Pulmonary/Respiratory Diseases

Question 1

90% of the time acute bronchitis is caused by a virus, but who do we always prescribe abx for?

Answer 1

Elderly with underlying cardiopulmonary disease and immunocompromised

Question 2

Patients will have a chronic daily cough with thick, mucopurulent, bad smelling sputum.

Answer 2

Acute bronchiectasis

Question 3

What on chest x-ray shows a “tram track” sign?

Answer 3

Acute bronchiectasis

Question 4

Most common pathogen to cause community acquired pneumonia?

Answer 4

Strep pneumo

Question 5

What disease is associated with hilar adenopathy and apical or upper lobe infiltrates?

Answer 5

Tuberculosis

Question 6

What four drugs are used in TB treatment?

Answer 6

Rifampin, isonizaide, pyrazinamide, ethambutol

Question 7

If someone has a terrible cough for 2 weeks and is coughing to the point of vomiting, what should you think of?

Answer 7

Pertussis

Question 8

What are the three stages of whooping cough?

Answer 8

1. Catarrhal: 7-10 days, mild cough, runny nose, afebrile, cough that worsens
2. Paroxysmal: lasts 2-6 weeks, coughing paroxysms worsen, inspiratory “whoop” after coughing paroxysms
3. Convalescent: weeks to months, cough can worsen with intercurrent URIs

Question 9

This disease is associated with chromosome 7 – involves lack of chloride transporter leading to respiratory and digestive issues

Answer 9

Cystic fibrosis

Question 10

What is a sign in a newborn baby of cystic fibrosis?

Answer 10

Failure to pass 1st meconium

Question 11

What are some causes of an exudative pleural effusion? transudative?

Answer 11

Exudative: pneumonia, PE, malignancy

Transudative: cirrhosis, HF

Question 12

This disease is due to a chronic inflammatory exaggerated T cell response – leading to formation of granulomas

Answer 12

Sarcoidosis

Question 13

What will a tissue biopsy of sarcoidosis cause?

Answer 13

Noncaseating granulomas

Question 14

Is sarcoidosis a restrictive or an obstructive disease?

Answer 14

Restrictive

Question 15

What is samters triad?

Answer 15

Aspirin allergy, nasal polyp, and asthma

Question 16

If a patient has asthma, during a PFT their FEV:FCV ratio should improve by what percent with the use of a bronchodilator?

Answer 16

12 percent

Question 17

How do we treat asthma?

Answer 17

Step-wise approach (SABA, ICS, LABA)

Question 18

This disease is caused by destruction of the alveolar membranes

Answer 18

Emphysema/chronic bronchitis

Question 19

In order to be diagnosed with chronic bronchitis, you must have a productive cough for _____ months for _____ years in a row

Answer 19

3 months, 2 years

Question 20

What will you see on CxR in a COPD patient?

Answer 20

Hyperinflation (increased AP ratio and flattened diaphragm)

Question 21

What is the most common cause of cor pulmonale?

Answer 21

COPD

Question 22

If you suspect a PE in a patient and they pass PERC, what is the next step? What if they fail PERC?

Answer 22

If they pass PERC, your work is done. Not a PE.

If they fail PERC, you do the WELLS criteria.

Question 23

If you have to do the WELLS criteria (because they failed PERC), and you find that you have a low suspicion for PE, what do you do? what about if you have a high suspicion for a PE?

Answer 23

Low suspicion – D-dimer

High suspicion – go right to imaging

Question 24

What is the most common cause of cancer mortality?

Answer 24

Lung cancer

Question 25

Is small cell or non-small cell more aggressive?

Answer 25

Small cell

Question 26

If a patient presents with persistent cough, hemoptysis, and weight loss, what should be high on your differential?

Answer 26

lung cancer

Question 27

If a patient is obese, has a short neck, and complains of being tired during the day, you should think of?

Answer 27

Sleep apnea