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PGY-4 Board Prep > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

Methacholine/Bronchial Challenge Test

A

FEV1 falls by 20%

High NPV

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2
Q

Bronchodilator Challenge in Asthma

A

increase of 12% and at least 200 mL.

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3
Q

Allergic bronchopulmonary aspergillosis

A

severe asthma
elevated IgE
positive skin tests for Aspergillus

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4
Q

α1-antitrypsin testing in COPD

A

when diagnosed under 45 years of age

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5
Q

Bronchiectasis Diagnosis

A

airway diameter greater than that of its accompanying vessel, and lack of distal airway tapering.

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6
Q

Break down of ILD/DPLD

A
  • smoking related
  • steroid responsive
  • connective tissue related
  • exposure related
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7
Q

Smoking Related ILD/DPLD

A

1) DIP: Desquamative Interstitial Pneumonia
2) RBLD: Respitoray Bronchiolitis ILD
3) PLCH: Pulmonary Langershans Cell Histiocytosis
4) Idiopathic pulmonary fibrosis

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8
Q

Connective Tissue ILD/DPLD

A

RA and systemic sclerosis are most common

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9
Q

Steroid Responsive ILD

A

sarcoidosis
organizing PNA
eosinophilia PNA
hypersensitivity PNA

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10
Q

Organizing Pneumonia

A

peripheral sparing on CT
often follows acute infection, radiation exposure, or autoimmune disease
called cryptogenic if no cause is found

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11
Q

Treatment of Sarcoidosis Lung Disease

A

depends on the stage, earlier stages can be managed with observation and may spontaneously resolve
prednisone for more severe stages

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12
Q

Time Frame for Asbestos Related Disease

A

15-35 years

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13
Q

Risk Factors for Asbestos Related Disease

A

mine works, construction, naval shipyards, automotive

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14
Q

Asbestos Lung Disease Imaging Findings

A

Pleural Plaques or calcifications

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15
Q

Risk Factors for Silicosis

A

concrete, tile, and masonry

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16
Q

What to consider with worsening silicosis

A

TB

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17
Q

Lights Criteria

A

Pleural to serum protein >.5
Pleural to serum LDH >.6
LDH>2/3 ULN

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18
Q

Pleural Fluid Cholesterol

A

> 55 consistent with exudative

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19
Q

pH and Pleural fluid

A

less than 7.2 = complicated pleural effusion

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20
Q

Pleural Fluid amylase evaluates for

A

esophageal rupture, pancreatitis

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21
Q

Pleural Fluid triglycerides evaluates for

A

chylothorax

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22
Q

Causes of Chylothorax

A

Malignancy (lymphoma)
TB
Surgery/Disruption of Thoracic Duct

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23
Q

How to Diagnose TB in Pleural Effusion

A

Adenosine deaminase (ADA)

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24
Q

Definition of Parapneumonic Effusion

A

effusion associated with a pneumonia

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25
Q

Prevention of Primary Pneumothoraxes versus prevention of secondary

A

Primary- Smoking cessation

Secondary- Pleurodesis

26
Q

Complication Parapneumonic effusion

A

pH less than 7.2 and glucose less than 60 mg/dL

27
Q

Definition of Pulmonary Hypertension

A

pulmonary artery pressure of 25 mm Hg or greater

28
Q

Pulmonary Hypertension Class One

A

pulmonary artery hypertension

29
Q

Pulmonary Hypertension Class Two

A

left sided heart disease

30
Q

Pulmonary Hypertension Class Three

A

lung diseases and/or hypoxia

31
Q

Pulmonary Hypertension Class Four

A

chronic thromboembolic pulm HTN

32
Q

Pulmonary Hypertension Class Five

A

unclear or multifactorial

33
Q

Pulmonary Hypertension Exam Findings

A

prominent –> split S2
prominent jugular venous a wave
parasternal heave

34
Q

Nitric Oxide Testing in Class 1 Pulm HTN

A

done to see if benefit with CCB

35
Q

Bosentan is for

A

Group 1 Pulm HTN

36
Q

Pirfenidone is for

A

idiopathic pulm fibrosis

37
Q

Pulmonary Nodule Size

A

Less than 3cm

38
Q

Solid Pulmonary Nodule Management less than 8mm

A
  • calculate risk

- f/u CT

39
Q

Solid Pulmonary Nodule Management more than 8mm

A
  • calculate risk

- PET scan

40
Q

Types of NSCLC

A

adenocarcinoma, squamous cell carcinoma, and large cell carcinoma

41
Q

Mesothelioma

A

pleural thickening or exudative pleural effusion

poor prognosis, survival 6-8 months

42
Q

Masses in Anterior Mediastinum

A

thymoma
teratoma/germ cell tumor
“terrible” lymphoma
thyroid

43
Q

Most common presentation of thymic lesion in adults

A

paraneoplastic syndrome such as myasthenia gravis

44
Q

Masses in Middle Mediastinum

A

tend to be lymphadenopathy

45
Q

Masses in Posterior Mediastinum

A

neurogenic tumors

46
Q

Apnea-hypopnea index in OSA

A

5-15 is mild

47
Q

Definition of Central Apnea in Adults

A

the absence of respiratory effort associated with loss of airflow for at least 10 seconds.

48
Q

Risk Factors for Central Apnea in Adults

A

HF, A fib

49
Q

Sleep-related hypoventilation syndromes

A

by impaired gas exchange during wakefulness that is further compromised with sleep
decrease in oxygen saturations

50
Q

Obesity Hypoventilation Syndrome

A
  • diagnosed by hypercapnia, defined as a Pco2 greater than 45 mm Hg
  • caused by combination of the mechanical load on the respiratory pump and blunting of the chemoreflex (ventilatory response to carbon dioxide)
51
Q

What sleep disorder do you use bilevel ventilation for

A

obesity hypoventilation syndrome

neuromuscular disorders

52
Q

Ethylene Glycol

A
  • antifreeze

- crystals in renal tubules –> renal damage

53
Q

Methanol

A
  • wood alcohol

- lead to retinal damage and blindness

54
Q

Treatment for cyanide poisoning

A

Hydroxocobalamin

55
Q

Medication that can treat benzodiazepine overdose

A

flumazenil

56
Q

Cyanide Poisoning

A

can be from vinyl burning in house fires

57
Q

Blau Syndrome

A

sarcoidosis

arthritis, uveitis, and rash

58
Q

Lofgren Syndrome

A

sarcoidosis

bilateral hilar LAD, erythema nodosum + polyarthritis/athralgia

59
Q

Prevention of High Altitude Pulmonary Edema

A

nifedipine, sildenafil

60
Q

Prevention of High Altitude Cerebral Edema

A

dexamethasone

PGY-4 Board Prep (18 decks)

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