella

Question 18

Pneumonia with: gram positive cocci in clusters

Answer 18

Staph aureus

Question 19

Pneumonia with: gram positive cocci in pairs

Answer 19

Strep pneumo

Question 20

Pneumonia with: gram negative rods in 80 year old

Answer 20

E.coli

Question 21

Pneumonia with: gram positive cocci in neonates

Answer 21

GBS

Question 22

Pneumonia with: gram negative rods in neonates

Answer 22

E.coli

Question 23

In a patients with pulmonary edema how can a cardiogenic cause be differentiated from ARDS?

Answer 23

PCWP measure via Swan-Ganz catheter. Cardiogenic cause with have elevated PCWP , while in ARDS it will be 18 or lower.

Question 24

Diagnostic characteristics of ARDS

Answer 24

PCWP

Question 25

What should you do if you see bilateral lobar pneumonia ?

Answer 25

Hospitalize because these patients have a high likelihood of de compensating even of they look alright

Question 26

Substances to avoid in central apnea patients

Answer 26

Anything that acts as a sedative or decreases respiratory drive: alcohol, opioids, anti-histamines

Question 27

Shortly after birth a child has stridor, wheezing and shortness of breath despite medical treatment, what is the most likely diagnosis

Answer 27

Vascular ring compressing upper airway and trachea; clue here is that it continues despite medical treatment

Question 28

What is a diagnostic result of pilocarpine sweat chloride tests for cystic fibrosis

Answer 28

A result of >60 mEq

Question 29

MCC of epiglottis and treatment

Answer 29

H. Influenza type b, this is a pediatric emergency. Children should be intubated in OR with anxiety decreased and holding off on examining throat as this can cause spasm. Abx ceftriaxone for 7-10 days

Question 30

MCC croup and treatment

Answer 30

Usually caused by Parainfluenza virus and RSV. Treat with steroids if mild, add racemic epinephrine if severe. Administer humidified oxygen.

Question 31

Causes of transudative pleural effusion

Answer 31

Transudative means low protein, mostly water. Caused by heart failure, cirrhosis and nephrotic syndrome renal failure

Question 32

What is xray finding of steeple sign due to?

Answer 32

Croup

Question 33

What is the chest xray finding of the thumb-print sign?

Answer 33

Epiglottis

Question 34

What is the L:S ratio obtained from amniocentesis that indicates high risk of respiratory distress syndrome and normal fetal lung maturity?

Answer 34

2 means mature fetal lungs

Question 35

Dx and Management of Trauma patient is respiratory distress with pleural effusion on cheat xray

Answer 35

Most likely Dx is hemothorax since trauma, chest tube for drainage is indicated

Question 36

What size pneumothorax requires chest tube placement?

Answer 36

If greater than 15%

Question 37

What medication should be used before intubation of a he injury patient?

Answer 37

Lidocaine

Question 38

What is there treatment for RSV bronchiolitis?

Answer 38

Oxygen, racemic epinephrine and albuterol neb; steroid are not indicated here

Question 39

What is the most common finding of PE on EKG? What is the "classic" finding on EKG?

Answer 39

Most common is sinus tachycardia. | Classic is S1Q3T3; wide s lead I, wide Q and inverted T on lead III

Question 40

MCC Pneumonia in immunocompromised pts

Answer 40

PCP

Question 41

List one toxicity/association for each of the four TB drugs (RIPE)

Answer 41

Rifampin- red body secretions Isoniazid- peripheral neuropathy that can be treated with pyridoxine (B6) Pyrazinamide- hyperurecemia Ethambutol- optic neuritis with color changes

Question 42

What is the treatment protocol for active TB

Answer 42

6 months of treatment total 2 months with full RIPE last 4 months with rifampin and isoniazid

Question 43

Cases in which TB treatment protocol is extended to 9 months

Answer 43

Bone involvement (osteomyelitis) Military TB meningitis Pregnancy

Question 44

What is the diagnostic criteria doe ARDS?

Answer 44

pO2/FIO2 ratio of

Question 45

What is the best support/treatment of ARDS?

Answer 45

Low tidal volume mechanical ventilation to allow lungs to recover - 6mL per kg of tidal volume - PEEP is used to try to decrease FIO2