Pulmonary Flashcards

1
Q

silhouette sign

A

peumonia

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2
Q

If lungs appear white on CXR

A

pneumonia
TB
mass
pleural effusion

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3
Q

If lungs appear black on CXR

A

pneumothorax

PE

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4
Q

IMaging of choice for lung after CXR

A

CT

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5
Q

H1 blockers

A

loratadine
diphenhydramine
cyproheptadine

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6
Q

alpha 1 agonist used for bronchodilation in asthma, nasal congestion

A

ephedrine

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7
Q

used in prophylaxis only for bronchial asthma

A

cromolyn sodium

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8
Q

rescue inhalers vs maintenance inhalers

A

rescue: sympathomimetics: epi, albuteroal, metoproterenol
maintenence: steroids (fluticasone), advair

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9
Q

chronic cough

A

> 8 weeks

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10
Q

three most common causes of chronic cough in non-smokers, not on ACEi

A

postnasal drip
asthma
GERD

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11
Q

what is a methacholine challenge used for

A

to diagnose asthma

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12
Q

wheezing, dyspnea, cough, nocturnal sx

A

asthma

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13
Q

DDX asthma

A
CHF
PE
GE reflux
aspiration
upper airway obstruction (tumor, etc)
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14
Q

decreased breath sounds with hyperresonance to percussion, shift of mediastinal structures on CXR

A

pneumothorax

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15
Q

absent lung sounds, dullness to percussion, mediastinal deviation toward affected side

A

atelectasis

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16
Q

most common pathogens for acute bronchitis

A

s. pneumonia
H. flu
morexella catarrhalis
*klebsiella in alcoholics

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17
Q

lung condition caused by pigeon droppings

A

cryptococcal pneumonia

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18
Q

lung condition found in midwest (Ohio and Mississippi River Vally), Ontario, and Quebec, and south central US, Midwest
atypical pneumonia sx with patchy infiltrates
flu like sx
calcifications in 75%

A

histoplasmosis

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19
Q

East of Mississippi River!
soil fungus found in eastern and mid-western US
hemoptysis, cough, wt loss, pleurisy, flu-like

A

blastomycosis

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20
Q
valley fever 
san joaquin vally
texas, s ca, south america
fever, malaise, dry cough, chest pain, anorexia
can see fine rash or erythema nodosum
A

coccidiomycosis

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21
Q

chronic obstructive lung disease

A

airflow limitation from obstruction
overinflation of lungs
difficulty blowing air out

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22
Q

restrictive (interstitial) lung disease

A

infiltration of inflammation and scarring of lung parenchyma
lung fibrosis
smaller lung volume
difficulty getting air in

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23
Q

lower respiratory disease

A

bronchitis

emphysema

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24
Q
pink puffer
normal CO2
permanent dilation of alveolar walls
barrel chest
pursed lips
A

emphysema

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25
Q
blue bloater
increased pCO2
persistent cough with sputum > 2years
obese
cor pulmonale
A

Chronic bronchitis

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26
Q

If pH and PCO2 move in same direction

A

metabolic acidosis or alkalosis

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27
Q

If pH and PCO2 move in opposite directions

A

respiratory acidosis/alkalosis

28
Q

tx for COPD

A

bronchodilators
O2
glucocorticoids

29
Q
sudden onset dyspnea
chest pain (pleuritic)
hypoxemia
recent surgery
normal CXR
A

PE

30
Q

tx for PE

A

anticoagulation

31
Q

widespread white patches on CXR
dry cough for several weeks
fever
small airway pbstruction

A

cryptogenic organizing pneumonia (idiopathic bronchiolitis obliterans)

32
Q
noncaseating granulomas
loss of lung function
20-40 yr 
CXR bilateral hilar infiltrate
restrictive pattern on PFT
A

sarcoidosis

33
Q

chronic scaring of lung that obliterates small airways

can be acute following viral illness or seen in RA or organ transplant

A

bronchiolitis obliterans

34
Q
autoimmune disorder of basement membrane
hemoptysis
dyspnea
cough
hypoxemia
bilateral alveolar infiltrate
iron def anemia
Dx based on igG deposits
A

Goodpastures

35
Q
rare disorder causing inflammation of blood vessels in upper resp tract
arthritis
eyes effected
\+ANCA
preceded by sinusitis or ear infections
A

Wegeners granulomatosis

36
Q

Tiotropium

A

Bronchodilator indicated for chronic bronchitis/COPD - helps reduce bronchospasms.

37
Q

what is most indicated for a pt with chronic bronchitis

A

spirometry

38
Q

atypical pneumonia

A

mycoplasma, chlamydia, viral pneumonias

39
Q

most common place to find bilateral diffuse infilatrate on CXR

A

mycoplasma/atypical pneumonias

40
Q

soil pathogens, cxr shows solitary lesion, round intracavitary mass.

A

aspergillosis

41
Q
irreversible dilation of bronchial tree due to tumor, foreign bodies, etc. 
copius purulent sputum
rales
clubbing
honeycombing on CXR
A

bronchiectasis

42
Q

how to treat mycosis

A

azoles

43
Q

dx mucosis

A

sputum culture

44
Q

signet ring on CT

A

bronchiectasis

45
Q

tx for bronchiectasis

A

inhaled corticosteriods

46
Q

RSV virus in infants

A

bronchiolitis

47
Q

imaging for lung abscess

A

CT

48
Q

stepwise for asthma

A

albuterol (if greater than 2x/week) add steroid inhaler if not working put on LABA (have to be on corticosteroid with LABA or they will die)
can add leukotriene for allergies too

49
Q

tx blastomycosis

A

pt with sx, treat with Amphotericin B and Itraconazole

*same tx for all mycosis and histoplasmosis

50
Q

see decrease in FEV1 over time

A

chronic bronchitis

51
Q

who do you treat with Tiotropium and Theophyline

A

COPD pt

52
Q

What causes pneumoconiosis

A

inhalation of mineral dust (silica, asbestos, etc)

53
Q

pulmonary htn

A

mean pulmonary artery pressure > 25mmHg

54
Q

lung tumor that secretes PTH ectopically

association with smoking

A

Squamous cell carcinoma

55
Q

lung tumor more common in women

less associated with smoking

A

adenocarcinoma

56
Q

lung tumor more common in men
mets early
can secrete ADH or ACTH
association with smoking

A

small cell carcinoma (oat)

57
Q

workup for mesothelioma

A

CT (CXR)

58
Q

lung tumor that involves brachial plexus
produces Horner’s syndrome
pain in shoulder

A

pancoast tumor

59
Q

non-sedating antihistimines

A

Loratadine (claritin)

60
Q

sedating antihistimines

A

Diphenhydramine
Hydroxyzine
Cyproheptadine

61
Q

inhaled steriods

A

fluticasone

62
Q

anticholinergic bronchodilator

A

tiotropium

63
Q

Leuikotriene receptor antagonist

A

montelukast

- persistnet asthma

64
Q

cough suppressant

A

dextromethorphan

65
Q

mucolytic

A

guaifenesin

66
Q

anti-tubercular drug

A

isoniazid