Pulmonary

Question 1

Risk factors for DVT

Answer 1

Stasis, endothelial injury, and hypercoagulability (Virchow’s triad)

Question 2

Criteria for exudative effusion

Answer 2

Pleural/serum protein >0.5; pleural/serum LDH >0.6

Question 3

Causes of exudative effusion

Answer 3

Think of leaky capillaries. Malignancy, TB, bacterial or viral infection, PE w/ infarct, and pancreatitis.

Question 4

Causes of transudative effusion

Answer 4

Think of intact capillaries. CHF, liver or kidney dz, and protein-losing enteropathy.

Question 5

Normalizing PCO2 in a patient having an asthma exacerbation may indicate?

Answer 5

Fatigue and impending respiratory failure

Question 6

Sarcoidosis

Answer 6

Dyspnea, lateral hilar lymphadenopathy on CXR, noncaseating granulomas, increased ACE, and hypercalcemia

Question 7

PFTs of obstructive pulmonary dz

Answer 7

Decreased FEV1/FVC

Question 8

PFTs of restrictive pulmonary dz

Answer 8

Increased FEV1/FVC. Decreased TLC.

Question 9

Honeycomb pattern on CXR. Tx?

Answer 9

Diffuse interstitial pulmonary fibrosis. Supportive care; steroids may help

Question 10

Treatment for SVC syndrome

Answer 10

Radiation

Question 11

Treatment for mild persistent asthma

Answer 11

Inhaled B-agonists and inhaled corticosteroids

Question 12

Treatment for COPD exacerbation

Answer 12

O2, bronchodilators, abx, corticosteroids w/ taper, smoking cessation.

Question 13

Treatment for Chronic COPD

Answer 13

Smoking cessation, home O2, B-agonits, anticholinergics, systemic or inhaled corticosteroids, flu, and pneumococcal vaccines

Question 14

Acid-base disorder in PE

Answer 14

Respiratory alkalosis w/ hypoxia and hypocarbia

Question 15

Non-small cell lung cancer (NSCLC) a/w hypercalcemia

Answer 15

Squamous cell carcinoma

Question 16

Lung cancer a/w SIADH

Answer 16

Small cell lung cancer (SCLC)

Question 17

Lung cancer highly related to cigarette exposure

Answer 17

SCLC

Question 18

A tall Caucasian man presents w/ acute SOB. Dx? Tx?

Answer 18

Spontaneous pneumothorax. Spontaneous regression; supplemental O2 may be helpful.

Question 19

Tx for tension pneumothorax

Answer 19

Immediate needle thoracostomy

Question 20

Characteristics favoring carcinoma in an isolated pulmonary nodule

Answer 20

Age > 45-50; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins

Question 21

ARDS

Answer 21

Hypoxemia and pulmonary edema w/ normal pulmonary capillary wedge pressure (PCWP)

Question 22

Sequelae of asbestos exposure

Answer 22

Pulmonary fibrosis, pleural plaques, bronchogenic carcinoma (mass in lung field), mesothelioma (pleural mass)

Question 23

Increased risk of what infection w/ silicosis?

Answer 23

Mycobacterium tuberculosis

Question 24

Causes of hypoxemia

Answer 24

Right-to-left shunt, hypoventilation, low inspired O2, tension, diffusion deffect, V/Q mismatch

Question 25

Classic CXR findings for pulmonary edema

Answer 25

Cardiomegaly, prominent pulmonary vessels, Kerley B lines, “bat’s-wing” appearance of hilar shadows, and perivascular and peribronchial cuffing

Question 26

Westermark’s sign and Hamptom’s hump

Answer 26

CXR findings suggestive of PE