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PANRE > Pulmonology > Flashcards

Pulmonology Flashcards

1
Q

What is the most common complaint in a patient with emphysema?

A

Shortness of breath

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2
Q

At what age should vaccinations for pneumonococcal pneumonia begin?

A

65 yo

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3
Q

Prolonged expiration (low FEV1) should make your think of what diagnosis?

A

Asthma or COPD

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4
Q

Hampton’s hum on CXR should make you think of what diagnosis?

A

Pulmonary embolism

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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 organism?

A

Encaspulated organisms - like Strep pneumonia and H flu

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7
Q

What is the most common cause of pneumonia in a child less than 1 year old?

A

RSV

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8
Q

What is the treatment for pneumocystis jiroveci pneumonia?

A

bactrim

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9
Q

What occupations are associated with berylliosis?

A

Aerospace and nuclear plant workers

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10
Q

Was CxR finding might make you think of berylliosis?

A

diffuse infiltrates with hilarious adenopathy

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11
Q

What it the gold standard for diagnosis of a pleural effusion?

A

thoracocentiesis

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12
Q

What performing a decompression for a tension pneumonia thorax, where do yo put the needle?

A

2nd intercostal space at the mid clavicular line

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13
Q

Oseltamirvir (Tamiflu) may be given to children above what age?

A

1 year

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14
Q

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

A

7

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15
Q

An HIV patient has a ground glass appearance on his CXR - what should be your diagnosis?

A

Pneumocystits jiroveci ( used to be carinii)

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16
Q

A non-caveating granuloma found on a chest Xray should make you think of what disease?

A

Sarcoid

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17
Q

A pearl formation of the CXR should make you think of …

A

Squamous cell lung CA

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18
Q

Ghon of Ranke complexes should make you think of …

A

TB

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19
Q

A westermark sign on CXR should make you think of…

A

Pulmonary Embolism

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20
Q

Mesothelioma is most commonly found in what lung location?

A

80% are found in the pleural lining

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21
Q

What chest CXR should make you think of mesothelioma

A

Pleural thickening - remember 80% are found in the pleural lining

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22
Q

Hyperinflation as well as eosinophilia on a CBC should make you think of what diagnosis?

A

Asthma

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23
Q

What organism is the most common cause of pneumonia in a patient with cycstic fibriosis

A

Pseudomonas

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24
Q

A college student present with pneumonia. what 2 organisms should you be thinking of??

A

Chlamydia and mycoplasma

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25
Q

At what induration would a PPD be positive in an HIV patient?

A

5mm

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26
Q

‘you suspect a patient has a pneumothorax. What instructions should go along with the order for CXR?

A

It should ben and end expiratory view in order to look for visceral pleural air.

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27
Q

List the 3 most commonly used medical treatments which for COPD?

A

O2, ipratropium, and albuterol

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28
Q

List 4 medications which may cause asthm

A

BETABLOCKERS, NSAIDS, ACEI AND ASS

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29
Q

Nodular opacities in the uppeerlung fields should make you think of what diagnosis?

A

Silicosis

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30
Q

What is the initial treatment for TB?

A

INH + RIF + PZ + EMB x several months (until cultures are back) and they typically 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 presentation with 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 way to diagnosis bronchiectasis?

A

CT scan

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35
Q

What are the main sideffects of Isoniazid (INH)

A

Hepatitis a nd peripheral neuropathy

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36
Q

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

A

Rifampin

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37
Q

Ethambutol has what 2 major side effects?

A

optic neuritis and red green vision loss

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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

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39
Q

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

A

Haemophilus influenza

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40
Q

Where is a pan coast tumor found on CXR?

A

at the apex of the wither the right of left lungs

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41
Q

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

A

Upper

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42
Q

A patient has pneumonia with rust color sputum. What is the most likely diagnosis?

A

Strep pneumo

43
Q

Coal miniers often show n ocular opacities in what lung fields?

A

upper

44
Q

When you stop up the diagnosis from intermittent asthma to mild persistent asthma - what medication are you adding?

A

Inhaled steroid like fluticasone

45
Q

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

A

Tularemia

46
Q

Dullness to percussion should make you think of what diagnosis

A

Lobar pneumonia

47
Q

A young child presents to the ED and you see him waiting in the “tripod” position. What is the most likely diagnosis?

A

Epiglotitis

48
Q

What size induration would a PPD be positive for a healthcare worker?

A

10mm

49
Q

List 6 extra pulmonary 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 pneumonia

51
Q

What happens to a total lung capacity in sarcoidosis?

A

It goes down

52
Q

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

A

Linear opacities at the bases with pleural plaques

53
Q

Tyomany to percussion should make you think of what diagnosis?

A

Large pneumothorax

54
Q

What are the 3 most common cancers to metastasize to the lungs?

A

Breast liver and colon

55
Q

A thumbprint sign on Xray should make you think of what 2 diagnosis’s?

A

Lateral C-spine + epiglottis

Abdominal + intestinal ischemia

56
Q

A barrel chest should make you think of what diagnosis:

A

quietEmphysema

57
Q

List 4 indications for the flu vaccineAre the lungs quiet or noisy in COPD?

A

Child 6-59 months
pregnant femlare;
healthcare worker
age greater than 50 yo.

58
Q

Posttussive rales should make you think of what diagnosis?

A

TB

59
Q

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

A

Emphysema

60
Q

Rhonchi or wheezes that clear after coughing suggest what diagnosis?

A

Bronchitis or atelectasis

61
Q

Does FEV1 go up or down with asthma?

A

IT goes down

62
Q

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

A

ARDS (acute respiratory distress syndrome

63
Q

What is the most common cause of bronchiectasis

A

Cystic Fibrosis

64
Q

What is the gold standard for the diagnosis of cystic fibrosis

A

Chloride sweat test

65
Q

An exudative pleural effusion should make you think of what?

A

TB

Lung cancer

66
Q

What is the first line antibiotic for epiglottis

A

3rd gen cephalosporin - Ceftriaxone

67
Q

Transudative pleural effusions should make you think of what diagnosis?

A

CHF

68
Q

What 2 lung cancers are typically found centrally on CXR

A

Small cell and squamous cell

69
Q

What 2 lung cancers are typically found peripherally on CXR??

A

Adenocarcinoma and large cell

70
Q

Pertussis is most commonly treated with what antibiotic?

A

Erythromycin

71
Q

List the 4 most common places lung cancer will metastaze to?

A

Bone
brain
adrenals
liver

72
Q

If you clomacross a question where the patient has erythema nodosum and an enlarged parotid gland - what is the most likely diagnosis?

A

Sarcoidosis

73
Q

What is erythemal nodosum?

A

Tender red nodules usually found on the shins

74
Q

A thin looking hear 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 diagnosied with pneumonia - what is the most likely organism?

A

Klebsiella

76
Q

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

A

Bronchiectasis and idiopathic pulmonary fibrosis

77
Q

Prasocial pulses may be found in what pulmonary disorder?

A

Asthma

78
Q

A older patient present with pneumonia and diarrhea. What is the most likely diagnosis?

A

Legionella pneumonia

79
Q

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

A

Silicosis

80
Q

List 3 cause of decreased tactile fremitus

A

COPD, Asthma, Pleural effusion, pneumothorax

81
Q

Hyperrsonance to percussion should make you think of what diagnosis?

A

Emphysema, pneumothorax, asthma

82
Q

If you hear crackles in the lung fields list 3 pulmonary issues that should be in your differential

A

Pneumonia, fibrosis, CHF, Bronchitis

83
Q

Does total lung capacity go u or down in COPD?

A

It goes up

84
Q

List 3 things that should be in your differential when you hear wheezes on a lung exam

A

Asthma, COPD, Bronchitis

85
Q

What is it called when a patient says “EEE” but on auscultation you hear “ayyy”

A

egophony

86
Q

A physical exam ringing of egophony should make you think of what diagnosis?

A

Lobar pneumonia

87
Q

A CXR shows vascular redistribution and blurred vascular outlines what is the most likely diagnosis>

A

CHF

88
Q

What are the stages of Pertussis?

A

Catarrhal - coryza, snezzing
Paroxysmal - onset of cough
Convalescent - decreasing symptoms

89
Q

What is an ominous sign for a child with a foreign body aspiration?

A

Aphonia - indicates a complete airway obstruction

90
Q

Describe the physiology of Emphysema

A

Abnormal permanent enlargement of the air

91
Q

What is the definitive study for a foreign body aspiration?

A

Bronchoscopy - as you can identify and retrieve.

92
Q

If you were to see peripheral pruning of the large pulmonary arteries - you should immediately think of what diagnosis

A

Pulmonary hypertension as in Emphysema

93
Q

Egg shell calcification of hilarious or mediastinal lymph nodes are characteristic of what disease state?

A

Silicosis

94
Q

Which type of lunge cancer has the worst prognosis?

A

small cell

95
Q

What is the antibiotic treatment of choice in an HIV patient with Legionella?

A

Azithromycin/Clarithromycin or a Fluoroquinolone such as Levaquin.

96
Q

What is the gold standard for diagnosing DVT?

A

Contrast venography

97
Q

What is the gold statndard for diagnosing a Pulmonary Embolism?

A

Pulmonary arteriogram

98
Q

If a patient has a found smelling sputum - this should make you think of …

A

Bronchiectasis - which is likely found in Cystic fibrosis

99
Q

What is the pathophysiology of bronchiectasis?

A

Permanent abnormal dilation and destruction of the bronchial walls

100
Q

What is the physiologic make up of a transudate?

A

Found in CHF - a transudate has
Glucose>60
Protein <3 WBC ,1000
LDJH > 200

101
Q

What is the physiologic make up of an EXUDATE?

A 
found in cancer, etc
Glucose <60
Protein >3
WBC<1000
LDH <200
102
Q

What is the method of transmission of the influenza virus?

A

droplet particles

103
Q

What is the method of transmission of RSV?

A

Fomite/ large particle spread

104
Q

What medications could be given to a preterm infant after delivery with respiratory issues?

A

Methylxanthines

PANRE (12 decks)

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