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PANRE Review > Pulmonology > Flashcards

Pulmonology Flashcards

1
Q

Asthma medication associated with arrhythmias and seizures

A

Theophylline

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2
Q

Classification of asthma severity

A

Intermittent: FEV1 >80%
Mild persistent: FEV1 >80%, SABA more than 2 times per week, minor limitation
Moderate: FEV1 60-80%
Severe: FEV1 <60%

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3
Q

COPD in a 30-40 year old makes you think of this diagnosis/work-up

A

alpha1- antitrypsin deficiency

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4
Q

Hyperinflation, flat diaphragm, trapped air, bullae/blebs on CXR

A

Emphysema

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5
Q

Enlarged right heart border, increase vascular marking on CXR

A

Chronic bronchitis

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6
Q

Stages of COPD management

A 
GOLD
I: FEV1 >80- SABA and/or anticholinergic
II: FEV1 50-79 Add LABA
III: FEV1 30-50 Add pulmonary rehab, ?steroids
IV: FEV1 <30 Add O2 therapy
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7
Q

Most common causes of bronchiectasis

A

Cystic Fibrosis (pseudomonas) most common cause

H.Flu most common cause if not CF

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8
Q

Cystic Fibrosis patient with bronchiectasis, What is the likely microorganism? Treatment?

A

Pseudomonas; Fluoroquinolone

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9
Q

CT reveals airway dilation, tram-track appearance, lack of tapering bronchi. What is the diagnosis?

A

Bronchiectasis

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10
Q

Treatment for Mycobacterium Avian Complex

A

clarithromycin + ethambutol

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11
Q

Manifestations of Cystic Fibrosis

A

GI: Meconium ileus at birth, pancreatic insufficency (foul smelling stool)
Resp: recurrent respiratory infections

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12
Q

Most common extrapulmonary findings of sarcoidosis

A

Skin: erythema nodosum, lupus pernio
LN’s: intrathoracic hilar adenopathy
Optic: uveitis

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13
Q

Elevated ACE makes you think of what diagnosis?

A

Sarcoidosis (NCG secrete ACE)

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14
Q

CXR/CT finding of idiopathic pulmonary fibrosis

A

Diffuse reticular opacities (HONEYCOMBING!)

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15
Q

CXR reveals nodular opacities in upper lobes, eggshell calcifications of hilar LN’s. What is the exposure?

A

Mining and quarry work (Silicosis!)

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16
Q

Byssinosis is caused from?

A

Long-term cotton exposure

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17
Q

What condition would be seen with CXR showing pleural plaques, thickening, interstitial fibrosis in lower lobes

A

Asbestosis

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18
Q

Most common mediastinal tumor

A

Thymoma

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19
Q

Characteristics of malignant pulmonary nodule

A

irregular, spiculated, rapid growth, cavitary with thickened walls

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20
Q

Where does lung cancer usually METs to?

A

brain, bone, liver, LN and adrenals

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21
Q

What are the two central lung cancers?

A

Squamous cell carcinoma and small cell carcinoma

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22
Q

Characterstics of small cell lung cancer

A

aggressive, central, SVC syndrome, SIADH/hyponatremia, paraneoplastic (Cushings)

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23
Q

Pancoast syndrome

A

shoulder pain, Horners syndrome, atrophy of hand/arm

seen with squamous cell carcinoma

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24
Q

Lung cancer associated with cavitary lesions, hyperkalemia, pancoast tumor

A

squamous cell carcinoma (NSCLC)

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25
Q

Diagnosis of bronchial carcinoid tumor

A

pink to purple well vascularized central tumor

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26
Q

Where does mesothelioma originate from

A

Pleura (80%)

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27
Q

The term for palpable edema of the costal cartilage

A

Tietze syndrome

28
Q

Most common cause of transudative pleural effusion

A

CHF

29
Q

How do you determine cause of pleural effusion?

A

Lights Criteria:
pleural protein: serum protein >0.5
pleural LDH: Serum LDH >0.6

30
Q

CXR shows blunting of costophrenic angles

Diagnosis?

A

Pleural effusion

31
Q

CXR reveals companion lines, decreased peripheral lung markings and lungs, trachea and heart to the left. What is the next step?

A

Needle aspiration: 2nd ICS, midclavicular line on the right followed by chest thoracostomy

32
Q

Hamptons Hump or Westermark’s sign on CXR are signs of?

A

PE (although most commonly CXR normal)

33
Q

Patient with PE who is hemodynamically stable and has history of ICH, malignant HTN. What is treatment in this patient?

A

IVC Filter

34
Q

Patient with PE who is hemodynamically unstable and has history of CVA 1 month ago. What is treatment in this patient?

A

Thrombectomy/embolectomy

35
Q

2 contraindications for LMWH

A 
Renal failure (Cr >2)
Thrombocytopenia
36
Q

Two most common causes of CAP?

A

S. Pneumo (MC) and H.Flu (CF, COPD)

37
Q

Most common cause of CAP in young, school-aged, college students?

A

Mycoplasma Pneumoniae

38
Q

What is a possible cause of pneumonia in an elderly patient in a home with N/V/D with hypnatremia and elevated LFTs?

A

Legionella

39
Q

Most common cause of viral pneuomnia in adults? children?

A

Adults: Influenza
Children: RSV, Parainfluenza

40
Q

Severe pneumonia seen with alcoholics, cavitary lesions on CXR

A

Klebsiella

41
Q

Pneumonia/Cough associated with bird/rat droppings

A

Histoplasmosis

42
Q

Currant jelly on sputum

A

Klebsiella

43
Q

CXR showing upper lobe (RUL) bulging fissure, cavitations

A

Klebsiella

44
Q

Physical exam findings of pleural effusion

A

Percussion: Dull
Fremitus: Decreased
Breath sounds: Decreased

45
Q

Empiric treatment for CAP pneumonia

A

Outpt: Macrolide or Doxycycline
Inpt: Beta-Lactam + Macrolide OR FQ
ICU: Beta-Lactam + Macrolide OR Beta-Lactam + FQ

46
Q

Empiric treatment for HAP

A

Anti-pseudomonal Beta-Lactam + AG or FQ

47
Q

Empiric treatment for suspected PCP

A

Bactrim + steroids

48
Q

Empiric treatment for aspiration pneumonia

A

Clindamycin or Augmentin +/- Metronidazole

49
Q

Reaction size of PPD in health care worker to warrant positive for infection

A

10 mm or greater

50
Q

CXR finding with primary TB

A

Middle/lower lobe consolidation

51
Q

CXR finding with reactivation TB

A

Apical fibrocavitary lesion

52
Q

Treatment for primary active TB

A 
Rifampin
Isoniazid
Pyrazinamide
Ethambutol (or streptomycin)
for 2 months then d/c PZA and ETH (if sensitive to RIF and INH)
53
Q

Main side effects of Isoniazid

A

Peripheral neuropathy and hepatitis

54
Q

Patient being treated for TB has scotoma, color perception problems which medication is responsible?

A

Ethambutol

55
Q

Most common cause (organism) for a premature 1 year old with fever, wheezing, tachypnea and nasal flaring?

A

RSV bronchiolitis

56
Q

Most common cause of acute bronchitis

A

Adenovirus

57
Q

1 year old with barking cough, stridor, dyspnea at night. What is the cause and what do you see on CXR?

A

Parainfluenza (Croup)

Steeple sign on CXR

58
Q

3 year od with dysphagia, drooling and distress, thumbprint sign on CXR. What is treatment of choice

A

2nd/3rd generation cephalosporin (ceftriaxone or cefotaxime) and dexamethasone for treatment of epiglottitis (H. Flu)

59
Q

Severe cough fits and post tussive emesis. What is the recommended treatment

A

Supportive care and macrolides/bactrim (B. Pertussis)

60
Q

CXR of 5 day old with bilateral diffuse reticular ground glass opacities and air bronchograms is suggestive of what disease?

A

IRDS

61
Q

Critically-ill patient PaO2/FI02 <200 not improving to 100% O2, bilateral pulmonary infiltrates that spares costophrenic angles on CXR and PCWP <18 has what condition?

A

ARDS

62
Q

PaO2 on ventilation and PEEP must maintain above 55 (less than 60) to prevent oxygen toxicity. What will happen if it is greater than 60 for extended duration?

A

Irreversible pulmonary fibrosis

63
Q

Causes of Metabolic Acidosis (Gap)

A 
Methanol
Uremia
DKA
Propylene glycol
INH or infection
Lactic acidosis
Etheylene glycol
Rhabdo/renal failure
Salicylates
64
Q

Most common cause of Primary pulmonary HTN? Secondary?

A

Primary: Idiopathic
Secondary: COPD

65
Q

EKG reveals RVH, RAE, RAD, RBB, CBC reveals polycythemia and inc HCT. Likely diagnosis?

A

Pulmonary HTN

PANRE Review (5 decks)

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