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PANCE Exam Review > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

What is the name of this triad?

1) Asthma
2) Nasal polyps
3) ASA/NSAID allergy

A

Samter’s Triad

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2
Q

What is Dx GOLD for Asthma and what does it show?

A
  • PFT

- Reversible obstruction: dec. FEV-1, dec. FEV-1 / FVC

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3
Q

MCC of COPD in Cystic Fibrosis

A

Pseudomonas

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4
Q

TOC for Bronchiectasis

A

CT scan

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5
Q

What is a polysomnography?

A

Sleep study

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6
Q

GI symptoms, hyponatremia, patchy unilobar lower lobe infiltrate. Dx?

A

Legionella Pneumonia

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7
Q

What is the CURB-65 score?

A

Predict severity of PNA to help determine inpatient vs. outpatient treatment.

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8
Q

What do the following fall under?

  • CHF
  • Cirrhosis
  • Nephrotic Syndrome
  • Pulmonary embolism
  • Hypoalbuminemia
A

Transudative

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9
Q

GOLD Dx for active/reactivated TB

A

Acid-Fast Smear and Sputum Culture (AFB)

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10
Q

4 lab criteria for exudative effusion:

A

1) Serum Protein >0.5
2) Serum LDH >0.6
3) Pleural fluid LDH > 2/3 normal upper limit for serum LDH.
* *4) GLUCOSE <60

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11
Q

-↓ breath sounds
-Dull percussion
-↓ tactile fremitus
Is found in:

A

Pleural Effusion

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12
Q

Organism most associated with PNA and bullous myringitis:

A

Strep pneumoniae

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13
Q

GOLD Dx for Latent/primary TB

A

PPD

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14
Q

What PNA would be post H. flu infection?

A

Staph aureus

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15
Q

What gram stain would you find with Strep pneumoniae?

A

Gram (+) cocci pairs

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16
Q

Cardiac dysrhythmia d/t macrolide use:

A

QT prolongation

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17
Q

Light’s Criteria

A
  • Serum protein

- Serum pleural fluid lactate dehydrogenase (LDH)

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18
Q

Acute Pancreatitis + Pleural Effusion (seen on CXR). Pleural fluid shows:

A

Elevated Amylase

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19
Q

Patho of Laryngotracheitis:

A

Parainfluenza

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20
Q

Sarcoidosis: decrease or increase in ACE?

A

Increase

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21
Q

TOC for Pulmonary Embolism:

A

CT pulmonary angiography

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22
Q

In active TB, do we need airborne or droplet precautions?

A

Airborne

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23
Q

What is the common SE of Rifampin?

A

Orange discoloration of body fluids.

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24
Q

Tx for Idiopathic Pulmonary Fibrosis

A
  • O2

- Pulmonary rehab

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25
Q

Pt. presents with GI complaints, skin flushing and wheezing. Dx?

A

Carcinoid Syndrome

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26
Q

What is given to PREVENT risk of Infant Respiratory Distress Syndrome?

A

Glucocorticoids (MC Betamethasone)

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27
Q

PPD: high-risk, homeless, health-care workers, IVDU, foreign-born

A

≥ 10 mm

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28
Q

Tx of TB

A

RIPE

  • Rifampin
  • Isoniazid (need B6 [Pyridoxine] to prevent peri neuropathy**)
  • Pyrazinamide
  • Ethambutol
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29
Q

Tx for Psittacosis

A

Doxy

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30
Q

MCC lung abscess

A

Aspiration PNA

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31
Q

What is the significance of a high amylase in a pleural fluid?

A

Signs of:

  • Pancreatitis
  • Esophageal rupture
  • Malignancy
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32
Q

What type of meds are Tiotropium and lpratropium?

A

Anticholinergics

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33
Q

-↓ breath sounds
-↓ fremitus
-hyperresonance to percussion
Is found in:

A

Pneumothorax

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34
Q

In a patient with CKD and suspected pulmonary embolism, what diagnostic tool is used?

A

Ventilation/perfusion scan

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35
Q

How do we Dx Carcinoid Syndrome?

A

24-hour URINE excretion of 5-hydroxyindoleacetic acid (5-HIAA)

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36
Q

MC presenting symptom of acute pulmonary embolism:

A

Dyspnea

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37
Q

Rheumatoid Arthritis (RA) + Pneumoconiosis =

A

Caplan’s syndrome

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38
Q

Elevated LDH and CXR bilateral infiltrates. Dx?

A

Pneumocystis jirovecii PNA

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39
Q

Carcinoid tumors commonly secrete:

A

Serotonin

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40
Q

When is Pertussis most contagious?

A
  • Catarrhal stage

- Lasts 1-2 wks

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41
Q

What is Hamman’s sign?

A

Crunching sound heard during auscultation with Pneumomediastinum.

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42
Q

With low suspicion of pulmonary embolism, what diagnostic tool can we use to R/O?

A

D-dimer

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43
Q

PPD: immunosuppressed, recent TB contact, abnormal CXR, steroid use

A

≥ 5 mm

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44
Q

CXR: lobar. What type on PNA is this?

A
  • Pneumococcal (AKA Strep pneumoniae)

- The ONLY lobar PNA!***

45
Q

Tx for Healthcare Associated Pneumonia (HCAP)

A

IV Abx and admit (D/T both typical and more resistant organisms)

46
Q

Long-term complication of obstructive sleep apnea:

A

Pulmonary HTN

47
Q

Exposure to shipyard, construction, and insulation occupations may lead to:

A

Asbestosis

48
Q

PE findings that aids in differentiating the cause of crackles or rales, heard on lung auscultation:

49
Q

What sleep apnea is associated with Cheyne-Stokes breathing, drug use, or central nervous system disorders?

A

Central sleep apnea

50
Q

Dx for Cystic Fibrosis

A

Elevated sweat chloride test

51
Q

MCC of Chronic Cor Pulmonale

52
Q

What is the name of this triad?

  • Stasis (shoulder immobilization)
  • Venous injury (recent trauma)
  • Hypercoagulability (OCPs)
A

Virchow triad

53
Q

Dx for Cor Pulmonale

A

Right heart cath

54
Q

Dx GOLD for Pneumomediastinum

55
Q

Tx of choice for Respiratory Distress Syndrome (Hyaline Membrane Disease)

A

Surfactant

56
Q

Newborn baby begins to have difficulties breathing. CXR shows parenchymal infiltrates and fluid in the pulmonary fissures. Dx?

A

Transient Tachypnea of the Newborn

57
Q

Bronchitis Tx for cough:

A

OTC Dextromethorphan or Guaifenesin

58
Q

MC EKG finding in acute pulmonary embolism:

A

Sinus tachy

59
Q

What spirometry values would be seen in COPD?

A
  • ↓ FEV-1
  • ↓ FVC
  • ↓ FEV1/FVC <70%
60
Q

Exposure to foundries, sandblasting, mines, stone may lead to:

61
Q

MCC of Acute Cor Pulmonale

A

Pulmonary Embolism

62
Q

MCC of Bronchiectasis

A

Cystic Fibrosis

63
Q

MCC of Epiglottitis

64
Q

Tx for Pertussis

A

Macrolides

65
Q

Which lung cancer presents with “CCCP” → Central, Cavitary lesions, hyperCa+, Pancoast syndrome?

66
Q

In Newborn Chlamydia Pneumonia, what is the cough described as? Does it present with fever?

A
  • Staccato

- NO fever

67
Q

What is Psittacosis?

A

Chlamydia psittaci (D/T birds)

68
Q

When diagnosing PNA in kids, which findings has the highest odds ratio?

A

Ox sat. <92%

69
Q

Dx of Pertussis

A

PCR of nasopharyngeal secretions

70
Q

What is the name of this triad?

  • Hilar adenopathy
  • Erythema nodosum
  • Polyarthralgia
A

Lofgren syndrome

71
Q

Rx for pulmonary arterial hypertension

A

Sildenafil

72
Q

How is pertussis spread?

A

Respiratory droplet

73
Q

MC opportunistic respiratory infection in patients with AIDS?

A

Pneumocystis jiroveci

74
Q

MCC pleural effusion in U.S.

75
Q

MCC massive pleural effusion (> 1.5–2 L)

A

Malignancy

76
Q

Tx for Sarcoidosis

A

PO Steroids

77
Q

Tx for lung abscess

A
  • Ampicillin-sulbactam
  • Carbapenems
  • Clindamycin
78
Q

Beta 2 Agonists MOA

A

Increase cAMP (cyclic adenosine monophosphate) to bronchodilate

79
Q

Tx for Psittacosis in kids and pregnancy

A

Erythromycin

80
Q

Screening for lung cancer is tested by ______ and recommended for ______.

A 
Low dose CT 
------------------------------------
55 to 80yo with:
-30 pack-year Hx and still smoke 
OR
-Quit within last 15 yrs
81
Q

Which Dx’s require airborne precautions?

A
  • TB
  • Pneumocystis jirovecii
  • Measles
  • Zoster
82
Q

Criteria for Pneumocystis PNA and getting Prednisone before Tx with Bactrim

A
  • PaO2 <70 mm Hg

- A-a gradient >35 mm Hg

83
Q

If unexplained isolated pleural effusion, think _______.

A

Pulmonary Embolism

84
Q

Tx for acute asthma exacerbation

A

Oxygen and beta-2-agonist neb (Albuterol)

85
Q

MC patho of Bronchiolitis

86
Q

Mgmg for pulmonary nodule <6mm and no RFs

87
Q

Albuterol can lead to what electrolyte abnormality?

88
Q

Tx for Infant Respiratory Distress Syndrome

A

Surfactant

89
Q

MC and 2nd MC type of lung cancer

A

Non-small cell:
1st Adenocarcinoma
2nd: SCC

90
Q

What is the treatment of choice for Pneumococcal (AKA Strep pneumoniae)?

A

Penicillin

2nd: Azithro or Augmentin

91
Q

Tx for Pneumothorax

A

Needle decompression of the chest in 2nd intercostal space at midclavicular line or 5th intercostal space in midaxillary line followed by chest tube insertion

92
Q

Post-op fever on day 1-2 would likely be:

A

Atelectasis (partial or complete collapsed lung)

93
Q

56 yo patient presents with a 6mm pulmonary nodule. What is your next step in management?

A

If given the options of CT of chest and biopsy, DO BX 1ST

94
Q

25 yo with has a Hx of DM. She has no TB RFs and is starting a new job at the hospital. What is the minimal number on PPD?

A

15mm (doesn’t matter that she has DM)

95
Q

Dx for Sarcoidosis

A

Bronchoscopy with Bx → noncaseating granulomas

96
Q

Decreased breath/heart sounds and hyperresonance to percussion is found in:

97
Q

A 50 yo presents with a community acquired pneumonia. He was previously treated with Azithromycin but he is back reporting no change. What is the next best med?

A

Levofloxacin (used for bounce-backs)

98
Q

SE of Ethambutol

A

Optic neuritis

99
Q

What is the best treatment for PNA caused by H. flu (HIB, type B MC)?

A

Ceftriaxone

2nd: Azithro

100
Q

2nd line Tx for Mycoplasma

101
Q

To identify a bacteria, what is the best initial test?

A

IFA (indirect fluorescent antibody)

102
Q

Tx for PNA in HIV pt.

103
Q

Pt. present with parents. He has a bowel obstruction. What do you worry about?

A

Cystic Fibrosis

104
Q

What is the most sensitive and specific pulmonary function test (PFT) for COPD?

A

Residual Volume (trash that’s left, CO2)

105
Q

1st and 2nd line Tx for COPD

A
  • Rescue inhaler

- L/A Anticholinergic (Tiotropium) + L/A Beta-2 (Salmeterol)

106
Q

Pt. presents with lung CA and Hx of endocrine dysfunction. What is the likely lung CA involved?

A

Small cell (always involves endo)

107
Q

Pt. with ARDS is placed on Positive end-expiratory pressure (PEEP). What is a side effect?

A

Pulmonary fibrosis

108
Q

Pt. presents with an asthma exacerbation. What would you expect to see on ABG?

A

Respiratory acidosis

109
Q

≤ 14yo Tx for PNA? What does it switch to at >15yo?

A
  • Amoxi

- Azithro

PANCE Exam Review (32 decks)

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