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Board review > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

Embolus that pass through interventricular or inter arterial defect

A

Paradoxical embolus

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2
Q

Common source of emboli

A

Deep calf vein

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3
Q

Common location of emboli infarction

A

Lower lobe

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4
Q

The great masquerader

A

Pulmo embolism

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5
Q

Most common history in pulmo embo

A

Unexplained breathlessness

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6
Q

Most common symptom pulmo embo

A

Dyspnea

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7
Q

Most common sign pulmo embo

A

Tachypnea

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8
Q

Most common history DVT

A

Cramp in lower leg for several days

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9
Q

ECG sign pulmo embo (2)

A

Tachy, S1Q3T3

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10
Q

Pulmo embo ECG common abnormality

A

T wave inversion V1-V4

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11
Q

Primary criterion for DVT

A

Loss of vein compressibility UTZ

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12
Q

Focal oligemia

A

Westermark’s sign

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13
Q

Peripheral wedge shaped density above diaphragm

A

Hampton’s hump

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14
Q

Enlarged right pulmo artery

A

Pall’s sign

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15
Q

Principal imaging for PE

A

Chest CT w/ Contrast

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16
Q

Second diagnostic test for PE

A

Lung scan

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17
Q

High probability lung scan

A

2 or more segmental perfusion defect

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18
Q

Large proximal PE diagnostic

A

MRI

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19
Q

Hypokinesis of RV free wall

A

McConnell’s sign

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20
Q

Definitive diagnosis of PE

A

Pulmo Angiography

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21
Q

Diagnostic test for suspected DVT

A

Contrast plebography

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22
Q

Direct thrombin inhibitor

A

Dabigatran

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23
Q

Embolus at main pulmo artery bifurcation

A

Saddle embolus

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24
Q

Accelerates activity of anti thrombin

A

Unfractioned Heparin

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25
Q

No monitoring or dose adjustment

A

Low molecular weight Heparin

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26
Q

Anti Xa pentasaccharide

A

Fondaparinux

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27
Q

Most common preventable death in hospitalized patients

A

Pulmo Embolism

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28
Q

Not associated with heparin induced thrombocytopenia

A

Fondaparinux

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29
Q

Monotherapy for symptomatic VTE patients with cancer

A

Dalteparin

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30
Q

Requires repeated dose adjustment

A

Unfractioned Heparin

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31
Q

Factor Xa inhibitor

A

Rivaroxaban

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34
Q

Most serious AE of anti coagulation

A

Hemorrhage

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35
Q

Antidote for hemorrhage induced by heparin

A

Protamine sulfate

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36
Q

Excessively high inr

A

Vit K

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37
Q

Renal insufficiency (anticoagulation)

A

Argatroban

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38
Q

Hepatic failure (anticoagulation)

A

Lepirudin

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39
Q

Indications for IVC filter (2)

A

Active bleeding

Recurrent Venous thrombosis

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40
Q

Complication of IVC filter

A

Caval thrombosis with bilateral leg swelling

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41
Q

Indication for PE fibrinolysis

A

Massive PE

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42
Q

Most common and important agent of human disease

A

M. Tuberculosis

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43
Q

Initial infection tubercle bacilli

A

Primary TB

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44
Q

Lesion after initial infection

A

Ghon focus

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45
Q

Lung areas in Primary TB

A

Middle and lower

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46
Q

Lung area secondary TB

A

Upper lobe

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47
Q

New culture positive TB case

A

2HRZE4HR

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48
Q

TB in Pregnancy

A

2HRE7HR

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49
Q

TB relapse

A

3HRZES5HRE

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50
Q

Resistance to isoniazid

A

6RZE

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51
Q

Resistance to Rifampicin

A

12-18HZEQ

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52
Q

Resistance to H+R

A

At least 20 months ZEQ+S

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53
Q

Intolerance to Pyrazinamide

A

2HRE7HR

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54
Q

Chronic inflammatory disease of the airway

A

Asthma

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55
Q

Largest risk factor for asthma

A

Atopy

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56
Q

Physiologic abnormality of asthma

A

Airway hyper responsiveness

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57
Q

Whorl like accumulation of epithelial cells

A

Curschmann’s spirals

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58
Q

Crystalloid of eosinophil derived protein

A

Charcot Leyden crystals

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59
Q

Most common stimuli asthma exacerbation

A

Infection

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60
Q

Stimuli that produce symptoms for weeks

A

Respiratory viruses

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61
Q

Triad of asthma

A

Dyspnea, cough, wheezing

62
Q

Test of compliance to therapy

A

Exhaled nitric oxide

63
Q

Confirms airflow limitation

A

Spirometry - reduced FEV1/FVC

64
Q

Inhibit smooth muscle contraction (3)

A

Beta agonist
Methylxanthine
Anticholinergic

65
Q

Symptom relief

A

Short acting beta agonist

66
Q

Relief of nocturnal exacerbation

A

Corticosteroids

67
Q

Side effect of B2 agonist

A

Muscle tremor and palpitations

67
Q

SABAs

A

Albuterol

Terbutaline

67
Q

LABA

A

Salmeterol

Formeterol

68
Q

Muscarinic receptor antagonist

A

Ipratropium

69
Q

SE of anticholinergic

A

Dry mouth
Urinary retention
Glaucoma

70
Q

Used with Inhaled Corticosteroids

A

LABAs

71
Q

Inhibits phosphodiesterase in airway smooth muscle cells

A

Theophylline

72
Q

Block cys-LT1 receptors

A

Antileukotrienes

73
Q

Cataract as SE

A

Systemic corticosteroids

74
Q

Childhood asthma

A

Cromones

75
Q

Reduce exacerbation of severe asthma

A

Anti - IgE (Omalizumab)

76
Q

Destruction and enlargement of alveoli

A

Emphysema

77
Q

Chronic cough & phlegm

A

Chronic bronchitis

78
Q

COPD Risk Factors (3)

A

Smoking
Airway responsiveness
Occupational exposure

79
Q

Genetic determinants Asthma and COPD

A

ADAM33

MMP12

80
Q

Significant risk factor emphysema both smoker and non smoker

A

Coal mine dust

81
Q

COPD susceptibility determinant

A

Hedgehog interacting protein (HHIP) in chromosome 4

82
Q

Typical finding COPD

A

Persistent reduction in forced expiratory flow

83
Q

Pink puffer

A

Emphysema

84
Q

Blue bloater

A

Chronic bronchitis

85
Q

COPD ABG

A

Hypercapnia

86
Q

COPD criteria for severity

A

Gold criteria

87
Q

Early alveolar edema and neutrophilic infiltration in ARDS

A

Exudative phase

88
Q

Interstitial inflammation

A

Proliferative

89
Q

Virchow’s triad

A

Venous stasis
Hypercoagulability
Vascular injury

90
Q

Most common inherited thrombophilia

A

Factor V Leiden deficiency

91
Q

Consequence of venous thromboembolism

A

Hypoxemia

Pulmo infarct

92
Q

Most common symptom in venous thromboembolism

A

Swelling, pain, erythema and warmth

93
Q

Gold standard diagnostic for DVT

A

Contrast Venography

94
Q

Prominent central artery

A

Fleischner sign

95
Q

Drug of choice for pulmo embolism (parenteral)

A

Unfractioned heparin

96
Q

Drug of choice for pulmo embo (oral)

A

Warfarin

97
Q

Property of acid fast of M. TB is due to

A

Mycolic acid

98
Q

Responsible for caseous necrosis in TB

A

Phosphatides

99
Q

Mode of transmission in TB

A

Droplet nuclei

100
Q

Most common symptom of TB

A

Unexplained weight loss

101
Q

Classic X-ray of TB

A

Upper lobe infiltrates with cavitation

102
Q

Gold standard for TB diagnosis

A

Culture

103
Q

Culture media for M. TB

A

Lowenstein-Jensen

Middle brook

104
Q

Hypersensitivity reaction in Extrinsic Asthma

A

Type 1 IgE mediated

105
Q

Most common trigger for extrinsic asthma

A

Atopy

106
Q

Most common trigger for intrinsic asthma

A

Respi infections

107
Q

Ciliated columnar cells sloughed off from bronchial linings

A

Creola bodies

108
Q

Severe airway obstruction persisting for days to weeks

A

Status Asthmaticus

109
Q

Reid Index

A

Chronic Bronchitis

110
Q

Hallmark of acute inflammation

A

Inc vascular permeability

111
Q

Increase size of bronchial mucous glands, squamous metaplasia of epithelium; dysplasia and bronchial narrowing from mucous plugging; fibrosis

A

Chronic bronchitis

112
Q

Hallmark of chronic inflammation

A

Fibrosis

113
Q

Alpha1 anti-trypsin deficiency

A

Emphysema

114
Q

Abnormal permanent enlargement of air spaces distal to terminal bronchioles with destruction of alveolar walls

A

Emphysema

115
Q

Most common type of emphysema in smokers

A

Centrilobar

116
Q

Type of emphysema associated with spontaneous pneumothorax

A

Paraseptal

117
Q

Emphysema associated with scarring

A

Irregular

118
Q

Cause of pneumothorax

A

Bleb

119
Q

Hallmark of COPD

A

Airway obstruction

120
Q

Treatment for COPD

A

Smoking cessation

121
Q

Target O2 sat for COPD

A

88-92%

122
Q

Sinusitis, bronchiectasis, situs inversus

A

Kartagener’s Syndrome

123
Q

Abnormal & irreversible dilation of the bronchial tree proximal to
terminal bronchioles

A

Bronchiectasis

124
Q

Prominent cystic spaces

A

Bronchiectasis

125
Q

Honeycomb lung

A

Bronchiectasis

126
Q

Lobe commonly involved in bronchiectasis

A

Bilateral lower lobes

127
Q

Patchy consolidation of lung

A

Bronchopneumonia

128
Q

Acute bacterial infection of a large portion of a lobe or an entire lobe

A

Lobar pneumonia

129
Q

Most common cause of atypical pneumonia

A

Mycoplasma

130
Q

Most common cause of lobar pneumonia

A

Strep pneumoniae

131
Q

Areas in the lung where bacteria can spread

A

Pores of Kohn

132
Q

Red vascular engorgement of lung with numerous bacteria

A

Congestion

133
Q

Exudation of RBC with liver-like consistency

A

Red Hepatization

134
Q

Disintegration of RBCs, fibrinosuppurative exudate

A

Gray hepatization

135
Q

Consolidated exudates within alveolar spaces

Organization and thickening

A

Resolution

136
Q

Pathognomonic for Staph aureus pneumonia

A

Pneumatocele

137
Q

Pneumatocele

A

PVL

Staph aureus

138
Q

PNA with Fleur de lis pattern

A

Pseudomonas pneumonia

139
Q

Walking pneumonia

A

Mycoplasma

140
Q

X-Ray looks worse than the patient

A

Mycoplasma PNA

141
Q

PNA associated with aircon

A

Legionella

142
Q

PNA with Hemolytic anemia

A

Mycoplasma

143
Q

Etiologic agent for SARS

A

SARS corona virus

144
Q

Enzyme that makes superbugs

A

New Delhi metallo-beta-lactamase 1

145
Q

Superbugs

A

E.coli

Kleibsiella

146
Q

Treatment for superbugs

A

Polymyxin

Tigecycline

147
Q

Most effective controller

A

Corticosteroids

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