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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
Prevention of Primary Pneumothoraxes versus prevention of secondary
Primary- Smoking cessation | Secondary- Pleurodesis
26
Complication Parapneumonic effusion
pH less than 7.2 and glucose less than 60 mg/dL
27
Definition of Pulmonary Hypertension
pulmonary artery pressure of 25 mm Hg or greater
28
Pulmonary Hypertension Class One
pulmonary artery hypertension
29
Pulmonary Hypertension Class Two
left sided heart disease
30
Pulmonary Hypertension Class Three
lung diseases and/or hypoxia
31
Pulmonary Hypertension Class Four
chronic thromboembolic pulm HTN
32
Pulmonary Hypertension Class Five
unclear or multifactorial
33
Pulmonary Hypertension Exam Findings
prominent --> split S2 prominent jugular venous a wave parasternal heave
34
Nitric Oxide Testing in Class 1 Pulm HTN
done to see if benefit with CCB
35
Bosentan is for
Group 1 Pulm HTN
36
Pirfenidone is for
idiopathic pulm fibrosis
37
Pulmonary Nodule Size
Less than 3cm
38
Solid Pulmonary Nodule Management less than 8mm
- calculate risk | - f/u CT
39
Solid Pulmonary Nodule Management more than 8mm
- calculate risk | - PET scan
40
Types of NSCLC
adenocarcinoma, squamous cell carcinoma, and large cell carcinoma
41
Mesothelioma
pleural thickening or exudative pleural effusion | poor prognosis, survival 6-8 months
42
Masses in Anterior Mediastinum
thymoma teratoma/germ cell tumor “terrible” lymphoma thyroid
43
Most common presentation of thymic lesion in adults
paraneoplastic syndrome such as myasthenia gravis
44
Masses in Middle Mediastinum
tend to be lymphadenopathy
45
Masses in Posterior Mediastinum
neurogenic tumors
46
Apnea-hypopnea index in OSA
5-15 is mild
47
Definition of Central Apnea in Adults
the absence of respiratory effort associated with loss of airflow for at least 10 seconds.
48
Risk Factors for Central Apnea in Adults
HF, A fib
49
Sleep-related hypoventilation syndromes
by impaired gas exchange during wakefulness that is further compromised with sleep decrease in oxygen saturations
50
Obesity Hypoventilation Syndrome
- 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
What sleep disorder do you use bilevel ventilation for
obesity hypoventilation syndrome | neuromuscular disorders
52
Ethylene Glycol
- antifreeze | - crystals in renal tubules --> renal damage
53
Methanol
- wood alcohol | - lead to retinal damage and blindness
54
Treatment for cyanide poisoning
Hydroxocobalamin
55
Medication that can treat benzodiazepine overdose
flumazenil
56
Cyanide Poisoning
can be from vinyl burning in house fires
57
Blau Syndrome
sarcoidosis | arthritis, uveitis, and rash
58
Lofgren Syndrome
sarcoidosis | bilateral hilar LAD, erythema nodosum + polyarthritis/athralgia
59
Prevention of High Altitude Pulmonary Edema
nifedipine, sildenafil
60
Prevention of High Altitude Cerebral Edema
dexamethasone

PGY-4 Board Prep (18 decks)

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