Pulmonary

Question 1

criteria for massive PE

Answer 1

1. SBP<90 for 15 minutes
2. SBP<100 with h/o hypertension
3. > 40% reduction in baseline SBP

Question 2

indications for thrombolysis with massive PE

Answer 2

1. respiratory distress
2. hypotension
3. hypoxia (<90) despite supplemental O2
4. right heart strain on echo
5. elevated troponin

Question 3

pleural based wedge infarct

Answer 3

hampton’s hump

Question 4

westermark’s sign

Answer 4

vascular cutoff sign

Question 5

characteristic finding in high altitude pulmonary edema

Answer 5

patchy alveolar infiltrates mostly involving the right middle lobe

Question 6

MCC of death from high altitude illness

Answer 6

high altitude pulm edema

Question 7

findings from thoracentesis of empyeme

Answer 7

1. Ph<7.2
2. glucose <60
3. WBC>50K
4. positive bacterial culture
5. grossly purulent fluid

Question 8

effusion with LDH>2/3 upper limit of serum LDH suggestive of

Answer 8

exudative effusion

Question 9

pleural LDH: serum LDH>0.6 suggestive of

Answer 9

exudative effusion

Question 10

pleural protein: serum protein >0.5 suggestive of

Answer 10

exudative effusion

Question 11

hemoptysis + renal dysfunction

Answer 11

goodpasture’s syndrome or wegeners (granulomatosis with polyangitis)

Question 12

massive hemoptysis

Answer 12

≥ 100 mL/hour or ≥ 500 mL over 24-hours

Question 13

diastolic murmur + hemoptysis

Answer 13

mitral stenosis

Question 14

small vessel vasculitis that is the result of circulating anti-glomerular basement membrane antibodies

Answer 14

goodpasture syndrome

Question 15

asthma +eosinophilia

Answer 15

churg-strauss (eosinophilic granulomatosis with polyangitis)

Question 16

treatment of goodpasture syndrome

Answer 16

steroids, plasmapheresis, cyclophosphamide

Question 17

benign, painful, nonsuppurative localized swelling of the costosternal, sternoclavicular, or costochondral joints

Answer 17

tietze (usually caused by coughing or viral URI)

Question 18

upper lobe infiltrates, hard rock and coal miners, sometimes hilar lymphadenopathy

Answer 18

silicosis

Question 19

lower lobe opacities in someone who works in construction and handle insulation

Answer 19

asbestos

Question 20

upper lobe infilrates in patient with aerospace, computer manufacturing and fluorescent light bulb manufacturing

Answer 20

berylliosis

Question 21

paO2 in metHgb

Answer 21

high

Question 22

infants can get methgb without exposure from what otehr conditions

Answer 22

stress, sepsis, diarrhea

Question 23

why is it harder for an anemia patient to be diagnosed with methgb

Answer 23

higher percentage of their Hgb has to be with metHgbfor them to turn blue

Question 24

things that cause metHgb

Answer 24

benzocaine, prilocaine, nitrites (poppers), pyridium, dapsone, bactrim

Question 25

how to avoid re-expansion pulmonary edema after chest tube placement

Answer 25

avoiding suction for expansion of lung and limiting the amount of fluid actually drained

Question 26

Causes of non-cardiogenic pulmonary edema

Answer 26

``` ARDS High altitude illness and neuro pulm edema Opioid overdose PE Eclampsia TRALI ```

Question 27

PFTS in COPD Residual volume: TLCO: FEV1/FVC:

Answer 27

RV: high TLCO: high FEV1/FVC: decreased

Question 28

criteria in terms of cough for chronic bronchitis

Answer 28

chronic productive cough for at least three months in at least two successive years (blue bloaters)

Question 29

light's criteria

Answer 29

(1) pleural fluid to serum protein ratio > 0.5 (2) pleural fluid and serum lactate dehydrogenase (LDH) ratio > 0.6 (3) pleural fluid LDH > 200 IU/mL.

Question 30

When should you put bad lung down

Answer 30

massive hemoptysis, severe pleural effusions, and large pulmonary abscesses.

Question 31

at what vital capacity should you consider intubating someoen

Answer 31

less than 20ml/kg

Question 32

Interstitial disease from aerospace

Answer 32

Berylliosis

Question 33

Foundries, sandblasting, mines, granite- lung disease

Answer 33

Silicosis

Question 34

Deposition of iron in tissue- welding

Answer 34

Siderosis

Question 35

Tin welding lung disease

Answer 35

Stannosis

Question 36

Lung disease from cotton

Answer 36

Byssinosis