Pulmonary I

Question 1

what is the most common cause of cough?

Answer 1

Post nasal drip
GERD
asthma
90% of non smokers with a cough have one of these

Question 2

what is a common presenting complaint to the doctor?

Answer 2

cough

Question 3

what determines an acute cough?

Answer 3

<3weeks (commonly follows viral or bacterial infection)

Question 4

what determines a subacute cough?

Answer 4

3-8 weeks

Question 5

what determines a chronic cough?

Answer 5

> 8 weeks

Question 6

what is the MCC of chronic cough?

Answer 6

chronic bronchitis secondary to smoking

Question 7

what is the criteria for diagnosing chronic bronchitis?

Answer 7

3 mo of any given year for 2 consecutive yrs

Question 8

what are common causes of acute cough?

Answer 8

common cold
acute bacterial sinusitis
allergic rhinitis
environmental irritants
COPD exacerbations

Question 9

what are less common causes of acute cough?

Answer 9

pertussis
pneumonia
asthma
heart failure

Question 10

what does the data say about using mucolytics, suppressants and antitussives for acute URI?

Answer 10

they don’t help

Question 11

what do you have to be cautious about prescribing with pts with chronic cough?

Answer 11

codeine anti tussives

Question 12

what are common causes of chronic cough?

Answer 12

chronic bronchitis
asthma
chronic rhinosinusitis (MCC in non smokers)
ACE cough
Post-infectious
GERD

Question 13

when can a pt have an ACE cough?

Answer 13

anytime during treatment

Question 14

what are work up exams for pulmonary?

Answer 14

CXR
pulmonary function testing
staturations

Question 15

what is a good question to identify dyspnea?

Answer 15

are you able to take a full deep breathe?

Question 16

what part of the lungs has feeling?

Answer 16

pleura, vasculature

parenchyma has no feeling

Question 17

what does wheezing mean?

Answer 17

obstruction

Question 18

what are rales?

Answer 18

crackles

Question 19

what do fine crackles indicate?

Answer 19

chronic interstitial lung disease problem

Question 20

what do coarse crackles mean?

Answer 20

pneumonia

HF, pleural fluid

Question 21

what do ronchi mean?

Answer 21

upper airway

bubbly, mucousy stuff

Question 22

what FEV1/FVC is normal?

Answer 22

> 70%

Question 23

how long do you have to remove ACE inhibitor to analyze chronic cough?

Answer 23

6 months

Question 24

what is an important hx question for former smokers?

Answer 24

SOB with exertion

Question 25

what is DLCO?

Answer 25

diffusion capacity

diminished in emphysema

Question 26

what does alpha 1 antitypsin test indicate?

Answer 26

if pt has deficiency which leads to emphysema

Question 27

what WBC characterize astham?

Answer 27

eosinophils

Question 28

what WBC characterizes COPD?

Answer 28

macrophage

neutrophil

Question 29

what CD is a/w asthma?

Answer 29

CD4

Question 30

what CD is a/w COPD?

Answer 30

CD8

Question 31

what do cigarettes do to lung function?

Answer 31

accelerate decline in lung function
release oxidants and free radicals
increase neutrophils
suppresses elastase-inhibitory activity

Question 32

what are irreversible airflow limitations?

Answer 32

fibrosis and narrowing
loss of elastic recoil
destruction of alveoli

Question 33

what are reversible airflow limitations?

Answer 33

inflammatory cell infiltration
smooth muscle contraction in peripheral and central airways
dynamic hyperinflation during exercise

Question 34

what is a bullectomy?

Answer 34

remove a bullae or bleb to remove dead space and allow more expansion of good lung tissue

Question 35

who should be tested for airflow limitations?

Answer 35

pts with chronic cough and sputum production with history of risk factors

Question 36

what test is the gold standard for assessment of COPD?

Answer 36

spirometry