Pulmonary

Question 1

Criteria for exudative effusion

Answer 1

• Pleural/serum protein >0.5

- Pleural/serum LDH >0.6

Question 2

Causes of exudative effusion

Answer 2

Think of leaky capillaries: malignancy, TB, bacterial/viral infxn, pulmonary embolism (PE) with infarct, pancreatitis

Question 3

Causes of transudative effusion

Answer 3

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

Question 4

Normalizing PCO2 in a pt having an asthma exacerbation may indicate ____.

Answer 4

Fatigue and impending respiratory failure

Question 5

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

Answer 5

Sarcoidosis

Question 6

PFTs: decreased FEV1/FVC

Answer 6

Obstructive pulmonary dz (ex: asthma)

Question 7

PFTs: increased FEV1/FVC

Answer 7

Restrictive pulmonary dz

Question 8

Honeycomb pattern on CXR. Dx? Tx?

Answer 8

Diffuse interstitial pulmonary fibrosis

-Tx: supportive care, steroids may help

Question 9

Tx for SVC syndrome

Answer 9

Radiation

Question 10

Tx for mild, persistent asthma

Answer 10

Inhaled ß-agonists and inhaled corticosteroids

Question 11

Tx for COPD exacerbation

Answer 11

O2, bronchodilators, abx, corticosteroids with taper, smoking cessation

Question 12

Tx for chronic COPD

Answer 12

Smoking cessation, home O2, ß-agonists, anticholinergics, systemic or inhaled steroids, flu and pneumococcal vaxs

Question 13

Acid-base d/o in pulmonary embolism (PE)

Answer 13

Hypoxia and hypocarbia (respiratory alkalosis)

Question 14

NSCLC a/w hypercalcemia

Answer 14

SqCC

Question 15

Lung CA a/w SIADH

Answer 15

SmCLC

Question 16

Lung CA highly related to cigarette exposure

Answer 16

SmCLC

Question 17

Tall white M presents with acute SOB. Dx? Tx?

Answer 17

Spontaneous pneumothorax

-Tx: Spontaneous regression. Supplemental O2 may be helpful.

Question 18

Tx of tension pneumothorax

Answer 18

Immediate needle thoracostomy

Question 19

Characteristics favoring carcinoma in an isolated pulmonary nodule

Answer 19

> 45-50 yo, lesions new or larger than old films, no calcification or irregular calcification, size >2 cm, irregular margins

Question 20

Hypoxemia and pulmonary edema with nl pulmonary capillary wedge pressure (PCWP)

Answer 20

ARDS

Question 21

Sequelae of asbestos exposure

Answer 21

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

Question 22

Silicosis is a/w increased risk of what infxn?

Answer 22

Mycobacterium tuberculosis

Question 23

Causes of hypoxemia

Answer 23

R-to-L shunt, hypoventilation, low inspired O2 tension, diffusion defect, V/Q mismatch

Question 24

Classic CXR findings for pulmonary edema

Answer 24

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

Question 25

RFs for DVT

Answer 25

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