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The Final Step > 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

What age should vaccinations for pneumococcal pneumonia begin?

A

65

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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

PE

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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

RSV

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8
Q

What is the treatment for pneumocystitis jiroveci?

A

Bactrim

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9
Q

What occupations are the most associated with berylliosis?

A

Aerospace and nuclear plant workers

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10
Q

What CXR finding combined with patient history might make you think of berylliosis?

A

Diffuse infiltrates with hilar adenopathy

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11
Q

What is the gold standard diagnosis of a pleural effusion?

A

Thoracentesis

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12
Q

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

A

2nd ICS at the midclavicular line

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13
Q

Tamiflu can be given to children above what age?

A

1

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14
Q

Zanamavir (Relenza) may be given to children above what age?

A

7

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15
Q

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

A

Pneumocystitis jiroveci pneumonia (PJP used to known as PCP)

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16
Q

A noncaseating granuloma should make you think of what diagnosis?

A

Sarcoidosis

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17
Q

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

A

Squamous lung cancer

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18
Q

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

A

TB

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19
Q

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

A

PE

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20
Q

Mesothelioma is most commonly found in what lung location?

A

80% found in pleural lining

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21
Q

What CXR finding might make you think of mesothelioma?

A

Pleural thickening, remember 80% are found in pleura lining

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22
Q

Hyperinflation on CXR as well as eosinophelia on CBC should lead you to what diagnosis?

A

Asthma

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23
Q

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

A

Pseudamonas

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24
Q

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

A

Chlamydia and mycoplasma

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25
Q

What size induration would a PPD be positive for in an HIV patient?

A

5mm

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26
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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27
Q

List the three most commonly used treatments for COPD?

A

Oxygen, ipatropium, and albuterol

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28
Q

List 4 medications which may cause asthma

A

Beta blockers, NSAIDS, ASA, ACE inibitors

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29
Q

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

A

Silicosis

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30
Q

What is the initial treatment for active TB?

A

RIPE

RIF + INH + PZA + EMB for several months followed by INH + RIF once sensitivities come back

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31
Q

Caseating granulomas should make you think of what diagnosis?

A

TB

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32
Q

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

A

Chronic bronchitis

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33
Q

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

A

Tension pneumothorax

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34
Q

What is the best test to diagnose bronchiectasis?

A

CT

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35
Q

What are the main side effects of isoniazid (TB med INH)

A

Hepatitis and peripheral neuropathy

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36
Q

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

A

RIF (Rifampin)

37
Q

Ethambutol has what major side effects?

A

Optic neuritis, red green vision loss

38
Q

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

A

Yersinia pestis

39
Q

What is the most common organism causing pneumonia in COPD patients?

A

H. influenzae

40
Q

Where is a pan coast tumor found on chest x-ray?

A

At the apex of either the right or left lung

41
Q

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

A

Upper

42
Q

Patient with pneumonia has rust colored sputum. What diagnosis should you be thinking of?

A

Strep pneumonia

43
Q

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

A

Upper lung fields

44
Q

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

A

Inhaled steroid like fluticasone

45
Q

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

A

Tularemia

46
Q

Dullness to percussion should make you think of what diagnosis?

A

Lobular pneumonia

47
Q

Young child presents to ER and you see him waiting in the tripod position. What diagnosis should you be thinking of?

A

Epiglottitis

48
Q

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

A

10mm

49
Q

List 6 extrapulmonary complications of lung cancer

A 
SPHERE
SVC syndrome
Pancoast tumor
Horner's syndrome
Endocrine problems
Recurrent laryngeal symptoms
Effusions (Exudative)
50
Q

Currant jelly sputum should make you think of what diagnosis?

A

Klebsiella pneumoniae

51
Q

What happens to TLC in sarcoidosis?

A

Decreases

52
Q

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

A

Linear opacities at the bases with pleural plaques

53
Q

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

A

Breast, liver, colon

54
Q

A thumbprint sign on X-ray should make you think of what diagnosis?

A

Later c-spine = epiglottitis

55
Q

A barrel chest should make you think of what diagnosis?

A

Emphysema

56
Q

Are the lungs noisy or quiet in COPD?

A

Quiet

57
Q

List four indications for the flu vaccine

A

Child 6-59 months
Pregnant female
Healthcare worker
Age greater than 50

58
Q

Post tussive rales should make you think of what diagnosis?

A

TB

59
Q

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

A

Emphysema

60
Q

Rhonci or wheezes that clear after coughing suggest what diagnosis?

A

Bronchi or atelectasis

61
Q

Does FEV1 go up or down with asthma?

A

Down

62
Q

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

A

ARDS

63
Q

What is the most common cause for bronchiectasis?

A

CF

64
Q

What is the gold standard for the diagnosis of CF?

A

Sweat chloride test

65
Q

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

A

TB, lung cancer

66
Q

What is the treatment for epiglottitis?

A

2nd or 3rd generation cephalosporins (ceftriaxone)

Erythromycin or clindamycin are other options

67
Q

Transudative pleural effusions should make you think of what diagnosis?

A

CHF

68
Q

What two lung cancers are typically found centrally on x-ray?

A

Small cell cancer and squamous cell cancer

69
Q

What two lung cancers are typically found peripherally on x-ray?

A

Adenocarcinoma and large cell

70
Q

Pertussis is most commonly treated with what antibiotic?

A

Erythromycin

71
Q

List for most common places for metastasis from lung cancer?

A

Bone, brain, liver, adrenal glands

72
Q

If you come across a question where the patient has erythema nodosum and an enlarged parotid gland what diagnosis should you be thinking of?

A

Sarcoidosis

73
Q

What is erythema nodosum?

A

Tender red nodules found on the shins

74
Q

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

A

Emphysema

75
Q

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

A

Klebsiella pneumoniae

76
Q

Honeycombing and tram tracks on CXR should make you think of what diagnosis?

A

Bronchiectasis and idiopathic pulmonary fibrosis

77
Q

Paradoxical pulses may be found in which pulmonary disorder?

A

Asthma

78
Q

An older patient presents with pneumonia and diarrhea. What diagnosis are you thinking of?

A

Legionella pneumonia

79
Q

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

A

Silicosis

80
Q

List three causes of decreased tactile fremitus

A

COPD, asthma, pleural effuison, pneumothorax

81
Q

Hyperresonance to percussion should make you think of what diagnosis?

A

Emphysema, pneumothorax, asthma

82
Q

Tympany to percussion should make you think of what diagnosis?

A

Large pneumothorax

83
Q

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

A

PNA, fibrosis, CHF, bronchitis

84
Q

Does TLC go up or down in COPD

A

Up

85
Q

List three differential diagnoses if you hear wheezes on lung exam?

A

Asthma, COPD, bronchitis

86
Q

What is it called when a patient says “eeee” but on auscultation you hear “ay”

A

Egophony

87
Q

A physical exam finding of egophany should make you think of what diagnosis?

A

Lobar pneumonia

88
Q

CXR shows vascular redistribution and blurred vascular outlines. What diagnosis should you be thinking of?

A

CHF

The Final Step (9 decks)

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