Pulmonology

Question 1

Indications for PFTs

Answer 1

• Dx and classify severity of pulm dysfxn
• Distinguish btn; obstructive, restrictive or mixed pulm dz
• Monitor response to therapeutic interventions
• Determine pulmonary risk prior to surgery

Question 2

Basic PFTs

Answer 2

• Air flow spirometry
• Lung volumes
• DLCO

Question 3

Considerations for PFTs

Answer 3

Age
Height
Weight
Gender
Ethnicity
Smoking

Question 4

How many times must spirometry testing be done

Answer 4

three times

Question 5

FEV-1/FVC ratio for obstructive pattern

Answer 5

below seventy percent

Question 6

Why is bronchodilator testing done

Answer 6

To test reversibility

Question 7

How long after nebulizer or inhaler is PFT done again

Answer 7

15 min

Question 8

What is the indication for reversibility

Answer 8

Increase in FEV1 by twelve percent or t200ml

Question 9

DLCO

Answer 9

Measures ability of lungs to transfer CO and saturate Hgb

Question 10

DLCO for healthy lung

Answer 10

Little CO collected after expiration (mostly absorbed)

Question 11

Gold std diagnostic for COPD

Answer 11

Reversibility below twelve precent on spirometry

Question 12

How often do you do asthma follow up

Answer 12

one to three months initially then three to twelve months depending on severity

Question 13

In what age is spirometry not beneficial

Answer 13

Five and under

Question 14

How long after an acute asthma exacerbation does an individual need to follow up

Answer 14

one week

Question 15

What is the 3rd leading cause of death in the US

Answer 15

COPD

Question 16

Chronic bronchitis

Answer 16

cough for three months during two consecutive yrs

Question 17

structural changes w/ chronic bronchitis

Answer 17

Mucous gland enlargement; hyper secretion
Bronchial squamous metaplasia
Loss of ciliary transport

Question 18

What cells are predominant in the inflammation associated with chronic bronchitis

Answer 18

Neutrophils

Question 19

What cells are predominant in the inflammation associated with asthma

Answer 19

Eosinophils

Question 20

Is the airflow obstruction in chronic bronchitis inspiratory or expiratory

Answer 20

Both

Question 21

Which causes more parenchymal damage; Emphysema or COPD

Answer 21

Emphysema

Question 22

Is the airflow obstruction in emphysema inspiratory or expiratory

Answer 22

Expiratory

Question 23

What DLCO is associated with emphysema

Answer 23

Reduced (destruction of capillary bed)

Question 24

What is the role of antitrypsin

Answer 24

Inhibit elastase

Question 25

What is the role of elastase

Answer 25

Break down elastin which reduces the elasticity of the lung alveoli

Question 26

How does smoking affect the lungs

Answer 26

It activates elastase which causes degeneration of alveolar elastin

Question 27

How is pursed breathing an adaptation in COPD

Answer 27

it increases the intrabronchial pressure to keep the bronchi open and more air can be expelle

Question 28

Causative agent of pneumonia in younger pple

Answer 28

Chlamydophila

Question 29

Causative agent of pneumonia associated w/ diarrhea and in elderly

Answer 29

Legionella

Question 30

Causative agent of pneumonia in CHF

Answer 30

Pseudomonas

Question 31

Post influenza causative agent of pneumonia

Answer 31

Staph aureus