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PANCE Exam Review > Pulmonary (New) > Flashcards

Pulmonary (New) Flashcards

1
Q

Chronic hypoxemic vasoconstriction from chronic bronchitis can lead to:

A

Cor Pulmonale

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2
Q

What PFT values are noted in Emphysema?

A

↓ FEV1/FVC

↑ TLC

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3
Q

What findings in O2, age, RR and CXR would merit a hospitalization of a child with Bronchiolitis?

A

O2 < 95%
Age <3 mo
RR >70
Atelectasis on CXR

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4
Q

What is the definitive diagnostic tool used for Acute Epiglottitis?

A

Laryngoscopy

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5
Q

What is the MCC of Laryngotracheitis (Croup)?

A

Parainfluenza

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6
Q

What is the MCC and 2nd MCC of Acute Bronchiolitis?

A

RSV** > adenovirus

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7
Q

At what ages are the Pertussis DTaP and Tdap vaccines given?

A

DTaP- 2, 4, 6, 15 mo and 4 yo

Tdap- 12 yo and pregnant (>27 wks)

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8
Q

What is the treatment for Pertussis? Do we treat close contacts?

A
  • Macrolide – Azithromycin or Clarithro

- Yes!

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9
Q

Shoulder pain + Horner’s + bone pain. Dx? In what d/o’s is this found?

A

Pancoast tumor

Adenocarcinoma and SCC

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10
Q

What is expected on ABG findings in Barbiturate overdose and COPD exacerbations (or any respiratory failure)? Why?

A

Respiratory acidosis d/t retention of CO2

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11
Q

What is the drug class and MOA of Cromolyn and Nedocromil?

A
  • Mast cell modifiers

- Inhibit degranulation of mast cells

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12
Q

Gram (+) diplococci pairs is found in what pneumonia?

A

Strep pneumoniae

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13
Q

What is the MC lung cancer seen in nonsmokers and women?

A

Bronchogenic adenocarcinoma

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14
Q

High concentrations of inspired oxygen delivered through a ventilator may lead to what disorder?

A

Pulmonary fibrosis

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15
Q

What is the best test to diagnose a pulmonary embolism? What about in a patient with CKD?

A 
Spiral CT (pulm angio)
Ventilation perfusion scan
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16
Q

What type of pneumonia causes HIGH fever, confusion, hematuria and diarrhea?

A

Legionella

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17
Q

A patient presents with an asthma exacerbation. She is in Respiratory Alkalosis and is given nebulized beta-agonists, IV steroids, and oxygen. Her ABG normalizes but her lips are still cyanotic. What is the next best step in management?

A

Intubate (clinically, the patient is in respiratory failure).

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18
Q

What is the most effective treatment of hypoxia and acidosis in the setting of near drowning?

A

Positive pressure mechanical ventilation, CPAP or Bi-PAP

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19
Q

In COPD, should the patient receive high or low concentrations of oxygen? Why?

A
  • Low

- With high, it causes hypoventilation d/t suppressed respiratory drive. Pt. becomes a CO2 container.

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20
Q

What is the treatment for Empyema Pleural Effusion?

A

Anti-staph antibiotics + chest tube (d/t thick fluid)

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21
Q

Low glucose, high protein, and high LDH levels would be significant for transudative or exudative effusion?

A

Exudative

22
Q

What is expected on ABG findings in hyperventilation, seen in anxiety, pain, ASA use, pregnancy?

A

Respiratory alkalosis

23
Q

In the treatment of hemothorax, where is the chest tube inserted? Why?

A

-At the base of lung since blood pulls

24
Q

What is the MCC of pulmonary HTN?

A

Mitral Stenosis

25
Q

What is the GOLD Dx for Pulmonary HTN?

A

Right heart cath

26
Q

Steps in acute respiratory distress

A

A- Airway
B- Breathing
C- Circulation

27
Q

What is the classic finding on CXR for lung abscess?

A

Consolidation air-FLUID level in thick-walled cavitary lesion

28
Q

What is the major chronic morbidity following chronic inhalant hydrocarbons abuse?

A

Encephalopathy

29
Q

What PNA is found to have ↑ cold agglutinins in 50% of patients?

A

Mycoplasma

-IgM

30
Q

What is most likely found on CXR of an asthma patient?

A

Normal findings

31
Q

Although risks vs. benefits must be weighed first, which BBs are more appropriate to use in asthma and COPD patients?

A

Beta-1 selective: Atenolol, Metoprolol
OR
Combo alpha / beta: Labetalol, Carvedilol

32
Q

How are Cheyne-Stokes breathing characterized?

A

Cycling of crescendo-decrescendo tidal volumes separated by apneic or hypopneic pauses.

33
Q

Low diffusion capacity of the lung for carbon monoxide (DLCO) is seen in ____ but normal in ____.

A
  • Emphysema

- Chronic bronchitis

34
Q

A newborn has a scaphoid (sunken) abdomen, respiratory distress, cyanosis and ↓ BS on his left side. What is the diagnosis?

A

Congenital Diaphragmatic Hernia (CDH)

35
Q

CXR showing apical cavitary satellite lesions is evidence of:

A

Active or reactivation TB

36
Q

IVD user presents with PNA. What is the best treatment for this patient?

A

IV Vanco&raquo_space;

IV Cefuroxime or Ampicillin-Sulbactam

37
Q

CXR in an infant showing air-bronchograms and ground-glass appearance would likely be found in:

A

Infant Respiratory Distress Syndrome (Hyaline Membrane Disease)

38
Q

What 5 D/O’s are Obstructive Diseases?

A 
Asthma
Bronchiectasis
Coal workers Pneumoconiosis 
COPD
Cystic Fibrosis
39
Q

The 3 common organisms causing pneumonias in patients with COPD and Cystic Fibrosis are:

A

H. flu**&raquo_space; Strep pneumo, Moraxella

40
Q

What is a SE of positive pressure ventilation?

A

Bullous rupture from barotrauma, leading to a pneumothorax

41
Q

What are GI related findings in Cystic Fibrosis?

A
  • Foul, greasy, fatty stools

- Vitamin deficiencies

42
Q

Carbon monoxide poisoning has a _____ shift in oxygen-hemoglobin dissociation curve.

A

Left

43
Q

What is the most common etiology of cancer in those exposed to asbestos?

A

Bronchogenic carcinoma

44
Q

What makes up Horner’s syndrome? In what disorder is this found?

A
  • Ipsilateral ptosis, anhidrosis, and miosis

- Lung CA

45
Q

What is the next step in management in a stable patient with a suspected pneumonia? What is the best way to diagnose?

A

Initial: CXR
Best: sputum

46
Q

What is the MCC disorder and cause of secondary spontaneous pneumothorax?

A

Rupture of bullae, MCC COPD

47
Q

In an asplenic patient, what pneumonia pathogen is most likely?

A

S. pneumonia

48
Q

When a patient has hemoptysis, what should you think of?

A
  • PE
  • FB
  • Lung CA
49
Q

What is the difference in presentation of a patient with epiglottitis vs tonsillitis or abscess?

A

In epiglottitis, the patient will be leaning forward with neck extended (tripod). The other two don’t make a difference with position.

50
Q

What is the treatment for hospital acquired PNA?

A

Vanco + Piper + Tazo

51
Q

What is the treatment for community acquired PNA?

A

Going home: PO Doxy or Clarithromycin

Admission: IV Ceph and Azithro

PANCE Exam Review (32 decks)

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