PULMONARY

Question 1

COPD

Gold 1-2

Answer 1

SABA or SAMA EXAM. BASCIALLY ANTICHOLINERGIC FIRST LINE FOR

COPD

Question 2

COPD
Gold 1-2
(poorly controlled)

Answer 2

LAMA or LABA. May use SABA for rescue

Question 3

COPD

Gold 3-4

Answer 3

LAMA first line. If poor use LAMA plus LABA. Alternative is LABA + ICS

Question 4

COPD
Gold 3-4
(poorly controlled)

Answer 4

REFER

Question 5

Long term tx for COPD?

Answer 5

Oxygen

Question 6

Tx for Intermittent Asthma

Answer 6

(< 2d, < 2x/wk): SABA

Question 7

Tx for Mild Persistent Asthma

Answer 7

(>2d, 3-4N)- SABA, Low dose ICS *Altern. Cromolyn, leukotriene,
theophylline

Question 8

Tx for Mod Persistent Asthma

Answer 8

(DAILY, NOT NIGHTLY)- SABA, Low dose ICS plus LABA or Medium dose
ICS.

Question 9

Tx for Severe Asthma

Answer 9

(Throughout the day, nightly)- SABA, Med ICS plus LABA

Question 10

CURB-65

Answer 10

(criteria for hospital admission): If > 1pt. hospitalize. Confusion, BUN > 19.6, Respiration
> 30, BP < 90/60, 65 years of age or older.

Question 11

What causes the greatest increase in respiration

Answer 11

Hypercapnia

Question 12

What do you see in a pt with Emphysema Lungs

Answer 12

Percussion-HYPERENNOSANCE tactile frem + egophony ↓. CXR- flattened
diaphragms with hyperinflation. Inc. AP diameter, accessory muscles, pursed-lip breathing, weight
loss.

Question 13

Acute Bacterial Pneumonia

Answer 13

Usually S. pneumoniaeCXR middle lobe

Question 14

Tuberculosis:

Answer 14

fatigue, fever, cough. Never do fewer than 3-4 drugs initially if positive, then u can
narrow it down. Latent TB usually treated with INH. If u suspect ACTIVE TB order, NAAT, C&S,
AFB. The AFB is not diagnostic. SPUTUM FOR C & S if gold standard. Deep morning cough
collected for three “consecutive days”. TB is usually upper lobes.