pulmonology Flashcards
What is the vector for transmission of Lyme disease, anaplasmosis, and babesiosis?
The deer tick.
What does lymphangioleiomyomatosis result from?
Smooth muscle growth in the lungs, leading to widespread cyst formation.
How can eosinophilic granulomatosis with polyangiitis be described?
Asthma with peripheral eosinophilia.
What are the diagnostic features of diffuse panbronchiolitis?
Diffuse centrilobular nodules in a tree in bud distribution and dilation of distal bronchioles.
What is the prognosis for advanced stages of non-small cell lung cancer adenocarcinomas with EGFR mutations?
More favorable prognosis.
What will a CBC show for hantavirus?
Thrombocytopenia as well as lymphocytosis.
What is the best treatment for a patient with COPD who has had at least two exacerbations and a blood eosinophil count of less than 300?
LABA and a LAMA.
What is the normal range for initial flow?
Approximately 40-60 Lpm.
What is the recommended duration of systemic anticoagulation for a provoked VTE?
3 months.
What RSBI value is positive for extubation?
Less than 105.
What do radiographs for idiopathic giant bullous emphysema show?
Paraseptal asymmetric upper lobe predominant giant bullae.
What is the vector for tularemia and Rocky Mountain spotted fever?
The dog tick.
Where is hantavirus most common in the United States?
Arizona, Colorado, New Mexico, and Utah.
What are the symptoms of hantavirus pulmonary syndrome?
Pulmonary edema, bronchorrhea, and cardiopulmonary collapse.
What is the typical length of a SBT?
Around 30 minutes.
What characterizes UIP?
Peripheral honeycombing, traction bronchiectasis, and basilar and subpleural predominance.
What is wrong with the P/F ratio calculation of 80 (PaO2)/40 (FiO2)?
You must convert FiO2 to a decimal: 80/.4 = 200.
How do you obtain the Vt value for the RSBI calculation?
Take the minute ventilation/RR.
What is diagnostic for airway obstruction?
FEV1/FVC ratio <70% or outside the 95% confidence interval for predicted FEV1/FVC.
What are the most common manifestations of Osler-Weber-Rendu syndrome?
Nosebleeds, GI bleeds, and AVMs on the mucosal surfaces.
When is pneumocystis jirovecii an unlikely diagnosis?
In a patient with a CD4 count of >200.
What is the normal range for initial pressure trigger sensitivity?
2 cmH2O.
What is the best strategy for treating IPF?
Supportive care including pulmonary rehabilitation and supplemental oxygen.
What is the next step for someone with uncontrolled asthma on medium dose inhaled steroid?
Add an inhaled LABA.
What symptoms indicate a diver may be suffering from nitrogen narcosis?
Acute onset of poor judgment, euphoria, or confusion.
What is decompression sickness associated with?
Pain/end organ damage due to nitrogen gas bubbles in tissue.
What is nitrogen narcosis associated with?
Neurological symptoms due to high partial pressure of nitrogen in the brain.
Who is lymphangioleiomyomatosis typically found in?
Young women and those with tuberous sclerosis.
What is granulomatosis with polyangiitis positive for?
cANCA.
What is the normal Vt range to set on a ventilator?
Typically 6-8 mL/kg.
What is the initial therapeutic management for exercise induced bronchoconstriction?
Administration of a SABA 15 minutes before activity.
What can long-term steroid use lead to in COPD patients?
Worsening dyspnea as a result of muscle weakness and volume overload.
What is idiopathic giant bullous emphysema most common in?
Young men with a short history of smoking.
What is the most common idiopathic interstitial pneumonitis?
Idiopathic pulmonary fibrosis.
What VC value is positive for extubation?
Greater than 10 ml/kg.
What is a typical SBT setting for proportional assist ventilation?
30 percent of the WOB.
What do radiographs for idiopathic giant bullous emphysema show?
Asymmetric upper lobe predominant giant bullae.
What is the treatment for a new diagnosis of uncomplicated PE without hemodynamic compromise?
Oral apixaban or rivaroxaban.
What is Langerhans cell histiocytosis associated with?
Patients aged 20 to 40 and smoking.
What is the benefit for lung transplantation in IPF greatest in?
Younger patients.
What do DOACS treat?
Patients with uncomplicated VTE.
What is the common finding on CBC differential for ABPA?
Peripheral eosinophilia.
What is the formula for Total Cycle Time?
Total Cycle Time = (60/RR).
What is the IBW male formula in pounds?
106 + 6(H-60).
What is the IBW female formula in pounds?
105 + 5(H-60).
What is the RSBI calculation?
RR/Vt (in liters).
What is the treatment for new diagnosis of uncomplicated PE?
Oral apixaban or rivaroxaban.
What does hantavirus show on peripheral smear?
Myelocytosis along with immunoblasts.
What is the preferred treatment for non-small cell lung cancer stage 1 to 2A?
Surgical resection.
What should LAMAs be used with caution in patients with?
BPH or bladder neck obstruction.
What is the most critical factor for reducing instances of VAP?
Daily assessment for extubation readiness.
What is the normal plateau pressure range?
Typically below 30 cm H2O.
What is the shortcut for determining mechanical ventilator tidal volume range?
IBW (kg)= 50 + (2 x inches over 5 feet), then add zero to get max tidal volume and divide by 2 for minimum.
What is the normal PIP range?
25-30 cm H2O.
What are the symptoms of chronic cough and dyspnea in a patient with Hodgkin’s lymphoma?
Interstitial lung opacities likely due to bleomycin.
What is the treatment for allergic bronchopulmonary Aspergillosis?
Often found in patients with a history of asthma.
What is the NIF value positive for extubation?
Less than -20.
What rare side effect can Nitrofurantoin cause?
Pulmonary fibrosis.
What is the most common pulmonary manifestation of hereditary hemorrhagic telangiectasia?
AVMs can also be in the pulmonary, hepatic, and cerebral vasculature.
What is the recommended treatment for patients with uncomplicated VTE?
DOACS are now the recommended treatment for patients with uncomplicated VTE.
What are common radiographic findings in ABPA?
ABPA may have central bronchiectasis with mucus plugging as common radiographic findings.
What characterizes diffuse panbronchiolitis?
Diffuse panbronchiolitis is characterized by dyspnea on exertion, chronic sinusitis, and chronic productive cough.
What is UIP characterized by?
UIP is characterized by peripheral honeycombing, traction bronchiectasis, and basilar and subpleural predominance.
What is the most common pulmonary manifestation of hereditary hemorrhagic telangiectasia?
The most common pulmonary manifestation of hereditary hemorrhagic telangiectasia is pulmonary arteriovenous malformations, also called Osler-Weber-Rendu syndrome.
What are typical SBT settings for weaning?
Typical SBT settings for weaning would be a CPAP of 5 and a PS of 5.
In which patients should LAMAs be used with caution?
LAMAs should be used with caution in patients with BPH or bladder neck obstruction.
What are the symptoms of hantavirus pulmonary syndrome?
Hantavirus pulmonary syndrome includes pulmonary edema, bronchorrhea, and cardiopulmonary collapse.
What describes decompression sickness?
Decompression sickness describes pain in the limbs/end organ damage due to nitrogen gas bubbles in tissue in a diver.
What is nitrogen narcosis characterized by?
Nitrogen narcosis is characterized by neurological symptoms due to high partial pressure of nitrogen in the brain.
What is diagnostic of pulmonary HTN?
Mean pulmonary artery pressures >20 on a right heart cath is diagnostic of pulmonary HTN.
What indicates a positive cuff leak for extubation?
Cuff leak greater than 15 percent is positive for extubation.
In which demographic is lymphangioleiomyomatosis typically found?
Lymphangioleiomyomatosis is typically found in young women and those with tuberous sclerosis.
What is idiopathic giant bullous emphysema most common in?
Idiopathic giant bullous emphysema is most common in young men with a short history of smoking.
What histologic pattern characterizes idiopathic pulmonary fibrosis?
Idiopathic pulmonary fibrosis is characterized by the histologic pattern of UIP.
What is the normal P/F ratio?
Normal P/F ratio is greater than or equal to 400.
What is the best strategy for treating IPF?
The best strategy for treating IPF is supportive care.
What should be avoided in chronic steroid use for COPD patients?
Chronic steroid use in COPD patients should be avoided if possible as it could lead to increased risk of pneumonia.
From which region do adenocarcinomas typically arise?
Adenocarcinomas typically arise from the periphery of the lung.
What is the appearance of Langerhans cell histiocytosis?
Langerhans cell histiocytosis has the appearance of thin walled cysts and small nodules in the mid and upper zones of the lungs.
What is the normal range FIO2 to start ventilation?
Normal range FIO2 to start ventilation is 40 to 60 percent.
From which region do large cell carcinomas typically arise?
Large cell carcinomas typically arise from the periphery of the lung.
What is the diagnostic test for COPD?
The diagnostic test for COPD is spirometry.
What autoimmune disease can be described as asthma with peripheral eosinophilia?
Eosinophilic granulomatosis with polyangiitis can be described as asthma with peripheral eosinophilia.
What is the anatomic dead space equal to?
Anatomic dead space is equal to 1 mL/pound of IBW.
What are the diagnostic features of diffuse panbronchiolitis?
Diffuse centrilobular nodules in a tree in bud distribution and dilation of distal bronchioles are diagnostic of diffuse panbronchiolitis.
