Pulmonology Flashcards
Exudative pleural effusion makes you think of what dx?
TB, lung cancer
Transudative pleural effusion makes you think what dx?
CHF
Paradoxical pulses are ____ & found in what disorder?
Large decrease in systolic BP during inspiration
Found in asthma
Most common patient complaint w/ emphysema
SOB
Age to begin vaccinations for pneumococcal pneumonia
65
Prolonged expiration (low FEV1) suggests what dx
Asthma or COPD
Hampton’s hump on CXR=
PE
Pt s spleen is more susceptible to what kinds of organisms?
Encapsulated organisms, most commonly strep pneumoniae and H. Flu
Most common cause of pneumonia in children lass than 1
RSV
Tx for pneumocystis jiroveci pneumonia
Bactrim
Occupations assoc c berylliosis
Aerospace & nuclear plant workers
CXR finding assoc c berylliosis
Diffuse infiltrates c hilar adenopathy
Gold standard for dx of pleural effusion
Thoracocentesis
To decompress a tension pneumothorax, where do you put the needle?
2nd intercostal space at midclavicular line
Oseltamivir (tamiflu) may be given to children above what age?
1 yr
Zanamivir (Relenza) may be given to children above what age?
7 yrs
HIV pt with ground glass appearance on CXR makes you think what dx
Pneumocystis jiroveci pneumonia (PJP, used to be CP)
Noncaseating granuloma should make you think of what dx
Sarcoidosis
Pearl formation on CXR should make you think of what dx
Squamous cell lung cancer
Ghon or Ranke complexes on CXR should make you think of what dx
TB
A westermark sign on CXR should make you think of what dx
PE
Mesothelioma is most commonly found in what location
Pleural lining
What CXR finding would make you think of mesothelioma
Pleural thickening–b/c most are found in pleural lining
Hyperinflation on CXR & eosinophilia on CBC should make you think of what dx
Asthma
Organism that is most common cause of pneumonia in a patient with cystic fibrosis
Pseudomonas
College student presents with pneumonia. What 2 organisms should you be thinking of?
Chlamydia & mycoplasma
You suspect pneumothorax. What instructions go along c order for CXR?
End expiratory view IOT look for visceral pleural air
3 most commonly used txs for COPD
Oxygen
Ipratropium
Albuterol
4 meds which may cause asthma
Beta blockers
NSAIDS
ACEI
ASA
Nodular opacities in upper lung fields makes you think of what dx
Silicosis
Initial tx for active TB
INH RIF PZA EMB for several months followed by INF RIF Once sensitivities come back
Caseating granulomas should make you think of what dx
TB
Blue bloater refers to
Chronic bronchitis
Contralateral mediastinal shift should make you think of what dx
Tension pneumothorax
Best test to dx bronchiectasis
CT
Main side effects of isoniazid INH
Hepatitis and peripheral neuropathy
Ethambutol has 2 major side effects
Optic neuritis
Red green vision loss
Question that has anything to do with rats and pt has pneumonia, should be thinking of
yersinia pestis
Most common organism causing pneumonia in COPD pts
Haemophilus influenze
Where is a pancoast tumor found on CXR
At the apex of either the right or the left lung
Will evidence of TB be found in the upper or lower lobes on CXR
Upper
A pt has pneumonia with rust colored sputum. What is the organism?
Strep pneumoniae
Coal miners lung often show nodular opacities in what lung fields
Upper lung fields
When you step up the dx from intermittent asthma to mild persistent asthma, what medication should you add?
An inhaled steroid like fluticasone
Any question about rabbits and pneumonia should make you think
tularemia
Dullness to percussion should make you think of what dx
Lobar pneumonia
A young child presents to ED and you see him sitting in tripod position. What is the most likely dx?
Epiglottitis
6 extra pulmonary complications of lung cancer
SPHERE SVC syndrome Pancoast tumor Horner's syndrome Endocrine problems Recurrent laryngeal symptoms Effusions (exudative)
Currant jelly sputum should make you think of what dx
Klebsiella pneumoniae
What happens to total lung capacity in sarcoidosis?
It goes down.
What will the likely findings be on a CXR of a pt c asbestosis?
Linear opacities at the bases with pleural plaques
Tympany to percussion should make you think of what dx
Large pneumothorax
3 most common cancers to metastasize to the lungs
Breast, liver, colon
Barrel chest = what dx
Emphysema
Are the lungs noisy or quiet in COPD
Quiet
4 indications for flu vaccine
Child 6-59 months
Pregnant female
Healthcare worker
age greater than 50
Posttussive rales should make you think of what dx
TB
Bullae & blebs on CXR should make you think of what dx
Emphysema
Rhochi or wheezes that clear after coughing suggest what dx
Bronchitis or atelectasis
Does FEV1 go up or down with asthma?
It goes down
A very sick pt with diffuse infiltrates that spare the costophrenic angles should make you think of what dx
ARDS
Most common cause of bronchiectasis
Cystic fibrosis
Gold standard for dx of cystic fibrosis
Sweat chloride test
Exudative pleural effusion should make you think of what dx
TB, lung cancer
First line abx for epiglottis
3rd gen ceph
Ceftriaxone
Transudative pleural effusions should make you think of what dx
CHF
What 2 lung cancers are typically found centrally on CXR
Small cell and squamous
Pertussis is most commonly treated with what abx
Erythromycin
4 most common places lung cancer will metastasize to
Bone
Brain
Adrenals
Liver
If you come across a question where pt has erythema nodosum and an enlarged parotid gland, what is the most likely dx
Sarcoidosis
A thin looking heart and flattened diaphragm on CXR should make you think of what dx
Emphysema
An alcoholic who has been dx’ed w/ pneumonia most likely has what organism
Klebsiella pneumonia
Honeycombing and tram tracks on the CXR should make you think of what dx
Bronchiectasis and idiopathic pulmonary fibrosis
Paradoxical pulses may be found in what pulmonary disorder
Asthma
An older pt presents with pneumonia and diarrhea. What is the most likely dx?
Legionella pneumonia
Eggshell opacities on CXR should make you think of what dx
Silicosis
3 causes of decreased tactile fremitus
COPD
Asthma
Pleural effusion
Pneumothorax
Hyper resonance to percussion should make you think of what dx
Emphysema
Pneumothorax
Asthma
If you hear crackles in the lung fields list 3 differentials
Pneumonia
Fibrosis
CHF
Bronchitis
Does total lung capacity go up or down in COPD
It goes up
List 3 differentials if you hear wheezes on exam
Asthma
COPD
Bronchitis
What is it called when a pt says “we” but on auscultation you here “ay”?
Egophony
PE finding of egophony should make you think of what dx
Lobar pneumonia
CXR shows vascular redistribution and blurred vascular outlines. What is the most likely dx
CHF