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WPC > Pulmonology > Flashcards

Pulmonology Flashcards

1
Q

What is the difference between carotid body and carotid sinus?

A

Carotid Body: Chemoreceptor

Carotid Sinus: Baroreceptor

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2
Q

What is the color of air on X-ray?

A

Black “radiolucent”

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3
Q

What is the color of fluid or a solid on X-ray?

A

White “radiopaque”

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4
Q

What disease has a steeple sign on neck films?

A

Croup (or Laryngotracheobronchitis)

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5
Q

What disease has a Thumb Sign on neck films?

A

Epiglottitis

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6
Q

What is a “Blue Bloater”?

A

Chronic Bronchitis

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7
Q

What is a “Pink Puffer”?

A

Emphysema

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8
Q

What are the pulmonary infiltrates with eosinophilia (PIE) syndromes?

A

Churg-Straus, Loeffler’s, allergic Bronchopulmonary Aspergillosis

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9
Q

What drugs cause Pulmonary Eosinophilia?

A

Nitrofurantoin and Sulfonamides

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10
Q

What are the risk factors for Lung CA?

A

Smoking, Radon, second hand smoke, pneumoconiosis (except Anthracosis)

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11
Q

What diseases have Hemoptysis?

A

Bronchiectasis, Bronchitis, Pneumonia, TB, Lung CA, Goodpasture’s, Wegener’s

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12
Q

Where is a Bochdalek Hernia?

A

Occur more commonly on the posterior left side (diaphragm), most common congenital Diaphragmatic Hernia (CDH)

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13
Q

Where is a Morgagni Hernia?

A

Anterior/middle of diaphragm, bowel sounds in thorax, seen on US in utero
surgery to fix immediately after birth

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14
Q

What diseases have Respiratory Alkalosis?

A 
Restrictive Lung disease
Anxiety
Pregnancy
Gram neg sepsis
PE
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15
Q

What diseases have respiratory acidosis?

A

Obstructive lung diseases

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16
Q

What diseases have metabolic alkalosis?

A

Low volume state: vomiting, diuretics, GI blood loss

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17
Q

What diseases have metabolic acidosis?

A

“MUDPILES” and diarrhea

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18
Q

What does auscultation of stridor tell you?

A

Extrathoracic narrowing (seen on inspiration on X-Ray)

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19
Q

What does auscaltation of wheezing tell you?

A

Intrathoracic narrowing (seen on expiration on x-ray)

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20
Q

What does auscultation of rhonchi tell you?

A

Mucus in the airway (obstructive airway disease)

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21
Q

What does auscultation of crackles tell you?

A

Blowing collapsed alveoli open (restrictive lung disease)

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22
Q

What does dullness to percussion tell you?

A

Something between the airspace and chest wall absorbing sound, can be solid or fluid

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23
Q

What does hyperresonance tell you?

A

Air in that region of the lungs`

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24
Q

What does Tracheal deviation tell you?

A

Moves away from tension

Pneumothorax moves towards Atelectasis

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25
Q

What does Fremitus, Egophony and Bronchophony tell you?

A

Consolidation (pathognomonic for pneumonia)

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26
Q

What is Restrictive Lung disease?

A

small still lungs, can’t get air in

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27
Q

What is obstructive lung disease?

A

Mucus filled lungs, cannot get air out

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28
Q

What is epiglottitis?

A

inflammation of the epiglottis
thumb sign on x-ray
excessive drooling

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29
Q

What is Croup?

A

Respiratory condition that is usually triggered by an acute viral infection of the upper airway, steeple sign on x-ray, barking cough

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30
Q

What is Tracheitis?

A

“Acute URI”
Patients look toxic
Grey Pseudomembrane
Leukocytosis

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31
Q

What is asthma?

A

Chronic inflammatory disease of the airways

characterized by variable and recurring symptoms, wheezing on expiration, elevated IgE and Eosinophils

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32
Q

What is Bronchiolitis?

A

Athma in kids less than 2 years old

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33
Q

What is sinusitis?

A

Inflammation of the paranasal sinuses, tooth pain worsens upon bending forward

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34
Q

What is Bronchiectasis?

A

Bad breath, purulent sputum, and hemoptysis

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35
Q

What is Bronchitis?

A

Increased sputum production “Blue Bloater”

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36
Q

What is Emphysema?

A

Obstructive disease

Alpha-1-antitrypsin deficiency

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37
Q

What is Laryngomalacia?

A

Epiglottis rolls in from side to side

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38
Q

What is Pneumonia?

A

Consolidation of airway

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39
Q

What is Pneumothorax?

A

Absent breath sounds on one side

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40
Q

How do you detect a Pulmonary Embolus?

A

Tachypnea
increased V/Q scan
ECG may show signs of right heart strain or acute cor pulmonale in cases of Large Pes - large S wave in lead I, a large Q wave in lead III and an inverted T wave in lead III
S1Q3T3

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41
Q

What is a Tamponade?

A

Decreased breathe sounds and blood pressure,
distant muffled heart sounds
icnreased JVD

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42
Q

What is Tracheomalacia?

A

Soft cartilage and stridor since birth

43
Q

What is Cystic Fibrosis?

A 
Defective chloride transporter
meconium ileus
steatorrhea
Bronchiectasis
Chromosome 7
44
Q

What is aspergillosis?

A

Mold, compost piles, associated with peanuts

45
Q

What is Asbestosis?

A

Shipyard workers, pipe fitters, brake mechanics, insulation installers

46
Q

What is Silicosis?

A

Sandblasters and glassblowers

47
Q

What is Byssinosis?

A

Cotton workers, textile workers

48
Q

What is Berylliosis?

A

Radio, TV repair, aerospace manufacturing, Beryllium mining, or manufacturing of fluorescent light bulbs

49
Q

What is Anthracosis?

A

Coal workers, extensive fibrosis

50
Q

What is Sarcoidosis?

A

Non-caseating granulomas, eggshell calcification around lymph nodes

51
Q

What is Carcinoid syndrome?

A

Flushing, wheezing, diarrhea

52
Q

What is Small Cell Cancer?

A

Located at the Carina, Malignant, Cushing’s syndrome, SIADH, and SVC syndrome

53
Q

What is squamous cell CA?

A

Seen in smokers, high PTH and Ca2+

54
Q

What is Bronchoalveolar CA?

A

Looks like pneumonia

due to pneumoconiosis, nonsmoker

55
Q

Clues for Typical pneumonia?

A

Typical pneumonia: short illness, high fever, usually >40 y/o, X-ray: one lobe, Streptococcus Pneumonia

56
Q

Clues for atypical pneumonia?

A

Atypical pneumonia: prolonged illness, low fever, usually >40 y/o
X-ray: diffuse, H. Influenza, Mycoplasma, Chlamydia

57
Q

FEV1/FVC in Obstructive lung disease

A

Lower than normal (N: 0.75-0.80)

58
Q

FEV1/FVC in Restrictive lung disease

A

Normal or elevated

59
Q

What is the MOA of Isoproterenol?

A

Non-specific, Beta-agonists;

relates bronchial smooth muscle (B2)

60
Q

What is the indication for Isoproterenol?

A

Bronchoconstriction due to sympathetic tone

61
Q

What are the adverse effects of Isoproterenol?

A

Tachycardia (B1)

62
Q

What is the MOA of albuterol?

A

B2 agonist; relaxes bronchial smooth muscle

63
Q

What is the indication for Albuterol?

A

Acute exacerbation

64
Q

What is the MOA of Salmeterol?

A

B2 agonist; relaxes bronchial smooth muscle

65
Q

What is the indication for Salmeterol?

A

Long acting agent for prophylaxis

66
Q

What are the adverse effects of Salmeterol?

A

Tremor and arrhythmia

67
Q

What is the MOA of Methylxanthines?

A

Inhibit Phosphodiesterase -> decreases cAMP hydrolysis promoting bronchodilation

68
Q

What is the indication for Methylxanthines?

A

Asthma

69
Q

What are the adverse effects of methylxanthines?

A

Cardiotoxicity, Neurotoxicity

70
Q

What are the methylxanthines?

A

Theophylline

71
Q

What is the MOA of a muscarinic antagonist?

A

competitively block muscarinic receptors preventing bronchoconstriction

72
Q

What is the indication for muscarinic antagonist?

A

Asthma, COPD

73
Q

What is the muscarinic antagonist drug used for asthma?

A

Ipratropium

74
Q

What is the MOA of cromolyn?

A

Prevents release of mediators from mast cells

75
Q

What are the inidcations for Cromolyn?

A

Asthma prophylaxis

76
Q

What is the MOA of coricosteroids?

A

Inhibits leukotriene synthesis -> reduces inflammation and leads to bronchodilation

77
Q

What are the indications for corticosteroids?

A

Chronic asthma, COPD

78
Q

What are the adverse effects of corticosteroids?

A

Osteoporosis, Cushingoid reaction, psychosis, glucose intolerance, infection, HTN, cataracts

79
Q

What are the corticosteroid drugs?

A

Beclomethasone, Prednisone

80
Q

What is the MOA of Antileukotriene?

A

5-lipoxygenase inhibitor -> inhibits conversion of arachidonic acid to leukotriene -> prevents bronchoconstriction and inflammatory cell infiltrate

81
Q

What are the indications for antileukotriene?

A

Asthma, aspirin induced asthma

82
Q

What are the antileukotriene drugs?

A

Zileuton, Zafirlukast, montelukast:
aspirin
induced asthma

83
Q

What is the MOA of H1 Blockers?

A

Reversible inhibitors of H1 histamine receptors

84
Q

What is the 1st generation H1 Blockers?

A

Diphenhydramine, Dimenhydrinate, Chlorpheniramine

85
Q

What are the indications for 1st generation H1 blockers?

A

Allergy, motion sickness, sleep aid

86
Q

What are the adverse effects of 1st generation H1 blockers?

A

Sedation, antimuscarinic, anti-alpha-adrenergic

87
Q

What are the 2nd generation H1 Blockers?

A

Loratadine, fexofenadine, Desloratadine, Cetirizine

88
Q

What are the indications for 2nd generation H1 Blockers?

A

Allergies

89
Q

What are the effects of 2nd generation H1 Blockers?

A

Far less sedating than the 1st generation because of decreased entry into the CNS

90
Q

What are the expectorants?

A

Guaifenesin, N-acetylcysteine

91
Q

What is the MOA of Guaifenesin?

A

Removes excess sputum but does not suppress cough reflex

92
Q

What are the indications for Guaifenesin?

A

Minor upper respiratory tract infections, common cold w/ cough

93
Q

What is the MOA of N-acetylcysteine?

A

loosen mucus plugs by breaking disulfide bonds

94
Q

What are the indications for N-acetylcysteine?

A

CF patients and antidote for Acetaminophen overdose

95
Q

What is the MOA of Bosentan?

A

Competitively antagonizes endothelium-1 receptors decreasing pulmonary vascular resistance

96
Q

What are the indications for Bosentan?

A

Pulmonary HTN

97
Q

What is the MOA of Dextromethorphan?

A

Antitussive (antagonizes NMDA glutamate receptors)

98
Q

What are the adverse effects of Dextromethorphan?

A

Mild opioid effect so mild abuse potential

99
Q

What is the MOA of Pseudoephedrine, phenylephrine?

A

Sympathomimetic alpha-agonists

non-prescription nasal decongestants

100
Q

What are the indications for Pseudoephedrine, Phenylephrine?

A

Reduces Hyperemesis, edema, nasal congestion, and opens obstructed Eustachian tubes

101
Q

What are the adverse effects of Pseudoephedrine, phenylephrine?

A

HTN, CNS stimulation/ anxiety

102
Q

What is the MOA of Methacholine?

A

Muscarinic receptor agonist

103
Q

What are the indications for Methacholine?

A

Asthma challenge test

WPC (16 decks)

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