Pulmonary Medicine Flashcards
1
Q
Test for suspected cough-variant asthma with normal spirometry
A
Methacholine challenge test
MKSAP 20
2
Q
High-prevalence condition in young patients with DPLD
A
Connective tissue disease
MKSAP 20
3
Q
Anterior mediastinal mass entities
A
Thymoma, teratoma, lymphoma, thyroid
MKSAP 20
4
Q
Common drug cause of CSA
A
Opioids
MKSAP 20
5
Q
Treatment for snoring and mild OSA
A
Weight loss
MKSAP 20
6
Q
Add-on therapy to short-acting bronchodilators in COPD
A
LABA and/or LAMA
MKSAP 20
7
Q
Treatment for vasoreactive-positive PAH
A
CCB
MKSAP 20
8
Q
Conditions causing an elevation in Dlco
A
Pulmonary alveolar hemorrhage, left-to-right shunt, asthma
MKSAP 20
9
Q
First step in evaluating excessive daytime sleepiness
A
Actigraphy or sleep diary
MKSAP 20
10
Q
Sarcoidosis management for asymptomatic patients without organ dysfunction
A
Observation
MKSAP 20
11
Q
Conditions warranting in-lab polysomnography
A
Cardiopulmonary or neuromuscular disease
MKSAP 20
12
Q
Treatment for uncontrolled severe eosinophilic phenotype asthma
A
Mepolizumab, reslizumab, or benralizumab
MKSAP 20
13
Q
Test for occupational asthma
A
Spirometry before and after workplace exposure
MKSAP 20
14
Q
Glucocorticoid treatment for moderate to severe COPD exacerbation
A
Oral prednisone, 40 mg for 5 days
MKSAP 20
15
Q
Pulmonary infections suggestive of bronchiectasis
A
Pseudomonas aeruginosa, Aspergillus, non-TB mycobacteria
MKSAP 20
16
Q
Diagnosis suggested by anterior mediastinal mass, myasthenia gravis
A
Thymoma
MKSAP 20
17
Q
Treatment for high-altitude cerebral edema
A
Descent, dexamethasone, supplemental oxygen, hyperbaric oxygen therapy
MKSAP 20
18
Q
Asthma monotherapy associated with increased mortality
A
LABA
MKSAP 20
19
Q
An underlying cause of neutrophil-predominant pleural effusion
A
Acute pneumonia
MKSAP 20
20
Q
Management for malignant pleural effusion
A
Repeat thoracentesis, indwelling pleural catheter, or chemical pleurodesis
MKSAP 20
21
Q
Preferred test for high likelihood of moderate/severe OSA
A
Home sleep apnea test
MKSAP 20
22
Q
Diagnosis suggested by respiratory distress, unilateral absent breath sounds, tracheal deviation
A
Tension pneumothorax
MKSAP 20
23
Q
Role of sputum culture in COPD exacerbation
A
None
MKSAP 20
24
Q
Pleural fluid enzyme test for TB
A
Adenosine deaminase
MKSAP 20
25
Most common middle mediastinal mass
Lymphadenopathy
| MKSAP 20
26
Lifestyle interventions for asthma
Allergen control, weight loss, no smoking
| MKSAP 20
## Footnote
These interventions aim to reduce asthma triggers and improve overall health.
27
Nonmalignant asbestosis-related pulmonary and pleural disease manifestations
Pulmonary fibrosis, pleural effusion, pleural plaques
| MKSAP 20
## Footnote
These manifestations are associated with long-term exposure to asbestos.
28
Test to determine supplemental O2 needs during air travel
Hypoxia altitude simulation testing or 6-minute walk test
| MKSAP 20
## Footnote
These tests assess the body’s response to low oxygen levels at high altitudes.
29
Safe anti-inflammatory agent in aspirin-exacerbated respiratory disease
The selective COX-2 inhibitor celecoxib
| MKSAP 20
## Footnote
Celecoxib is preferred due to its lower risk of triggering respiratory symptoms.
30
Initial treatment for mild COPD
Short-acting bronchodilator
| MKSAP 20
## Footnote
This helps relieve symptoms by opening the airways.
31
Recommended test for lung cancer screening
Low-dose CT
| MKSAP 20
## Footnote
This method is effective in detecting lung cancer at an early stage.
32
Treatment for severe COPD
Triple inhaler therapy with LABA, LAMA, inhaled glucocorticoid
| MKSAP 20
## Footnote
This combination addresses different aspects of COPD management.
33
COPD indication for systemic glucocorticoid
Acute COPD exacerbation
| MKSAP 20
## Footnote
Systemic glucocorticoids are used to reduce inflammation during exacerbations.
34
Treatment for CTEPH
Pulmonary thromboendarterectomy and anticoagulation
| MKSAP 20
## Footnote
These treatments are aimed at removing clots and preventing new ones.
35
Emergency treatment for tension pneumothorax
Needle thoracostomy
| MKSAP 20
## Footnote
This procedure quickly relieves pressure in the pleural space.
36
PSP indication for pleurodesis
Second ipsilateral occurrence
| MKSAP 20
## Footnote
Pleurodesis is indicated to prevent further pneumothorax in recurrent cases.
37
Most sensitive test for small pleural effusions while semirecumbent/supine
Ultrasonography
| MKSAP 20
## Footnote
This imaging technique is effective in detecting fluid in the pleural space.
38
Most common anterior mediastinal tumor
Thymoma
| MKSAP 20
## Footnote
Thymomas can be associated with autoimmune disorders.
39
Number of pleural fluid cytology exams for maximum yield
Two
| MKSAP 20
## Footnote
Performing multiple tests increases the likelihood of detecting malignant cells.
40
Common symptoms of bronchiectasis
Chronic productive cough, frequent respiratory infections
| MKSAP 20
## Footnote
These symptoms result from damage to the airways.
41
Pleural fluid LDH level in exudative pleural effusion
>2/3 upper limit of normal for serum LDH
| MKSAP 20
## Footnote
This helps differentiate exudative from transudative effusions.
42
Treatment for severe radiation pneumonitis
Glucocorticoids
| MKSAP 20
## Footnote
This treatment reduces inflammation caused by radiation therapy.
43
Bronchiectasis CT findings
Bronchial wall thickening, cysts, dilated airways without distal tapering
| MKSAP 20
## Footnote
These findings are characteristic of bronchiectasis.
44
OHS defining parameter
Daytime hypercapnia
| MKSAP 20
## Footnote
This indicates an inability to adequately ventilate.
45
Physical manifestation of CSA due to heart failure
Cheyne-Stokes breathing
| MKSAP 20
## Footnote
This pattern of breathing is often observed in patients with heart failure.
46
OSA symptom most responsive to treatment
Daytime sleepiness
| MKSAP 20
## Footnote
Effective treatment can significantly improve alertness.
47
Positive bronchial challenge test result
≥20% FEV1 reduction
| MKSAP 20
## Footnote
This indicates airway hyperresponsiveness.
48
Initial test for PH
Transthoracic echocardiography
| MKSAP 20
## Footnote
This is the first-line diagnostic tool for pulmonary hypertension.
49
USPSTF criteria for lung cancer screening with low-dose CT
Age 50-80 years, asymptomatic, ≥20 pack-years, smoker in past 15 years
| MKSAP 20
## Footnote
These criteria define the population at risk for lung cancer.
50
Treatment for IPF
Nintedanib or pirfenidone
| MKSAP 20
## Footnote
These medications are used to slow the progression of idiopathic pulmonary fibrosis.
51
First-line therapy for PAH if tolerated
Ambrisentan and tadalafil
| MKSAP 20
## Footnote
PAH stands for pulmonary arterial hypertension, and these medications help in vasodilation and improving exercise capacity.
52
# MKSAP 20
Drug treatments for high-altitude pulmonary edema
Nifedipine, PDE-5 inhibitor
| MKSAP 20
## Footnote
Nifedipine is a calcium channel blocker that helps reduce pulmonary artery pressure.
53
COPD indications for supplemental oxygen
Po2 ≤55 mm Hg, Spo2 ≤88%
| MKSAP 20
## Footnote
These values indicate severe hypoxemia requiring oxygen therapy.
54
Diagnosis suggested by asthma, sinusitis, nasal polyp
Aspirin-exacerbated respiratory disease
| MKSAP 20
## Footnote
This condition is characterized by respiratory reactions to aspirin and other NSAIDs.
55
Treatment for aspirin-exacerbated respiratory disease
Leukotriene-receptor antagonists
| MKSAP 20
## Footnote
These medications help block the action of leukotrienes, which are inflammatory mediators.
56
Initial test for cystic fibrosis
Sweat chloride
| MKSAP 20
## Footnote
Elevated sweat chloride levels indicate cystic fibrosis due to defective chloride channels.
57
Treatment after first occurrence of SSP
Pleurodesis
| MKSAP 20
## Footnote
This procedure helps to prevent recurrence of spontaneous pneumothorax.
58
Diagnosis suggested by asymptomatic bilateral hilar lymphadenopathy
Pulmonary sarcoidosis
| MKSAP 20
## Footnote
Sarcoidosis is an inflammatory disease that can affect multiple organs, primarily the lungs.
59
Most effective class of asthma controller medications
Glucocorticoids
| MKSAP 20
## Footnote
These medications reduce inflammation and help control asthma symptoms.
60
Most common cause of excessive daytime sleepiness
Insufficient sleep syndrome
| MKSAP 20
## Footnote
This syndrome is often due to inadequate sleep duration or quality.
61
CPAP treatment alternative for mild/moderate OSA
Oral appliance
| MKSAP 20
## Footnote
Oral appliances help keep the airway open during sleep for patients with obstructive sleep apnea.
62
Possible complication during air travel in asthma or COPD
Pneumothorax
| MKSAP 20
## Footnote
Changes in cabin pressure can lead to lung overinflation and subsequent pneumothorax.
63
Trimester of pregnancy with most frequent asthma exacerbations
Second trimester
| MKSAP 20
## Footnote
Hormonal changes and increased lung function can lead to exacerbations during this period.
64
Treatment for poorly controlled asthma, elevated IgE, and allergies
Omalizumab
| MKSAP 20
## Footnote
Omalizumab is a monoclonal antibody that targets IgE to reduce allergic responses.
65
Diagnosis suggested by nocturnal absence of respiratory effort, airflow
CSA
| MKSAP 20
## Footnote
CSA stands for central sleep apnea, characterized by a lack of respiratory effort during sleep.
66
Most common causes of pleural effusion
Heart failure, pneumonia, malignancy
| MKSAP 20
## Footnote
These conditions can lead to fluid accumulation in the pleural space.
67
# MKSAP 20
Postbronchodilator FEV1/FVC value consistent with COPD
<0.7
| MKSAP 20
## Footnote
A ratio of less than 0.7 indicates airflow obstruction consistent with COPD.
68
Emphysema amenable to lung reduction surgery
Upper lobe predominant
| MKSAP 20
## Footnote
Patients with upper lobe predominant emphysema may benefit from surgical intervention.
69
Diagnosis suggested by TLC <80% of predicted
Restrictive lung disease
| MKSAP 20
## Footnote
Total lung capacity (TLC) less than 80% indicates a restriction in lung expansion.
70
Diagnosis suggested by headache, nausea, disturbed sleep at altitude
Acute mountain sickness
| MKSAP 20
## Footnote
This condition occurs due to reduced oxygen availability at high altitudes.
71
Treatment for complicated parapneumonic effusion
Thoracostomy tube drainage
| MKSAP 20
## Footnote
This procedure helps drain infected or complicated pleural effusions.
72
Ratio of pleural fluid LDH to serum LDH in exudative pleural effusion
>0.6
| MKSAP 20
## Footnote
This ratio helps differentiate exudative from transudative pleural effusions.
73
Tests for atopy in patients with suspected allergic asthma
Skin prick or allergen-specific IgE
| MKSAP 20
## Footnote
These tests help identify specific allergens causing the allergic response.
74
Symptoms suggestive of COP
Subacute cough, fever, malaise, patchy infiltrates unresponsive to antibiotics
| MKSAP 20
## Footnote
COP stands for cryptogenic organizing pneumonia, which presents with these clinical features.
75
Medications for acute mountain sickness
Acetazolamide or dexamethasone
| MKSAP 20
## Footnote
These medications help alleviate symptoms and prevent progression of acute mountain sickness.
76
Symptoms and history suggestive of mesothelioma
Asbestos exposure, chest pain, night sweats, recurrent pleural effusion
| MKSAP 20
## Footnote
Mesothelioma is often linked to occupational asbestos exposure and presents with respiratory symptoms.
77
Systemic sclerosis variant associated with PAH
Limited cutaneous systemic sclerosis
| MKSAP 20
## Footnote
This variant of systemic sclerosis is characterized by skin changes confined to the fingers and face.
78
Diagnoses suggested by elevated pleural fluid amylase
Pancreatitis, esophageal rupture
| MKSAP 20
## Footnote
Elevated amylase levels in pleural fluid can indicate these underlying conditions.
79
Initial imaging for CTEPH
Ventilation-perfusion scan
| MKSAP 20
## Footnote
This scan helps assess blood flow in the lungs and detect chronic thromboembolic pulmonary hypertension.
80
First step in evaluating solid pulmonary nodule >8 mm
Estimate probability of malignancy
| MKSAP 20
## Footnote
This step is crucial in determining the management approach for pulmonary nodules.
81
Characteristic biomarkers in patients with allergic asthma
Serum eosinophilia, high IgE, elevated fractional exhaled nitric oxide
| MKSAP 20
## Footnote
These biomarkers help in diagnosing and monitoring allergic asthma.
82
Antifibrotic therapy for progressive fibrotic CTD-ILD
Nintedanib
| MKSAP 20
## Footnote
Nintedanib is used to slow the progression of interstitial lung disease associated with connective tissue disease.
83
Clinical presentation of allergic bronchopulmonary aspergillosis
Difficult-to-control asthma, productive cough, expectoration of mucus plugs
| MKSAP 20
## Footnote
This condition often complicates asthma and may require specific antifungal treatment.
84
Diagnosis suggested by environmental exposure, fever, fatigue, cough
Hypersensitivity pneumonitis
| MKSAP 20
## Footnote
This condition is caused by an immune response to inhaled organic antigens.
85
Preferred test for patients with likely mild OSA
In-lab polysomnography
| MKSAP 20
## Footnote
This test provides comprehensive data on sleep patterns and breathing abnormalities.
86
Diagnostic tests for allergic bronchopulmonary aspergillosis
Aspergillus-specific IgE and IgG; Aspergillus antigen skin test
| MKSAP 20
## Footnote
These tests help confirm the diagnosis by identifying an immune response to Aspergillus species.
87
Symptoms most suggestive of DPLD
Subacute/chronic nonproductive cough and dyspnea
| MKSAP 20
## Footnote
These symptoms indicate possible diffuse parenchymal lung disease.
88
Empiric antibiotic class for bronchiectasis exacerbation
Fluoroquinolone
| MKSAP 20
## Footnote
This antibiotic class is often used due to its effectiveness against common pathogens in bronchiectasis.
89
DPLD commonly associated with clubbing
Idiopathic pulmonary fibrosis
| MKSAP 20
## Footnote
Clubbing is a notable clinical feature in patients with this condition.
90
Change in SABA and inhaled glucocorticoid asthma treatment during pregnancy
None
| MKSAP 20
## Footnote
Standard asthma medications are typically continued during pregnancy unless contraindicated.
91
Indicators of well-controlled asthma
Daytime symptoms <2 times/week, nighttime symptoms <2 times/month
| MKSAP 20
## Footnote
These indicators help assess the effectiveness of asthma management.
92
Most common causes of lymphocyte-predominant pleural effusion
TB, cancer
| MKSAP 20
## Footnote
These conditions often lead to a lymphocytic response in pleural effusions.
93
Diagnostic test for mesothelioma
Pleural biopsy
| MKSAP 20
## Footnote
This test is essential for confirming the diagnosis of mesothelioma.
94
Characteristics of idiopathic NSIP compared with IPF
Typically affects younger population, has more favorable prognosis
| MKSAP 20
## Footnote
Idiopathic nonspecific interstitial pneumonia (NSIP) is often distinguished from idiopathic pulmonary fibrosis (IPF) by these traits.
95
Primary risk factor for CSA
Heart failure
| MKSAP 20
## Footnote
Central sleep apnea (CSA) is commonly associated with underlying heart conditions.
96
Spo2 level requiring supplemental O2 during air travel
<92%
| MKSAP 20
## Footnote
This threshold is important for ensuring adequate oxygenation during flights.
97
Imaging for evaluation of solid lung nodule >8 mm
CT and PET
| MKSAP 20
## Footnote
These imaging modalities help characterize lung nodules and assess for malignancy.
98
Asthma indication for adding LAMA
Poor control on glucocorticoid plus LABA
| MKSAP 20
## Footnote
Long-acting muscarinic antagonists (LAMA) are added for better asthma control.
99
DPLD mimic of ARDS
Acute interstitial pneumonia
| MKSAP 20
## Footnote
This condition can present similarly to acute respiratory distress syndrome (ARDS).
100
Test for exercise-induced bronchoconstriction
Methacholine or exercise bronchial challenge test
| MKSAP 20
## Footnote
These tests help diagnose bronchial hyperreactivity in patients with asthma.
101
Pleural fluid pH and glucose level in complicated parapneumonic effusion
pH <7.2, glucose <60 mg/dL
| MKSAP 20
## Footnote
These values indicate a more severe underlying infection or inflammation.
102
Common cystic fibrosis symptoms
Chronic productive cough, recurrent sinusitis and pulmonary infections, GI disease
| MKSAP 20
## Footnote
These symptoms are often due to mucus buildup and chronic infection.
103
Antibiotic class for severe COPD with frequent exacerbations
Macrolide
| MKSAP 20
## Footnote
Macrolides are used for their anti-inflammatory properties in addition to their antibacterial effects.
104
Noninvasive tool to quantify eosinophilic airway inflammation
Fractional exhaled nitric oxide test
| MKSAP 20
## Footnote
This test measures nitric oxide levels in exhaled air, which can indicate inflammation in asthma.
105
PDE-4 inhibitor to reduce severe COPD exacerbations, chronic bronchitis symptoms
Roflumilast
| MKSAP 20
## Footnote
Roflumilast is used to decrease inflammation and relax airway muscles.
106
Most common posterior mediastinal mass
Neurogenic neoplasms
| MKSAP 20
## Footnote
These tumors arise from nerve tissue and can be benign or malignant.
107
Factors predicting high risk for recurrent acute COPD exacerbations
FEV1 <50%, ≥2 acute exacerbations yearly, hospitalization for exacerbation
| MKSAP 20
## Footnote
These factors help identify patients who may benefit from more aggressive management.
