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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
What does Fremitus, Egophony and Bronchophony tell you?
Consolidation (pathognomonic for pneumonia)
26
What is Restrictive Lung disease?
small still lungs, can't get air in
27
What is obstructive lung disease?
Mucus filled lungs, cannot get air out
28
What is epiglottitis?
inflammation of the epiglottis thumb sign on x-ray excessive drooling
29
What is Croup?
Respiratory condition that is usually triggered by an acute viral infection of the upper airway, steeple sign on x-ray, barking cough
30
What is Tracheitis?
"Acute URI" Patients look toxic Grey Pseudomembrane Leukocytosis
31
What is asthma?
Chronic inflammatory disease of the airways | characterized by variable and recurring symptoms, wheezing on expiration, elevated IgE and Eosinophils
32
What is Bronchiolitis?
Athma in kids less than 2 years old
33
What is sinusitis?
Inflammation of the paranasal sinuses, tooth pain worsens upon bending forward
34
What is Bronchiectasis?
Bad breath, purulent sputum, and hemoptysis
35
What is Bronchitis?
Increased sputum production "Blue Bloater"
36
What is Emphysema?
Obstructive disease | Alpha-1-antitrypsin deficiency
37
What is Laryngomalacia?
Epiglottis rolls in from side to side
38
What is Pneumonia?
Consolidation of airway
39
What is Pneumothorax?
Absent breath sounds on one side
40
How do you detect a Pulmonary Embolus?
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
41
What is a Tamponade?
Decreased breathe sounds and blood pressure, distant muffled heart sounds icnreased JVD
42
What is Tracheomalacia?
Soft cartilage and stridor since birth
43
What is Cystic Fibrosis?
``` Defective chloride transporter meconium ileus steatorrhea Bronchiectasis Chromosome 7 ```
44
What is aspergillosis?
Mold, compost piles, associated with peanuts
45
What is Asbestosis?
Shipyard workers, pipe fitters, brake mechanics, insulation installers
46
What is Silicosis?
Sandblasters and glassblowers
47
What is Byssinosis?
Cotton workers, textile workers
48
What is Berylliosis?
Radio, TV repair, aerospace manufacturing, Beryllium mining, or manufacturing of fluorescent light bulbs
49
What is Anthracosis?
Coal workers, extensive fibrosis
50
What is Sarcoidosis?
Non-caseating granulomas, eggshell calcification around lymph nodes
51
What is Carcinoid syndrome?
Flushing, wheezing, diarrhea
52
What is Small Cell Cancer?
Located at the Carina, Malignant, Cushing's syndrome, SIADH, and SVC syndrome
53
What is squamous cell CA?
Seen in smokers, high PTH and Ca2+
54
What is Bronchoalveolar CA?
Looks like pneumonia | due to pneumoconiosis, nonsmoker
55
Clues for Typical pneumonia?
Typical pneumonia: short illness, high fever, usually >40 y/o, X-ray: one lobe, Streptococcus Pneumonia
56
Clues for atypical pneumonia?
Atypical pneumonia: prolonged illness, low fever, usually >40 y/o X-ray: diffuse, H. Influenza, Mycoplasma, Chlamydia
57
FEV1/FVC in Obstructive lung disease
Lower than normal (N: 0.75-0.80)
58
FEV1/FVC in Restrictive lung disease
Normal or elevated
59
What is the MOA of Isoproterenol?
Non-specific, Beta-agonists; | relates bronchial smooth muscle (B2)
60
What is the indication for Isoproterenol?
Bronchoconstriction due to sympathetic tone
61
What are the adverse effects of Isoproterenol?
Tachycardia (B1)
62
What is the MOA of albuterol?
B2 agonist; relaxes bronchial smooth muscle
63
What is the indication for Albuterol?
Acute exacerbation
64
What is the MOA of Salmeterol?
B2 agonist; relaxes bronchial smooth muscle
65
What is the indication for Salmeterol?
Long acting agent for prophylaxis
66
What are the adverse effects of Salmeterol?
Tremor and arrhythmia
67
What is the MOA of Methylxanthines?
Inhibit Phosphodiesterase -> decreases cAMP hydrolysis promoting bronchodilation
68
What is the indication for Methylxanthines?
Asthma
69
What are the adverse effects of methylxanthines?
Cardiotoxicity, Neurotoxicity
70
What are the methylxanthines?
Theophylline
71
What is the MOA of a muscarinic antagonist?
competitively block muscarinic receptors preventing bronchoconstriction
72
What is the indication for muscarinic antagonist?
Asthma, COPD
73
What is the muscarinic antagonist drug used for asthma?
Ipratropium
74
What is the MOA of cromolyn?
Prevents release of mediators from mast cells
75
What are the inidcations for Cromolyn?
Asthma prophylaxis
76
What is the MOA of coricosteroids?
Inhibits leukotriene synthesis -> reduces inflammation and leads to bronchodilation
77
What are the indications for corticosteroids?
Chronic asthma, COPD
78
What are the adverse effects of corticosteroids?
Osteoporosis, Cushingoid reaction, psychosis, glucose intolerance, infection, HTN, cataracts
79
What are the corticosteroid drugs?
Beclomethasone, Prednisone
80
What is the MOA of Antileukotriene?
5-lipoxygenase inhibitor -> inhibits conversion of arachidonic acid to leukotriene -> prevents bronchoconstriction and inflammatory cell infiltrate
81
What are the indications for antileukotriene?
Asthma, aspirin induced asthma
82
What are the antileukotriene drugs?
Zileuton, Zafirlukast, montelukast: aspirin induced asthma
83
What is the MOA of H1 Blockers?
Reversible inhibitors of H1 histamine receptors
84
What is the 1st generation H1 Blockers?
Diphenhydramine, Dimenhydrinate, Chlorpheniramine
85
What are the indications for 1st generation H1 blockers?
Allergy, motion sickness, sleep aid
86
What are the adverse effects of 1st generation H1 blockers?
Sedation, antimuscarinic, anti-alpha-adrenergic
87
What are the 2nd generation H1 Blockers?
Loratadine, fexofenadine, Desloratadine, Cetirizine
88
What are the indications for 2nd generation H1 Blockers?
Allergies
89
What are the effects of 2nd generation H1 Blockers?
Far less sedating than the 1st generation because of decreased entry into the CNS
90
What are the expectorants?
Guaifenesin, N-acetylcysteine
91
What is the MOA of Guaifenesin?
Removes excess sputum but does not suppress cough reflex
92
What are the indications for Guaifenesin?
Minor upper respiratory tract infections, common cold w/ cough
93
What is the MOA of N-acetylcysteine?
loosen mucus plugs by breaking disulfide bonds
94
What are the indications for N-acetylcysteine?
CF patients and antidote for Acetaminophen overdose
95
What is the MOA of Bosentan?
Competitively antagonizes endothelium-1 receptors decreasing pulmonary vascular resistance
96
What are the indications for Bosentan?
Pulmonary HTN
97
What is the MOA of Dextromethorphan?
Antitussive (antagonizes NMDA glutamate receptors)
98
What are the adverse effects of Dextromethorphan?
Mild opioid effect so mild abuse potential
99
What is the MOA of Pseudoephedrine, phenylephrine?
Sympathomimetic alpha-agonists | non-prescription nasal decongestants
100
What are the indications for Pseudoephedrine, Phenylephrine?
Reduces Hyperemesis, edema, nasal congestion, and opens obstructed Eustachian tubes
101
What are the adverse effects of Pseudoephedrine, phenylephrine?
HTN, CNS stimulation/ anxiety
102
What is the MOA of Methacholine?
Muscarinic receptor agonist
103
What are the indications for Methacholine?
Asthma challenge test

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