Pulmonology

Question 1

What is a normal FVC? FEV1? FEV1/FVC? and % predicted FVC?

Answer 1

5L
3.75L
70-75%
80-100%

Question 2

Name the adrenergic (epi/NE) receptor:

1) postsynap symp (cardiac), excitatory
2) postsynap symp, excitatory (vasoconstriction), GI tract inhibitory
3) postsynap symp, inhib (vasodilation, bronchodilation)
4) presynap symp (dec catecholamine release), CNS

Answer 2

1) beta-1
2) alpha-1
3) beta-2
4) alpha-2

Question 3

What type of medications are used as rescue/acute asthma inhalers? What type of medications are maintenance inhalers?

Answer 3

Sympathomimetics - Epi, Albuterol, Metaproterenol

Steroids, advair, intal, atrovent

Question 4

What conditions is described:

Dec breath sounds w/ hyperresonance to percussion, deviation of the trachea to the contralateral side

Answer 4

Pneumothorax

Question 5

What conditions is described:

Dec breath sounds w/ dullness to percussion, deviation of the trachea to the affected side

Answer 5

Atelectasis

Question 6

What agent usually causes more bilateral diffuse infiltrates in pneumonia?

Answer 6

Atypical agents (fungal)

Question 7

What is an important SSX of a lung abscess?

Answer 7

Foul/musty smelling sputum mixed with blood

Fever, chills, pain, weakness, wt loss.
Often due to aspiration when pt is recumbent.

Question 8

What can cryptococcal pneumonia develop into and must be ruled out?

Answer 8

Meningitis (LP)

Question 9

What is the MC fungal pneumonia? What fungal pneumonia is primarily found in the southern/western united states and mexico?

Answer 9

Histoplasmosis

Coccidioidomycosis

Question 10

T/F: Hemoptysis is TB or Lung CA until proven otherwise.

Answer 10

T

Question 11

T/F: A chronic cough is >6 wks.

Answer 11

F

> 8 weeks

Question 12

T/F: A chronic cough does NOT automatically warrants a chest xray?

Answer 12

F

Yes, do a chest xray

Question 13

Name the condition:
COPD w/ normal pCO2 w/ permanent dilationo f part or all of the acinus, cigarette smoking or def of serum alpha-1 protease inhib, barrel chest, pursed lips, slow forced expiration

Answer 13

Emphysema (“pink puffers”)

Question 14

Name the condition:

Increased pCO2 w/ persistant cough w/ sputum for at least 3 mo in the last 2 years, obese, cor pulmonale, cyanotic

Answer 14

Chronic bronchitis (“blue bloaters”)

Question 15

If pH and PCO2 move in the same direction think ______ acidosis/alkalosis. If pH and PCO2 move in opposite directions, think _______ acidosis/alkalosis.

Answer 15

Metabolic

Respiratory

Question 16

T/F: Acute onset of dyspnea of hypoxemia with normal chest x-ray should be a considered an MI until proven otherwise.

Answer 16

F

Rule out PE

Question 17

Besides, elderly and children, what condition predisposes people to pulmonary dz?

Answer 17

Collagen vascular dz

Question 18

Name the condition:
AI of basement membrane in lung and kidney. Hemoptysis and hematuria. Dx based on IgG deposits in glomeruli and presence of antiglomerular basement membrane antibody in serum

Answer 18

Goodpasture’s syndrome

Question 19

Name the condition:

Inflammation of the blood vessels and upper respiratory tract, lungs, and kidneys. Serum ANCA elevated.

Answer 19

Wegener’s granulomatosis

Question 20

Name the bronchogenic carcinoma:

1) Incidence 15%, larger peripheral mass
2) Incidence 20%, hilar mass, adenopathy
3) Incidence 35%, peripheral mass, solitary nodule
4) Incidence 30%, hilar mass, atelectasis or pos-obstructive pn.

Answer 20

1) Large cell
2) Small cell
3) Adenocarcinoma
4) Squamous cell