Pulmonary_RR

Question 1

Risk factors for DVT

Answer 1

Stasis, endothelial injury, and hypercoagulability

Virchow’s triad

Question 2

Criteria for exudative effusion

Answer 2

Pleural/serum protein > 0.5;

Pleural/serum LDH > 0.6

Question 3

Causes of exudative effusion

Answer 3

Think of leaky capillaries.

Malignancy, TB, bacterial, viral infection, PE with infarct, and pancreatitis

Question 4

Causes of transudative effusion

Answer 4

Think of intact capillaries.

CHF, liver or kidney disease, and protein-losing enteropathy

Question 5

What might normalizing PCO2 in a patient having an asthma exacerbation indicate?

Answer 5

Fatigue and impending respiratory failure

Question 6

Sarcoidosis

Answer 6

Dyspnea, lateral hilar lymphadenopathy on chest x-ray, non-caseating granulomas, increased ACE, and hypercalcemia

Question 7

PFTs of obstructive pulmonary disease

Answer 7

Decreased FEV1/FVC

Question 8

PFTs of restrictive pulmonary disease

Answer 8

Increased FEV1/FVC

Decreased TLC

Question 9

Honeycomb pattern on chest x-ray. Diagnosis? Treatment?

Answer 9

Diffuse interstitial pulmonary fibrosis.

Supportive care; steroids may help

Question 10

Treatment for SVC syndrome

Answer 10

Radiation

Question 11

Treatment for mild persistent asthma

Answer 11

Inhaled beta-agonists and inhaled corticosteroids

Question 12

Treatment for COPD exacerbation

Answer 12

O2, bronchodilators, antibiotics, corticosteroids with taper, smoking cessation

Question 13

Treatment for chronic COPD

Answer 13

Smoking cessation, home O2, beta-agonists, anticholinergics, systemic or inhaled corticosteroids, flu and pneumococcal vaccines.

Question 14

Acid-base disorder in PE

Answer 14

Respiratory alkalosis with hypoxia and hypocarbia

Question 15

Non-small cell lung cancer (NSCLC) associated with hypercalcemia

Answer 15

Squamous cell carcinoma

Question 16

Lung cancer associated with SIADH

Answer 16

Small cell lung cancer (SCLC)

Question 17

Lung cancer highly related to cigarette exposure

Answer 17

Small cell lung cancer (SCLC)

Question 18

A tall Caucasian man presents with acute shortness of breath. Diagnosis? Treatment?

Answer 18

Spontaneous pneumothorax.

Spontaneous regression; supplemental O2 may be helpful

Question 19

Treatment of tension pneumothorax

Answer 19

Immediate needle thoracostomy

Question 20

Characteristics favoring carcinoma in an isolated pulmonary nodule

Answer 20

Age > 45-50;
Lesions new or larger in comparison to old films;
Absence of calcification or irregular calcification;
Size > 2cm;
Irregular margins

Question 21

What are important findings in ARDS?

Answer 21

Hypoxemia and pulmonary edema with normal pulmonary capillary wedge pressure (PCWP)

Question 22

Sequelae of asbestos exposure

Answer 22

Pulmonary fibrosis, pleural plaques, bronchogenic carcinoma (mass in lung field), mesothelioma (pleural mass)

Question 23

Silicosis is associated with an increased risk of what infection?

Answer 23

Mycobacterium tuberculosis

Question 24

Causes of hypoxemia

Answer 24

Right-to-left shunt, hypoventilation, low inspired O2 tension, diffusion defect, V/Q mismatch

Question 25

Classic chest x-ray findings for pulmonary edema

Answer 25

Cardiomegaly, prominent pulmonary vessels, Kerley B lines, “bat’s-wing” appearance of hilar shadows, and perivascular and peribronchial cuffing

Question 26

Westermark’s sign and Hampton’s hump

Answer 26

Chest x-ray findings suggestive of PE