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, pulmonary emoblism (PE) with infarct, and pancreatitis

Question 4

Causes of transudative effusion

Answer 4

Think of intact capillaries. CHF, liver or kidney disease, 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

Treatment for acute asthma exacerbations.

Answer 6

Beta2-agonists and corticosteroids.

Question 7

Sarcoidosis

Answer 7

Dyspnea, lateral hilar lymphadenopathy on CXR, noncaseating granulomas, increase angiotensin converting enzyme, and hypercalcemia.

Question 8

PFTs of obstructive pulmonary disease

Answer 8

Decreased FEV1/FVC

Question 9

PFTs of restrictive pulmonary disease

Answer 9

Increased FEV1/FVC, decreased TLC

Question 10

Honeycomb pattern on CXR. Treatment?

Answer 10

Diffuse interstitial fibrosis. Supportive care, antifibrotic agents may help.

Question 11

Treatment for SVC syndrome

Answer 11

Radiation

Question 12

Treatment for mild persistant asthma

Answer 12

Inhaled beta-agonists and inhaled corticosteroids

Question 13

Treatment for COPD exacerbation

Answer 13

O2, bronhodilators, corticosteroids with taper, antibiotics, smoking cessation

Question 14

Treatment for chronic COPD

Answer 14

Smoking cessation, home O2, beta-agonists, anticholinergics, systemic or inhaled corticosteroids, flu and pneumococcal vaccines

Question 15

Acid-base disorder in PE

Answer 15

Respiratory alkalosis with hypoxia and hypocarbia

Question 16

Lung cancer associated with hypercalcemia

Answer 16

Squamous cell carcinoma

Question 17

Lung cancer associated with SIADH

Answer 17

Small cell lung cancer

Question 18

Lung cancer associated with Lambert Eaton syndrome

Answer 18

Small cell lung cancer

Question 19

Lung cancers highly related to cigarette exposure

Answer 19

Small cell and squamous cell

Question 20

A tall Caucasian man presents with acute shortness of breath. Diagnosis? Treatment?

Answer 20

Spontaneous pneumothorax. Treatment: will spontaneously regress, supplemental oxygen may be helpful

Question 21

Treatment of tension pneumothorax

Answer 21

Immediate needle thoracostomy

Question 22

Characteristics favoring carcinoma in an isolated pulmonary nodule

Answer 22

Age >45-50.
Tobacco use.
Size >2 cm
Lesions new or larger in comparison to old films.
Absence of calcification or calcification that is irregular
Irregular margins

Question 23

ARDS

Answer 23

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

Question 24

Sequelae of asbestos exposure

Answer 24

Pulmonary fibrosis
Pleural plaques
Broncochenic carcinoma (mass in lung field)
Mesothelioma (pleural mass)

Question 25

Increased risk of what infection with silicosis?

Answer 25

Tuberculosis

Question 26

Causes of hypoxemia

Answer 26

Hypoventilation
Right-to-left shunt
Diffusion defects
V/Q mismatch
Low inspired oxygen tension.

Question 27

Classic CXR findings for pulmonary edema

Answer 27

Cardiomegaly
Prominent pulmonary vessels
Kerley B lines
"Bat's-wing" appearance of hilar shadows
Perivascular and peribronchial cuffing

Question 28

CXR findings suggestive of PE

Answer 28

Westermark sign and Hampton hump