Pulmonology Flashcards
normal A-a gradient? What causes a high A-a gradient? What is the equation
5-15
PE, pulmonary edema, R-L shunt
atm air pressure x FiO2 - PaCO2/0.8 - PaO2
713X0.21
feared complication of strep pharyngitis
acute rheumatic fever
post strep GN
signs of peritonsillar abscess
muffled voice, uvula deviation, severe sore throat, fever, drooling
most commonly used empiric treatments for community acquired pneumonia in adults?
levofloxacin, moxifloxacin, gemifloxacin
beta lactam + macrolide or doxy
most common cause of atypical pneumonia in young adults
mycoplasma
most common cause of pneumonia in adults
strep pneumo
most common cause of pneumonia in younger children
RSV
most common cause of penumonia in neonates
GBS
Cystic fibrosis patients are at increased risk of acquiring pneumonia from which organism
pseudomonas
common cause of pneumonia in immunocompromised patients
PCP
pneumonia associated with currant jelly sputum
klebsiella
interstitial pneumonia in bird handlers
c psiiaci
pneumonia in patient with exposure to bats and bat dropping
histo
cause of pneumonia in patient who has visited cali, new mexico, west texas
coccidio
pneumonia acquired from air conditioners
legionella
pneumonia cause in children 1 year or younger
RSV
pneumonia in neonate
GBS
penumonia in young adults
mycoplasma
cause of woolsorters disease
bacillus anthracis
hallmark pulmonary function test in COPD
FEV1:FVC
48 y/o FEV1 of 55% of predicted and has SOB when walking, what medications would be appropriate for this patient?
short acting beta2, inhaled ach, smoking cessation, flu vaccine, pneumococcal vaccine
lung cancer associated with paraneoplastic syndrome: elevated ACTH, cushing syndrome
small cell lung Ca
lung cancer associated with paraneoplastic syndrome: elevated PTH related peptide, hypercalcemia
squamous cell lung Ca
lung cancer associated with paraneoplastic syndrome: elevated ADH, SIADH, hyponatremia
small cell lung Ca
lung cancer associated with paraneoplastic syndrome: antibodies to presynaptic Ca channels, lambert eaton syndrome
small cell lung Ca
classic findings in idiopathic pulmonary fibrosis
ground glass appearance, honeycomb lung
tx of idiopathic pulmonary fibrosis
pirfenidone, nintedanib
pneumoconiosis with progressive fibrosis
coal worker’s, silicosis
pneumoconiosis with increased risk of TB
silicosis
pneumoconiosis with working with electronics, causes increased Ca risk
berylliosus
pneumoconiosis with malignant mesothelioma and bronchogenic carcinoma
asbestos
classic sign of PE on CXR
hampton’s hump, wedge shaped infarct
CXR findings suggestive of pulmonary edema
kerley B lines, diffuse interstit fluid, cephalization of vessels
drugs used to treat pulmonary HTN
vasodilators
- prostanoids
- endothelin receptor antag
- cGMP PDE
- CCB
study to help differentiate pleural effusion loculated or free flowing in thorax
CXR upright and then lateral decubitus
cause of transudative pleural effusion
CHF, nephrotic syndrome, cirrhosis
size pneumothorax requiring a chest tube placement
> 15%
medication used prior to intubation in head injury patients
lidocaine
substances avoided in obstructive sleep apnea
alcohol, sedatives
tx of epiglottitis
intubate, abx covering staph/strep, steroids
tx of croup
supportive, racemic epi/O2
tx of RSV bronchiolitis
supportive care
CXR appearance of newborn RDS
ground glass and air bronchogram
low lung volumes
after birth, child has stridor, wheezing, SOB despite medical therapies, what is the likely cause?
vascular ring
tx of pulmonary components of CF
beta2 agonist
DNAse
hypertonic saline
physiotherapy
azithromycine/fluoroquinolones
causes of exudative pleural effusion
malignancy, TB, bacterial infection, pulmonary embolus, pancreatitis
treatment of wegener’s
steroids
cyclophosphamide/MTX/rituximab
patient with hypoxemia and pulmonary edema has normal pulmonary capillary wedge pressure. Diagnosis?
acute respiratory distress syndrome
diagnosis of patient with dyspnea, hilar LAD on CXR, with hypercalcemia
sarcoidosis
patient with chronic COPD qualifies for home O2 when…
O2 sat
patient with lung disease is found to have anti-glomerular basement membrane antibodies. Dx and tx?
goodpasture disease
tx: plasmapheresis, steroids, immunosuppression
40 year old black woman is found to have hypercalcemia and noncaseating granulomas of the lung. Dx?
sarcoidosis
four clinical features of strep pharyngitis
fever,
tender ant cervical LAD
tonsillar exudates
absence of cough
Patient is found to have honeycomb pattern on CT scan of the chest. What is the diagnosis and treatment?
pulmonary interstitial fibrosis
treatment: steroids, azathioprine, NAC, lung transplant
empiric treatment for a 2 month old with pneumonia
erythromycin, cefotaxime
empiric treatment for a 2 day old with pneumonia
amox/amp
rare, classic EKG finding in pulmonary embolism
S1Q3T3
most common EKG finding in pulmonary embolism
sinus tachy
lung cancer associated with elevated ACTH and cushing syndrome
small cell
lung cancer associated with elevated PTH related peptide and hypercalcemia
squamous cell
lung cancer associated with elevated ADH, SIADH, hyponatremia
small cell
lung cancer associated with antibodies to presynaptic Ca channels, lambert eaton syndrome
small cell
