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0. PANCE Review > Pulmonology > Flashcards

Pulmonology Flashcards

1
Q

What is the most common patient complaint with

emphysema?

A

Shortness of breath

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2
Q

At what age should vaccinations for pneumococcal pneumonia begin?

A

65 years old

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3
Q

Prolonged expiration (low FEV1) should make you think of what diagnosis?

A

Asthma or COPD

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4
Q

Hampton’s hump on CXR should make you think of what diagnosis?

A

Pulmonary embolism

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5
Q

How long after administering a PPD should it be read?

A

48-72 hours

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6
Q

A patient without a functioning spleen is more susceptible to what type of organisms?

A

Encapsulated organisms most commonly Strep pneumoniae and H. Flu.

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7
Q

What is the most common cause of pneumonia in children less than 1 year old?

A

Respiratory syncytial virus (RSV)

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8
Q

What is the treatment for pneumocystis jiroveci pneumonia?

A

Bactrin

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9
Q

What occupations are associated with berylliosis?

A

Aerospace and nuclear plant workers

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10
Q

What CXR finding might make you think of berylliosis?

A

Diffuse infiltrates with hilar adenopathy

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11
Q

When performing a decompression for a tension pneumothorax where do you put the needle?

A

2nd intercostal space at the midclavicular line

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12
Q

Oseltamivir (Tamiflu) may be given to children above what age?

A

1 year old

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13
Q

Zanamivir (Relenza) may be give to children above

what age?

A

7 years old

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14
Q

An HIV patient with ground glass appearance on CXR should make you think of what diagnosis?

A

Pneumocystis jiroveci pneumonia (PJP used to be know as PCP)

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15
Q

A noncaseating granuloma should make you think of what diagnosis?

A

Sarcoidosis

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16
Q

A pearl formation on CXR should make you think of what diagnosis?

A

Squamous cell lung cancer

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17
Q

Ghon or Ranke complexes on CXR should make you think of what diagnosis?

A

TB

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18
Q

A Westermark sign on CXR should make you think of what diagnosis?

A

Pulmonary embolism

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19
Q

Mesothelioma is most commonly found in what lung location?

A

80% are found in the pleural lining

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20
Q

What CXR finding might make you think of mesothelioma?

A

Pleural thickening, remember 80% are found in the pleura lining

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21
Q

Hyperinflation on a CXR as well as eosinophilia on CBC should make you think of what diagnosis?

A

Asthma

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22
Q

What organism is the most common cause of pneumonia in a patient with cystic fibrosis?

A

Pseudomonas

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23
Q

A college student presents with pneumonia. What two organisms should you be thinking of?

A

Chlamydia and Mycoplasma

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24
Q

At what size induration would a PPD be positive for an HIV patient?

A

5mm

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25
Q

You suspect a pneumothorax. What instructions should go along with the order for a CXR?

A

It should be an end expiratory view in order to look for visceral pleural air.

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26
Q

List the three most commonly used medical treatments for COPD?

A

Oxygen, ipratropium and albuterol

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27
Q

List 4 medications which may cause asthma.

A

Beta blockers, NSAIDS, ACEI, ASA

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28
Q

What is the initial treatment for active TB?

A

6months treatment:

2 months of:

  • INH (Isoniazid)
  • RIF (Rifempin)
  • PZA (Pyrazinamide)
  • EMB (Ethambutol)

Fallowed by 4months of:

  • INH (Isoniazid)
  • RIF (Rifempin)
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29
Q

Caseating granulomas should make you think of what diagnosis?

A

TB

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30
Q

Blue bloater refers to the characteristic physical exam findings of what disease?

A

Chronic bronchitis

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31
Q

A contralateral mediastinal shift should make you think of what diagnosis?

A

Tension pneumothorax

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32
Q

What is the best test to diagnose bronchiectasis?

A

CT

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33
Q

You are treating a patient for TB. He has noticed that his body fluids now have an orange tint. What drug is most likely causing this?

A

Rifampin

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34
Q

Ethambutol has what two major side effects?

A

Optic neuritis, red green vision loss

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35
Q

What is the most common organism causing

pneumonia in COPD patients?

A

Haemophilus influenzae

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36
Q

Where is a Pancoast tumor found on CXR?

A

At the apex of either the right or left lung

37
Q

Will evidence of TB be seen more frequently in the upper or lower lung lobes on CXR?

38
Q

A patient has pneumonia with rust colored sputum. What is the most likely diagnosis?

A

Strep pneumonia

39
Q

Coal miners lung often shows nodular opacities in what lung fields?

A

Upper lung fields

40
Q

When you step up the diagnosis from intermittent asthma to mild persistent asthma what medication should you add?

A

An inhaled steroid like fluticasone

41
Q

Any question about rabbits and pneumonia should make you think of what diagnosis?

42
Q

Dullness to percussion should make you think of what diagonsis?

A

Lobar pneumonia

43
Q

A young child presents to ER and you see him waiting in tripod position. What is the most likely diagnosis?

A

Epiglottitis

44
Q

At what size induration would a PPD be positive for a healthcare worker?

45
Q

List six extrapulmonary complications of lung cancer?

A
  • SPHERE - SVC syndrome,
  • Pancoast tumor,
  • Horner’s syndrome,
  • Endocrine problems,
  • Recurrent laryngeal symptoms,
  • Effusions (exudative)
46
Q

Currant jelly sputum should make you think of

what diagnosis?

A

Klebsiella pneumoniae

47
Q

What happens to total lung capacity in sarcoidosis?

A

It goes down

48
Q

What will the likely findings be on a CXR of a patient with asbestosis?

A

Linear opacities at the bases with pleural plaques

49
Q

Tympany to percussion should make you think of what diagnosis?

A

Large pneuomthorax

50
Q

What are the three most common cancers to metastasize to the lungs?

A

Breast, liver and colon

51
Q

A thumbprint sign on x-ray should make you think of what two diagnoses?

A

Lateral C-spine = epiglottitis, abdominal = intestinal ischemia

52
Q

A barrel chest should make you think of what diagnosis?

53
Q

Are the lungs noisy or quiet in COPD?

54
Q

List four indications for the flu vaccine.

A
  • Child 6-59 months,
  • Pregnant female,
  • Healthcare worker,
  • Age > 50yo
55
Q

Posttussive rales should make you think of what diagnosis?

56
Q

Bullae and blebs on CXR should make you think of what diagnosis?

57
Q

Rhonci or wheezes that clear after coughing suggest what diagnosis?

A

Bronchitis or atelectasis

58
Q

A very sick patient with diffuse infiltrates that spare the costophrenic angles should make you think of what diagnosis?

A

Acute respiratory distress syndrome (ARDS)

59
Q

What is the most common cause of bronchiectasis?

A

Cystic Fibrosis

60
Q

What is the gold standard for the diagnosis of cystic fibrosis?

A

Sweat chloride test

61
Q

An exudative pleural effusion should make you think of what diagnosis?

A

TB, Lung cancer

62
Q

What is the treatment for epiglottitis?

A

2nd or 3rd generation cephalosporin (ceftriaxone), macrolides may also be used (clindamycin)

63
Q

Transudative pleural effusions should make you think of what diagnosis?

A

Congestive heart failure

64
Q

What two lung cancers are typically found centrally on CXR?

A

Small cell and squamous cell

65
Q

What two lung cancers are typically found peripherally on CXR?

A

Adenocarcinoma and Large cell

66
Q

Pertussis is most commonly treated with what antibiotic?

A

Erythromycin

67
Q

List the four most common places lung cancer will metastasize to?

A

Bone, brain, adrenals and liver

68
Q

If you come across a question where the patient has erythema nodosum and an enlarged parotid gland what is the most likely diagnosis?

A

Sarcoidosis

69
Q

What is erythema nodosum?

A

Tender red nodules usually found on the shins.

70
Q

A thin looking heart and flattened diaphragm on CXR should make you think of what diagnosis?

71
Q

If you see a question with an alcoholic who has been diagnosed with pneumonia what is the most likely organism?

A

Klebsiella pneumoniae

72
Q

Honeycombing and tram tracks on the CXR should

make you think of what diagnosis?

A

Bronchiectasis and idopathic pulmonary fibrosis

73
Q

Paradoxical pulses may be found in what pulmonary disorder?

74
Q

An older patient presents with pneumonia and diarrhea. What is the most likely diagnosis?

A

Legionella pneumonia

75
Q

Eggshell opacities on the CXR should make you think of what diagnosis?

76
Q

List three causes of decreased tactile fremitus?

A

COPD, asthma, pleural effusion, pneumothorax

77
Q

Hyperresonance to percussion should make you think of what diagnosis?

A

Emphysema, pneumothorax, asthma

78
Q

If you hear crackles in the lung fields list three pulmonary issues that should be in your differential.

A
  • Pneumonia,
  • Fibrosis,
  • CHF,
  • Bronchitis
79
Q

Does total lung capacity go up or down in COPD?

A

It goes up.

80
Q

List three things that should be in your differential if you hear wheezes on a lung exam?

A

Asthma, COPD, Bronchitis

81
Q

What is it called when a patient says “ee” but on auscultion you here “ay”?

82
Q

A physical exam finding of egophony should make you think of what diagonsis?

A

Lobar pneumonia

83
Q

A CXR shows vascular redistribution and blurred vascular outlines. What is the most likely diagnosis?

84
Q

What is the gold standard for diagnosis of a pleural effusion?

A

Thoracocetesis

85
Q

Nodular opacities in the upper lung fields should make you think of what diagnosis?

86
Q

If you see a question with anything to do with rats and the patient has pneumonia, what organism should you be thinking of?

A

Yersinia pestis

87
Q

What are the main side effects of isoniazid?

A

Hepatitis and peripheral neuropathy

88
Q

Does FEV1 go up or down with asthma?

A

It goes down

0. PANCE Review (15 decks)

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