Pulmonary

Question 1

In an adult male, the ETT should be advanced to:

Answer 1

22-24 cm

Question 2

In an adult female, the ETT should be advanced to:

Answer 2

21-23 cm

Question 3

Pulsus paradoxus is defined as:

Answer 3

Fall in systemic BP greater than 10 mm HG upon inspiration

Question 4

T/F: Pulsus paradoxus can be seen in severe asthma exacerbations

Answer 4

True

Question 5

What drug is most beneficial in an acute COPD exacerbation?

Answer 5

Beta adrenergic agonists such as albuterol

Question 6

Risk factors for developing S. Pneumoniae pneumonia (8):

Answer 6

>65;
Alcoholism;
Diabetes;
CAD;
Splenectomy;
Sickle Cell;
Malignancy;
Immunosuppressive disorders

Question 7

Common patients for Varicella zoster penumonia:

Answer 7

Smokers;

Pregnant

Question 8

Frequent complications of Klebsielle pneumonia:

Answer 8

Empyema
Bacteremia
Abscess formation

Question 9

Currant-jelly sputum;

dx?

Answer 9

Klebsiella pneumonia

Question 10

Most common pathogens to generate cavitary lesions in the lung:

Answer 10

TB;
Anaerobic bacteria (aspiration pneumonia);
aerobic gram negative bacilli;
Staph aureus;
Fungal disease

Question 11

CHF findings in CXR

Answer 11

Diffuse pattern of edema

Question 12

Hypotension and JVD suggest

Answer 12

Obstructive shock

Question 13

More likely site of aspiration

Answer 13

Right mainstem bronchus

Question 14

CXR sings of aspiration of food

Answer 14

Hyperinflation or atelectasis of affected lung

Question 15

Virchow’s triad:

Answer 15

Venous stasis;
Endothelial injury;
Hypercoagulability

Question 16

Cancers with low PE risk

Answer 16

Leukemia

Esophageal and laryngeal cancer

Question 17

Cancers with high PE risk

Answer 17

Ovarian

Colon

Question 18

Development of PE without underlying RFs warrants:

Answer 18

Search for underlying malignancy

Question 19

Autopsy studies indicate what percentage of patients with ovarian cancer have PE?

Answer 19

25%

Question 20

Most common findings on EKG of patients with PE:

Answer 20

Tachycardia;

Nonspecific ST segment and T-wave abnormalities

Question 21

Diffuse PR depression is typically seen in:

Answer 21

Pericarditis

Question 22

S1Q3T3 pattern:

Answer 22

Suggestive but not diagnostic of PE;

A in lead I, Q and T inverted in lead III

Question 23

Pneumonia organizm commonly associated with bullous myringitis:

Answer 23

Mycoplasma pneumoniae

Question 24

RFs for Klebsiella pneumonia

Answer 24

Elderly
Smokers
Alcoholics
Co-morbidities

Question 25

CXR finding in Klebsiella pneumonia:

Answer 25

Bulging fissure (usually of minor fissure) from heavy exudate

Question 26

Relative bradycardia can be seen in what pneumonia?

Answer 26

Legionella

Question 27

Tx for pertussis

Answer 27

Macrolide ie z pack | Bactrim in macrolide allergy

Question 28

Postexposure protocol for people exposed to pertussis in close contact, with full immunization

Answer 28

Postexposure prophylaxis with an appropriate macrolide (e.g., azithromycin) is indicated for any individual who has been exposed to a person with pertussis via face-to-face contact within four feet, enclosed in a room for an hour, had physical contact with secretions, or any close contact (e.g., household member or healthcare worker)

Question 29

What is the classic triad of tension pneumothorax?

Answer 29

Hypotension, Absent breath sounds on one side, JVD

Question 30

Vent failure pneumonic

Answer 30

``` DOPE Displacement Obstruction PTX Equipment failure ```

Question 31

O2 % RA

Answer 31

21%

Question 32

O2 % NC

Answer 32

28%

Question 33

O2% NRB

Answer 33

60-70%

Question 34

Acutely, for every 10 change in pCO2, there will be what change in pH?

Answer 34

0.08

Question 35

CXR in Klebsiella PNA

Answer 35

Right upper lobe predominance with "bulging fissure" often complicated by empyema

Question 36

Pancreatitis is associated with what kind of PNA?

Answer 36

Legionella

Question 37

CXR in Legionella PNA

Answer 37

Patchy infiltrate and hilar adenopathy

Question 38

Staccato cough, what PNA?

Answer 38

Chlamydia

Question 39

Lab test most sensitive for PJP PNA?

Answer 39

LDH > 220

Question 40

When to give steroids in PJP PNA

Answer 40

pO2 <70 mmHg or A-a gradient > 35

Question 41

Definition of empyema

Answer 41

Infiltrate crossing a fissure line

Question 42

Antibiotic treatment for PCP PNA

Answer 42

Bactrim

Question 43

Lung pathology in a pt drunk with dental disease and air-fluid level

Answer 43

Abscess

Question 44

PNA in Missouri basin

Answer 44

Blastomycosis

Question 45

PNA in auto mechanic who works with brake line

Answer 45

Asbestos

Question 46

PNA in farmer who works in a silo

Answer 46

Hypersensitivity pneumonitis

Question 47

Primary TB occurs in the

Answer 47

Lower lobes

Question 48

Reactivation TB occurs in the

Answer 48

Upper lobes

Question 49

Positive PPD in HIV/immunocompromised

Answer 49

5 mm

Question 50

Treatment for latent TB

Answer 50

INH for 9 months

Question 51

TB treatment causing orange tears/urine

Answer 51

Rifampin

Question 52

TB treatment causing neuropathy

Answer 52

INH

Question 53

Treat INH-induced seizures with

Answer 53

Pyridoxine

Question 54

TB treatment causing optic neuritis

Answer 54

Ethambutol

Question 55

TB treatment do not use in pregnancy

Answer 55

Streptomycin

Question 56

Upper limit to drain pleural effusion, to prevent re-expansion pulmonary edema

Answer 56

1-1.5L

Question 57

Catamenial PTX is associated with

Answer 57

Menstruation

Question 58

Rate of resolution of PTX

Answer 58

1.25% per day

Question 59

Only FDA approved medication for hiccups

Answer 59

Thorazine (chlorpromazine)

Question 60

The 5 Ts of mediastinal disease

Answer 60

``` Thymoma Thyroid Teratoma T cell lymphoma Terrible carcinoma ```

Question 61

Ventilator, initial mode of choice for respiratory fatigue

Answer 61

Assist control

Question 62

When to use SIMV

Answer 62

When weaning from AC to PS

Question 63

PS requires

Answer 63

A spontanesouly breathing patient