Pulmonology

Question 1

triggers for asthma

Answer 1

-pollutants
-infection
-cold
-smoke

Question 2

other conditions often seen with asthma

Answer 2

-eczema
-allergies

Question 3

What is Samter’s triad

Answer 3

Question 4

s/s of asthma

Answer 4

-cough
-chest tightness
-SOB
-wheezing

Question 5

diagnosis of asthma

Answer 5

-children: reduction in either FEV1 or FVC by >12% (85% of predicted)
-adults: reduction in either FEV1 or FVC by >12% AND a minimum of >200mL (70% of predicted)

Question 6

mild intermittent asthma

Answer 6

-symptoms <2 or fewer days per week
-<2 night awakenings per month
-doesn’t interfere with normal activities

Question 7

mild persistent asthma

Answer 7

-symptoms >2 times weekly
-3-4 night awakenings per month
-use of SABA more than twice a week

Question 8

moderate persistent asthma

Answer 8

-daily asthma symptoms
-nighttime awakenings >1/week
-daily need for SABA

Question 9

severe persistent asthma

Answer 9

-symptoms of asthma throughout the day
-nightly awakenings
-need for SABA multiple times per day

Question 10

treatment of asthma

Answer 10

-SABA (albuterol, metaproterenol, terbutamine)
-SABA + ICS (budesonide, declomethasone dipropionate)
-SABA + ICS + LABA (salmeterol, fometerol)

Question 11

causes of bronchitis

Answer 11

typically viral or bacterial

Question 12

s/s of acute bronchitis

Answer 12

-cough
-substernal pain
-wheezing
-fever
-SOB

Question 13

treatment of acute bronchitis

Answer 13

-symptomatic treatment

Question 14

MCC of COPD

Answer 14

smoking

Question 15

COPD symptoms

Answer 15

-dyspnea
-chronic cough
-sputum production
-wheezing
-chest tightness

Question 16

COPD vs EMPHYSEMA

Answer 16

Question 17

diagnosis of COPD

Answer 17

-FEV1 less than 80% predicted
-FEV1/FVC ratio: less than (0.7) 70%

Question 18

vaccine recommendations for COPD patients

Answer 18

-pneumonia (over 18)
-flu
-COVID

Question 19

GOLD classification

Answer 19

Gold 1: FEV1: >80 predicted
Gold 2: FEV1: 50-79 predicted
Gold 3: FEV1: 30-49 predicted
Gold 4: FEV1:<30 predicted

Question 20

ABCD assessment tool

Answer 20

-A: 0-1 exacerbations and CAT <10
-B: 0-1 exacerbations and CAT >10
-C: >2 exacerbations and CAT<10
-D: >2 exacerbations and CAT>10

Question 21

treatment of COPD

Answer 21

-A: intermittent use of SABA
-B: SABA + LABA or LAMA
-C: SABA + LAMA
-D: SABA + LABA + LAMA

Question 22

treatment of COPD exacerbation

Answer 22

-increase SABA use
-neb
-oral steroids
-azithromycin, augmentin, or doxy

Question 23

solid vs subsolid pulmonary nodule

Answer 23

-solid: less likely to be cancer
-subsolid: more likely to be cancer

Question 24

management of solitary pulmonary nodules

Answer 24

->30mm: resection
-<30mm: determine risk for malignancy

Question 25

screening criteria for lung cancer

Answer 25

-50-80 years old -currently smoke or quit in the last 15 years -20 pack year history

Question 26

s/s of lung cancer

Answer 26

-**cough** -blood tinged sputum -CP -SOB

Question 27

diagnosis of lung cancer

Answer 27

-CT with contrast then biopsy

Question 28

techniques for biopsy depending on location of tumor

Answer 28

-central: endobronchial -peripheral: transthoracic

Question 29

small cell carcinoma

Answer 29

-smokers -central

Question 30

adenocarcinoma

Answer 30

-nonsmokers -peripheral | Most common type of lung cancer-non small cell (adenocarcinoma)

Question 31

squamous cell carcinoma

Answer 31

-smokers -central

Question 32

large cell carcinoma

Answer 32

-peripheral

Question 33

treatment for NSCLC

Answer 33

-stage 0 and 1: surgery -stage 2 and 3: surgery + chemo -stage 4: chemo and palliative surgery or radiation

Question 34

treatment for SCLC

Answer 34

-limited stage with no mets: surgery + chemo -limited stage with mets: chemo + radiation -extensive: chemo

Question 35

MCC for pneumonia

Answer 35

strep pneumo

Question 36

Dx of pneumonia

Answer 36

CXR

Question 37

when do you order sputum cultures for pneumonia?

Answer 37

when hospitalizing

Question 38

s/s of pneumonia

Answer 38

-cough -**sputum** -fever -dyspnea

Question 39

determine if patient needs hospitalized for pneumonia

Answer 39

PSI and CURB65 | 3-5: hospitalize 4-5: ICU

Question 40

CURB65

Answer 40

C - Confusion U - BUN >19 R - RR>30 B - BP <90/60 >65 Any criteria > 2 indicate need for inpatient admission

Question 41

treatment of pneumonia

Answer 41

-**outpt with no comorbidities**: amoxicillin + (macrolide or doxy) *if penicillin allergy use a 3rd gen ceph (cefpodoxime)* -**outpt with comorbidities**: azithromycin + rocephin OR levaquin -**inpatient non ICU**: levaquin OR rocephin + azithromycin -**inpatient ICU**: rocephin + levaquin OR rocephin + azithromycin

Question 42

s/s of sleep apnea

Answer 42

-HTN -sleepy appearance -bull neck -right rided HF

Question 43

diagnosis of sleep apnea

Answer 43

sleep study | polysomnography

Question 44

tx of sleep apnea

Answer 44

CPAP

Question 45

s/sx of TB

Answer 45

fever, night sweats, loss of energy/appetite, weight loss

Question 46

dx of TB

Answer 46

ppd skin test

Question 47

in what pts is positive >5 mm ppd

Answer 47

-HIV -contact with TB patient -immunosuppressed -xray findings

Question 48

positive >10 mm ppd

Answer 48

-high risk workers -people who come to us from areas where TB is common -comorbidities -children

Question 49

positive >15 mm ppd

Answer 49

anyone else

Question 50

tx of TB

Answer 50

Isoniazid Rifampin Pyrazinamide Ethambutol Streptomycin