Pulmonology

Question 1

what is the presentation of bronchitis

Answer 1

cough >5 days with or without sputum production, lasting 2-3 weeks
- chest discomfort
- SOB
- +/- fever

Question 2

what is the treatment of bronchitis

Answer 2

ABX are not recommmended due to common viral casues

Question 3

what PFT volumes determine Chronic bronchitis

Answer 3

FEV1/FVC ratio less than 0.7

Question 4

what type of lung cancer presents with a central mass

Answer 4

small cell

Question 5

who does small cell lung cancer affect

Answer 5

15% of cases
99% smokers

Question 6

what is the typical presentation of small cell cancer

Answer 6

recurrent pneumonia,
anorexia, weight loss, weakness and cough

Question 7

what other conditions is small cell lung cancer associated wtih

Answer 7

superior vena vaca syndrom
phrenic nerve palsy
recurrent laryngeal nerve palsy
horner syndrom
malignant pleaural effusion
eaton-lambert syndrome

Question 8

what is superior vena cava syndrome

Answer 8

obstruction of SVC by mediastianl tumor, facial fullness and facial/arm edema with dilated veins over anterior chest, arms and face. jvd

Question 9

what is horner syndrome

Answer 9

invasion of cervical sympathetic chain by apical tumor causing unilateral facial anhidrosis, ptosis and miosis

Question 10

what is the treatment of small cell lung cancer

Answer 10

combo chemotherapy as it does not respond to surgery

Question 11

what is the most common type of non-small cell lung cancer

Answer 11

adenocarcionma (peripheral mass)

Question 12

what are the differnt types of non-small cell lung cancer

Answer 12

squamous cell (central mass)
Large cell
adenocarcioma (peripheral mass)

Question 13

what is the treatment options for non-small cell lung cancer

Answer 13

surgery
+/- chemo

Question 14

what is carcinoid syndrome

Answer 14

flushing, diarrhea, telangectasias

Question 15

what is a pancoastal tumor

Answer 15

shoulder pian, horners syndrome and brachial plexus compression

Question 16

what is the most common etiology of community-acquired pneumonia

Answer 16

S. Pneumoniae

Question 17

what are risk factors for community-acquired pneumonia

Answer 17

advanced age, alcholoism, tobacco use, and comorbid medical conditions (asthma, COPD)

Question 18

what is seen on CXR with community-acquired pneumonia

Answer 18

pathcy airspace opacities to lobar consolidation

Question 19

what are preventative measures for pneumonia

Answer 19

Pneumovax 23
Prevnar13

Question 20

who should get prevnar13

Answer 20

65+ and immunocompromised

Question 21

what pathogens are associated with nosocomial pneumonia

Answer 21

S. aureus, K. pneumoniae, E. coli and pseudomonas aeruginosa

Question 22

what are the treatment options for community-acquired pneumonia

Answer 22

Marcrolide: clarithromycin 500mg PO BID for 5 days or azithromycin 500mg PO then 250mg PO for 4 days

Question 23

what are the treatment options for inpatient (non-icu) pneumonia pts

Answer 23

Respiratory FQ: IV levofloxacin 750 daily or IV ciprofloxacin 400mg Q8-12hr

Question 24

what are the treatment options for ICU pts with pneumonia

Answer 24

azithromycin or respiratory FQ + antipneumococcal beta-lactam: cefotazime, ceftriaxone or unasyn

Question 25

what is the treatment of latent TB

Answer 25

rifamycin-based 3 or 4 month

Question 26

what is treatment of active TB

Answer 26

4 months Rifapentine-moxifloxacin (rifapentine, moxifloacin, isoniazid and pyrazindamide)
or Quad therapre RIPE: rifampin, isoniazid, pyrazinamide, ethambutol

Question 27

what are the SE of moxifloxacin

Answer 27

QT-prolonging agent - associated wiht cardiac arrythmias - which may be fatal

Question 28

what is the side effect of Rifampin

Answer 28

orange body fluids, hepatitis