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MS3 Year > Pulmonology > Flashcards

Pulmonology Flashcards

1
Q

How do you diagnose PE with abnormal chest xray?

A

CT scan with IV contrast

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2
Q

What are 4 things you do when pt comes in with asthma exacerbation?

A

SpO2 gt 90%, give nebulizer tx q30m x3, give steroids, measure PEFR (peak expiratory flow rate)

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3
Q

Hyponatremia and lung cancer = ?

A

Small cell, SIADH

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4
Q

COPD exacerbation, you want antibiotics, but there is a prolonged QT, what do you give them?

A

Doxycycline, NOT azithromycin

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5
Q

How do you diagnose COPD?

A

PFTs

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6
Q

Who gets antibiotics in COPD exacerbation?

A

productive cough, increased sputum

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7
Q

How do you screen lung cancer?

A

CT scan

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8
Q

COPD exacerbation, you want antibiotics, there is no heart history, what do you give them?

A

Azithromycin preferred, doxycycline is ok

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9
Q

PCWP in ARDS? In CHF?

A

Normal or low; high

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10
Q

How do you diagnose PE with bad kidneys?

A

V/Q scan (need a normal CXR for this to work)

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11
Q

What is the definition of ARDS?

A

Noncardiogenic pulmonary edema

BNP, Echo, PCWP normal; CXR shows pulmonary edema, P/F ratio less than 200

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12
Q

Biopsy of a lung cancer in the middle of the lung parenchyma, how do you do it?

A

VATS (video assisted thorascopic surgery)

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13
Q

Biopsy of a lung cancer adjacent to the trachea, what test do you use?

A

Bronchoscopy with EUS (endoscopic ultrasound)

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14
Q

How do you spot an inhaled corticosteroid by its name?

A

-asone

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15
Q

When do you use tPA in a PE?

A

Massive PE - hypotension!

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16
Q

You find an effusion on CXR, they have heart failure, what do you do?

A

diuresis

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17
Q

Sand blasting and rock quarries, lung disease?

A

Silicosis (correlation with TB)

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18
Q

What medications are used in an asthma exacerbation?

A

Albuterol + ipratropium, methylprednisone/prednisone

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19
Q

Asthma question, the wheezing stops but air movement is reduced. What do you do?

A

Intubate

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20
Q

The pleural effusion fluid is loculated, what do you do?

A

Thoracostomy (chest tube)

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21
Q

For diffuse parenchymal lung disease, when do you give O2 supplementation?

A

When SpO2 is less than 88%

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22
Q

Wheezing, flushing, diarrhea, lung cancer, what’s the diagnosis? What test can you get?

A

Lung carcinoid; 5-HIAA in the urine

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23
Q

How long do you bridge someone with heparin to coumadin?

A

INR 2-3 or for 5 days, whichever is longer

24
Q

Ship-yards, construction, and lung cancer = ?

A

Asbestosis, pleural plaques, adenocarcinoma (don’t forget mesothelioma!)

25
Q

How do you diagnose asthma?

A

PFTs, FEV1/FVC is reduced and reversible

26
Q

What is the mechanism of action of beclomethasone?

A

inhaled corticosteroid (-asone)

27
Q

What does the ABG look like in a PE (that you’ll see on USMLE)?

A

low pO2, low CO2, respiratory alkalosis (may also see a metabolic acidosis)

28
Q

What are the danger of LABAs?

A

Asthma related death (must be used with inhaled corticosteroids)

29
Q

Lung cancer and hypercalcemia = ?

A

Metastatic disease OR PTH-rp from squamous cell carcinoma

30
Q

Who do you screen for lung cancer and how?

A

55-80 yo, gt 30 pack years, ongoing smoker (or have quit within 15 years); low dose CT

31
Q

What is the mechanism of action of formoterol?

A

Long acting beta agonist

32
Q

How do you diagnose PE with good kidneys?

A

CT scan with IV contrast (otherwise use V/Q scan - though you need a normal CXR)

33
Q

First long-acting medication in COPD management?

A

LAMA - tiotropium

34
Q

PE and metastatic cancer tx?

A

low molecular weight heparin only (no bridge)

35
Q

Pleural effusion has malignant cells in it, what does that mean?

A

Stage IV (metastatic) cancer

36
Q

Cushing’s syndrome and lung cancer = ?

A

small cell, ACTH producing (would fail low and high dose dex suppression test)

37
Q

There are a lot of red blood cells in the pleural effusion, what does that mean?

A

hemothorax

38
Q

How do you spot a long acting beta agonist by its name?

A

-oterol

39
Q

Bilaterally fluffy infiltrates and hypoxemia (3)?

A

CHF, ARDS, PCP pneumonia

40
Q

Heart block from which diffuse parenchymal lung disease?

A

sarcoid

41
Q

Aeronautics, nuclear, which diffuse parenchymal lung disease?

A

Berylliosis

42
Q

CO2 is elevated from baseline but pt is moving air in a COPD exacerbation, what do you do?

A

BiPAP (non-invasive positive pressure ventilation)

43
Q

Shipyards, construction, lung cancer?

A

Asbestosis

44
Q

What is the mechanism of action of zafirlukast?

A

Leukotriene-antagonist (-leukast)

45
Q

You find an effusion on CXR, no heart failure, what do you do?

A

Lateral decubitus xr OR u/s

46
Q

How do you bx a lung cancer on the periphery of the lung?

A

Percutaneous, CT guided

47
Q

What disease can coal miner’s develop and what are the symptoms?

A

Caplan syndrome - arthralgias + pulmonary fibrosis

48
Q

Adenosine deaminase is high in the pleural fluid, what does that mean?

A

TB

49
Q

Air mvmt stops or the CO2 rises in a COPD exacerbation, what do you do?

A

intubate

50
Q

Sarcoid on a CXR? Bx?

A

bilateral hilar lymphadenopathy; non-caseating granuloma

51
Q

One leg is more swollen than the other, what do you do?

A

DVT, ultrasound!

52
Q

The pleural effusion is an empyema, what do you do?

A

Thoracotomy (surgery)

53
Q

When do you use a IVC filter?

A

when patient has a contraindication to anticoagulation

54
Q

What is the ARDS protocol (3)?

A

low tidal volume (to reduce pressure and prevent overdistension of alveoli), high respiratory rate (so CO2 doesn’t accumulate), PEEP (to keep good alveoli open)

55
Q

Pleural plaques on CXR?

A

Asbestosis

56
Q

What improves COPD mortality?

A

Oxygen and smoking cessation

MS3 Year (18 decks)

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