Pulmonology

Question 1

Patient with poorly controlled asthma, eosinophilia on CBC, and bronchiectasis on CXR; wheezing on exam

Answer 1

Allergic bronchopulmonary aspergillosis; get IgE aspergillosis tired as initial testing; antifungal treatment can help

Question 2

What level of O2 sat qualifies patient for home O2

Answer 2

Severe hypoxemia or resting O2 sat less than 88%; or severe hypoxemia with exertion meaning O2 sat drops below 88% with activity/exertion

Question 3

what is the most common early finding on CXR of pulmonary sarcoidosis

Answer 3

bilateral hilar adenopathy; later findings are infiltrates and ultimately fibrosis; pathology will show noncaseating granulomas

Question 4

first line tx for persistent pediatric asthma

Answer 4

inhaled corticosteroid

Question 5

black box warning for Singulair in 2020?

Answer 5

suicidality and other neuropsychiatric events

Question 6

what is the only medication proven to improve persistent cough related to URI in adults?

Answer 6

intranasal atrovent

Question 7

what is the USPSTF guideline for lung cancer screening?

Answer 7

low dose CT chest in patient 50-80 y/o with 20+ pack year smoking history who currently smoke or have smoked within the last 15 years

Question 8

three medications that commonly cause restrictive pattern lung disease as an adverse reaction

Answer 8

amiodarone, methotrexate, nitrofurantoin

Question 9

what is the most common cause of pulmonary HTN?

Answer 9

left heart disease

Question 10

consider what diagnosis in patient with dyspnea and normal spirometry and reduced DLCO?

Answer 10

chronic thromboembolic pulmonary HTN (screen for this with V/Q scan); other causes could be chronic PE, CHF, anemia, connective tissue disease with pulm involvement