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Pulm > Pulmonary Clin Med Buzz Words > Flashcards

Pulmonary Clin Med Buzz Words Flashcards

1
Q

Recent sepsis

A

ARDS

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2
Q

PaO2/FiO2 <300

A

ARDS

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3
Q

Brown mucus plugs

A

Allergic bronchopulmonary aspergillosis

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4
Q

Central bronchiectasis on CXR

A

Allergic bronchopulmonary aspergillosis

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5
Q

Young patient (<45 YO) with COPD

A

Alpha-1-Antitrypsin deficiency

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6
Q

Atopic dermatitis

A

Asthma

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7
Q

Allergic rhinitis

A

Asthma

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8
Q

Chronic cough + sputum + dyspnea

A

Bronchitis

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9
Q

Cobblestoning

A

Post-nasal drip

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10
Q

Barking cough

A

Croup

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11
Q

Steeple sign

A

Croup

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12
Q

Drooling

A

Epiglottitis

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13
Q

Epiglottitis TX

A

Secure airway in OR first!

Empiric ceftriazone and rifampin for close contacts

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14
Q

Velcro rales

A

Idiopathic Pulmonary Fibrosis

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15
Q

Honeycombing + reticular opacities

A

Idiopathic pulmonary fibrosis

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16
Q

Drugs that can cause IPF symptoms

A

bleomycin (chemo)
nitrofurantoin (used for UTIs)
amiodarone (used for a-fib)
methotrextate (used in auto-immune disorders)

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17
Q

Post-tussive emesis

A

Pertussis

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18
Q

Most contagious phase of pertussis

A

Catarrhal stage

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19
Q

Eggshell calcifications

A

Silicosis

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20
Q

Malignant mesothelioma

A

Asbestosis

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21
Q

Rheumatoid arthritis symptoms + respiratory symptoms

A

Caplan syndrome, coal exposure

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22
Q

Mosaic attenuation

A

Hypersensitivity pneumonitis

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23
Q

Black female patient 20-60 YO

A

Probably sarcoidosis because med school is racist

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24
Q

Non-caseating granulomas

A

Sarcoidosis

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25
Q

Bilateral adenopathy

A

Sarcoidosis

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26
Q

Ruptured or paralyzed diaphragm

A

Absolute contraindication for thoracentisis

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27
Q

Diagnostic criteria for ARDS that excludes cardiac causes

A

Capillary wedge pressure <18 mmHg

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28
Q

Tx for ARDS

A

Mechanical ventilation with low TV and PEEP
Restrict fluids/use diuretics
Tx underlying cause
Care for psych concerns after

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29
Q

Diagnostic lab for aspergillosis

A

Elevated IgE (>1000)

30
Q

Tx for allergic bronchopulmonary aspergillosis

A

Long-term oral prednisone (month - years)

31
Q

How to dx Alpha-1-Antitrypsin deficiency

A

PFT with obstructive pattern
CXR showing changes at lung bases
*Genetic screening
Low serum [AAT]

32
Q

3 components of asthma pathophys

A

Airway hyperreactivity
Bronchoconstriction
Inflammation

33
Q

Among asthma/copd meds, what cannot be used alone?

A

Never use LABA (ex: salmeterol) alone in asthma

34
Q

Tx for bronchiolitis?

A

Supportive, but admit if severe.

35
Q

Prevention for RSV?

A

Preterm infants who are less than 1 YO at start of RSV season

BPD patients for 1st year of life

BPD patients for 2nd year of life if still requiring meds 6 months before RSV season

Infants with congenital heart disease

^^ Treat all of these guys with palivizumab

36
Q

Most common etiological agent of acute bronchitis?

A

Influenza A/B, parainfluenza, coronavirus, rhinovirus, RSV

Mnemonic: PRICR

37
Q

What happens to the compliance in an infant without sufficient surfactant?

A

Becomes less compliant

38
Q

Tx BPD?

A

Exogenous surfactant;
Corticosteroids;
Mechanical ventilation with small TV and PEEP

39
Q

What are some meds that can be used for a COPD exacerbation?

A

Azithromycin (for anti-inflammatory properties)
Prednisone 5 days
Roflumilast

40
Q

COPD control meds, in order from mild to most severe

A

Start with albuterol (SABA) PRN
Add tiotropium (LAMA)
Progress to ICS/LABA combo (Symbicort, Advair)
Progress to Trelegy - combo ICS/LABA/LAMA

41
Q

What meds can be used to control bothersome acute cough symptoms?

A

Dexomethorfan

Benzonatate

42
Q

What meds should be considered with chronic cough with evidence of cobblestoning of the airway?

A

PND can be treated with topical steroids (flonase) and antihistamines

Consider abx if bacterial sinusitis is present

43
Q

What is the most common etiological agent of croup?

A

Parainfluenza (influenza a/b tends to be more severe but more rare)

44
Q

What meds should be considered in croup?

A

Dexamethasone; blow-by O2; humidified air.

If in SEVERE respiratory distress, consider racemic epinephrine.

45
Q

What gene is mutated in CF and what is it’s location?

A

CFTR gene on the long arm of chromosome 7.

46
Q

What drug is used in CF when channels are being biosynthesized but have troubles with maturation?

47
Q

Tx of cystic fibrosis?

A 
Bronchodilators PRN
Dornase alfa (breaks up DNA in mucus)
Hypertonic saline
Chest vest
Oral corticosteroids
High-dose ibuprofen
Azithromycin
Ivacaftor
48
Q

What are the most common etiologic agents of epiglottitis?

A

HiB in unvaccinated kids

Other Haemophilus spp, S. penumo, or S aureus in vaccinated kids

49
Q

What is the narrowest region of an infant’s airway?

A

Subglottic region

50
Q

What is the tx for chronic IPF?

A

Nintedanib (suppresses tyrosine kinase = slows repair cascade to reduce scarring)

Pirfenidone (supresses fibrosis by slowing TGF-B pathway

51
Q

What is influenza myositis, who does it primarily affect, and how is it diagnosed?

A

Complication of flu, associated with influenza B
Usually affects school-age Boys
Causes Bilateral calf pain
Confirm with measurement of creatinine kinase

52
Q

Aside from clinically, how do you dx pertussis?

A

PCR of nasopharyngeal swab showing lymphocytosis w/in first 2 weeks

53
Q

Tx of pertussis?

A

Early azithromycin

Supportive care

54
Q

Prevention of pertussis?

A 
DTaP at:
2 mo
4 mo
6 mo
1.5 YO
4-5 YO

and with every pregnancy!

55
Q

Patient presents with dullness to percussion, decreased fremitus, and decreased breath sounds. Possible dx?

A

Pleural effusion.

56
Q

Patient presents with dullness to percusion, increased fremitus, bronchial breath sounds, and egophony. Possible dx?

57
Q

Patient presents with hyper-resonant percussion, decreased fremitus, and decreased breath sounds. Possible dx?

A

Pneumothorax or obstructive disorder

58
Q

Light’s Criteria

A

Excessive protein in pleural fluid (>.5 ratio)
Excessive LDH in pleural fluid (>.6 ratio)
LDH > 2/3 upper limit of normal serum LDH

Any of above is exudate
Otherwise, it is transudate

59
Q

Most likely cause of transudate

60
Q

Tx for CAP in patient with no co-morbidities

A 
Doxycycline
OR
Amoxocillin
OR
If S. pneumo resistance <25%, azithromycin
61
Q

Tx for CAP in patient with co-morbidities

A 
Levofloxacin 
OR
Augmentin + azithromycin OR doxy
OR
High-dose amox + azithro OR doxy
62
Q

What are the classic risk factors for a PE?

A

Virchow’s triad:

Damage (trauma, infection, inflammation)
Stasis (immobilization, surgery, sitting >4 hr)
Hypercoagulability (including use of oral contraceptives, pregnancy, smoking, or familial causes)

63
Q

Dx of PE?

A

CT angiography; D-dimer

CXR will likely be normal

EKG should be done

64
Q

Split of S2 may indicate what?

A

Pulmonary hypertension

65
Q

How is pulmonary HTN diagnosed?

A

Catheterization is gold standard but echo is more reasonable

66
Q

What are the 4 classifications of pulmonary HTN?

A
  1. idiopathic
  2. caused by left-heart dz
  3. caused by chronic pulm dz (COPD)
  4. caused by thromboembolic dz
67
Q

Tx of pulmonary HTN?

A

Ca+ channel blockers; heart/lung transplant

68
Q

Tx for sarcoidosis?

A

Methotrexate; rituximab

69
Q

You’re about to do a thoracentesis. Where do you aim?

A

Over 5th rib and don’t take more than 1.5 L max

70
Q

What is a positive TB skin test result for a patient with HIV?

71
Q

What is a positive TB skin test result for a healthcare worker or recent immigrant?

Pulm (3 decks)

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