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USMLE Step 3 > Pulmonology > Flashcards

Pulmonology Flashcards

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USMLE® Step 1 flashcards
1
Q

Asthma Diagnosis

  • improvement in FEV1 by ___% after bronchodilator
  • Decrease in FEV1 by ___% after metacholine challenge
  • DLCO: Increased to unchanged for mild-moderate, low for severe asthma
A

12, 20

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2
Q

Acute management of Asthma

1) Nebulized Ipatropium/Albuterol
2) _________
3) Magnesium
4) Intubate if worsening respiratory acidosis

A

Methylprednisone

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3
Q

Backbone of asthma management ______

A

Steroids

SABA, Steroid inhaler, LABA + Steroid inhaler

LABA substitute: Theophylline, Cromolyn, Leukotriene (Montelukast)

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4
Q

Salvage asthma therapy includes

1) Oral steroids
2) ________ (IL-5 Inhibitor)
3) ________ (Anti IgE)
4) Bronchial Thermoplasty

A

Mepolizumab

Omalizumab

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5
Q

Loud P2 sound is a sign of ______

A

Pulmonary hypertension

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6
Q

Backbone of COPD management_____

A

SABA/LABA

SABA –> LABA—> LABA+Steroid /LAMA (tiotropium)

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7
Q

For OSA, apnea defined as greater than ______ seconds

A

10

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8
Q

_____ is a treatment for OSA, causes a metabolic acidosis which produces respiratory drive

A

Acetazolamide (causes bicarb leeching at level of renal tubule, resulting in acidosis)

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9
Q

_____ is a treatment for central OSA, CNS respiratory stimulant

A

Medroxyprogesterone

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10
Q

A1 antitrypsin results in _____ emphysema

A

pan-acinar

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11
Q

____, ____, ____ drugs associated with pulmonary fibrosis

A

Bacterim, nitrofurantoin, bleomycin

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12
Q

ILD 2 treatment philosophies

1) Steroids for acute flare, transition to _____
2) Cyclophosphamide
3) Next generation medication _______, nintedanib

A

AZT

Pirfenidone

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13
Q

_____ is like an ILD flare , fevers/chills, cough, myalgia

Most accurate biopsy

A

BOOP , Lung biopsy

Because BOOP is a flare, it will respond to steroids, standard ILD mostly does not

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14
Q

Extra pulmonary manifestations of ______ include, uveitis, 7th nerve palsy, erythema nodosum, restrictive cardiomyopathy, ACE, CD4:CD8 ratio, non-caseating granuloma,

Tx: ______

A

Sarcoid

Steroids

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15
Q

Most accurate test for pulmonary HTN diagnosis_____

A

R heart cath: swan ganz

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16
Q

Chronic therapies for primary pulmonary hypertension

1) Bosentan
2) _______
3) Riociguat

A

Epoprostenol, Selexipag (prostacyclin agonist)

17
Q

Treatment for chronic thrombo-embolic PE______

A

Riociguat

30% of PE originate in pelvic veins, wont be visualized on DVT scan LE

18
Q

Most accurate test for PE______

A

Angiogram, although never done

19
Q

T/F : PPI increases risk of HAP

A

True, natural defense against bacterial organisms suppressed

20
Q

______ pneumonia associated with farm exposure, birth of an animal

A

Coxiella

21
Q

Standard of care for TB is ____ months of RIPE

A

6 months

22
Q

Standard of care for TB is ____ months of RIPE

A

6 months

23
Q

____ is a side effect of ethambutol, _____ is a side effect of Pyrazinamide

A

optic neuritis, hyper uricemia

24
Q

PPD Cutoff

1) Normal Person: _____mm
2) At Risk Groups (nurse, physician, jail)____mm
3) HIV(+)/Steroid/TNF_____

A

15mm

10mm

5mm

25
Q

Latent TB Treatment
1) Isoniazid monotherapy ______

Even if BCG vaccine with positive skin test, treat the patient as normally would

A

9 months

26
Q

____ is a serious, bronchioectasis like pneumonia common among atopy/asthma patients treated with ______

A

ABPA, oral steroids + itraconazole; never use inhaled steroids

27
Q

People with HIV and _____ are at risk of MAC pneumonia

A

COPD

Dx: requires serial sputum (+) not just 1, and clinical symptoms

Tx: Azithromycin/Rifampin/Ethambutol

28
Q

_____ is a MAC species causing cavitary lung lesions

A

Kansaii

29
Q

_____ is a skin, soft tissue version of MAC, que: colonized denta lines

A

Abscessus, Fortuitum

30
Q

For asthma, you see a patient with the following what would you add on :

1) High peripheral eosinophils (IL-5) _____
2) High peripheral IgE______
3) COPD____

A

mepolizumab

Omalizumab

Tiotropium (anti muscarinic: anti secretion, pro dilation)

31
Q

The caveats to VQ scan

1) ______
2) ______

A

Have to have a normal CXR before doing it

A high probability result dosent mean anything, 15% may still have PE

32
Q

The caveats to VQ scan

1) ______
2) ______

A

Have to have a normal CXR before doing it

A high probability result dosent mean anything, 15% may still have PE

33
Q

Treatment of hemodynamically unstable PE_______

A

Thrombolysis

34
Q

Treatment of hemodynamically unstable PE_______

A

Thrombolysis

35
Q

Urine tests for pneumonia ____, _____

A

Pneumococcus, legionella

36
Q

RIPE: Rifampin, Isoniazid (6 months), Pyrazinamide, Ethambutol (2 months), stop if liver enzymes>____times the limit

A

5

37
Q

T/F TB during pregnancy requires >6 months treatment

A

True

38
Q

A more rapid growing mycobacterium species that my cause cavitary lesions in a immunodeficiency-competent host_____

A

M. Kansaii

USMLE Step 3 (19 decks)

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