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Emergency Medicine > Pulmonology > Flashcards

Pulmonology Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Asthma if FEV1 increases by?

A

12%

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2
Q

Given methacoline with increased concentration, stopped when X drops by Y?

A

FEV1

Drops by 20%

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3
Q

Positive methacholine challenge

A

> 16 = normal
4- 16 = borderline
1 -4 : mild (+)
<1 : moderate-severe

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4
Q

Admission for asthma:

A

PEFR <50% predicted, ER visit within 3 days, status asthmaticus, post-treatment failure, AMS

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5
Q

Intermittent asthma: symptoms

A

2 or less d/wk

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6
Q

Intermittent asthma: night time awakenings

A

<2 x / month

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7
Q

Intermittent asthma: SABA

A

2 or less d/wk

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8
Q

Intermittent asthma: interfernece

A

none

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9
Q

Intermittent asthma: lungs

A

FEV1 >80%

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10
Q

Intermittent asthma: exacerbations

A

0-2 year

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11
Q

Mild asthma: symptoms

A

> 2 d/wk

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12
Q

Mild asthma: night time awakeneings

A

3-4 x month

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13
Q

Mild asthma: SABA

A

> 2 d/ wk

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14
Q

Mild asthma: Interference

A

minor

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15
Q

Mild asthma: lungs

A

> 80%

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16
Q

Mild asthma: exacerbations

A

> 2 yr

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17
Q

moderate asthma: symptoms

A

daily

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18
Q

moderate asthma: night time awakenings

A

> 1 x weekly

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19
Q

moderate asthma: SABA

A

daily

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20
Q

moderate asthma: interference

A

some

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21
Q

moderate asthma: lungs

A

60-80%

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22
Q

moderate asthma: exacerbations

A

> 2 years

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23
Q

severe asthma: symptoms

A

throughout day

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24
Q

severe asthma: nighttime awakenings

A

7x-week

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25
Q

severe asthma: SABA

A

several x day

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26
Q

severe asthma: interference

A

extreme

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27
Q

severe asthma: lungs

A

<60%

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28
Q

severe asthma: exacerbation

A

> 2 year

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29
Q

Asthma treatment progression:

A

SABA –> ICS –> LABA or LD ICS OR MD ICS –> MD ICS + LABA –> HD ICS + LABA

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30
Q

What should not be used as a monotherapy in asthma?

A

LABA

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31
Q

Procalcitonin of X should encourage abx use?

A

> 0.25

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32
Q

What arrythmia is associated with COPD?

A

MAT

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33
Q

MC type of emphysema?

A

Proximal acinar (centrilobular)

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34
Q

What type of emphysema is more common in upper lobes?

A

proximal acinar (centrilobular)

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35
Q

What type of emphysema is described as “moth-eaten”?

A

proximal acinar (centrilobular)

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36
Q

What type of emphysema is associated with alpha 1?

A

panacinar

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37
Q

What emphysema is more peripheral?

A

paraseptal

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38
Q

What type of emphysema is described as saw-toothed?

A

paraseptal

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39
Q

MC symptom of emphysema?

A

dyspnea

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40
Q

MC symptom of chronic bronchitis?

A

cough

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41
Q

FEV1/FVC < x = COPD

A

<0.70

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42
Q

FEV1 is used to categorize severity of COPD: GOLD 1

A

> 80%

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43
Q

FEV1 is used to categorize severity of COPD: GOLD 2

A

<80%

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44
Q

FEV1 is used to categorize severity of COPD: GOLD 3

A

<50%

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45
Q

FEV1 is used to categorize severity of COPD: GOLD 4

A

<30%

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46
Q

What type of COPD is assoc with decreased vascular markings?

A

emphysema

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47
Q

What type of COPD is assoc with increased vascular markings?

A

chronic bronchitis

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48
Q

Gold guideline tx: A

A

SABA or short-acting anti-C

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49
Q

Gold guideline tx: B

A

LABA or long acting anti-C

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50
Q

Gold guideline tx: C

A

inhaled ICS + LABA or long-acting anti-c

51
Q

Gold guideline tx: D

A

inhaled ICS + LABA or long-acting anti C

52
Q

COPD treatment progression

A

SABA –> SABA + antic C or LABA –> SABA + anti C + LABA –> SABA + anti C + LABA + ICS

53
Q

What should not be used as a monotherapy in COPD?

A

ICS

54
Q

What treatment prolongs life in COPD?

A

02 if administered 15 hours a day

55
Q

lung nodule if

A

3 cm

56
Q

lung mass if >

A

3 cm

57
Q

Location of lung nodule more likely to be malignant

A

upper lobe

58
Q

MCC of malignant lung nodule

A

primary lung CA

59
Q

MC primary lung CA

A

adenocarcinoma

60
Q

MC benign cause of of SPN?

A

infectious granuloma

61
Q

Nodule tx: <6 mm

A

annual CT every two years

62
Q

nodule tx: 6-8 mm

A

LDCT in 3 months; if no increase repeat in 3 months.

  • No increase: annual LDCT
  • Increase: resect
63
Q

Nodule tx: >8 mm

A

PET/CT

  • -> low suspicion: LDCT 3 months, resect if increases
  • -> high supsion, biopsy
64
Q

MC site of bronchial carcinoid tumor?

A

GI

65
Q

2nd MC site of bronchial carcinoid tumor?

A

lungs

66
Q

Tx for NSCLC?

A

sx

67
Q

Tx for SCLC?

A

chemo

68
Q

MC type of bronchogenic carcinoma?

A

non-small cell

69
Q

MC type of non-small cell lung cancer?

A

adenocarcinoma

70
Q

Types of non-small cell cancer?

A

adenocarcinoma; squamous

71
Q

Type of lung cancer assoc with pancoast tumor?

A

squamous

72
Q

Lung cancer that has early mets?

A

small cell

73
Q

Pancoast syndrome mneumonic?

A

CCCP: central, cavitary, hyper C, pancoast

74
Q

SVC syndrome is MC with?

A

SCLC

75
Q

Lambert-Eaton?

A

like MG, but weakness improves with use; associated with lung cancer

76
Q

Pancoast has shoulder pain down what distribution of arm?

A

ulnar

77
Q

Aspiration is MC in which lobe?

A

Right

78
Q

Pneumonia CM quad?

A

cough + fever + dyspnea + pleuritic CP

79
Q

MCC of bacterial pneumonia

A

Strep pneumo

80
Q

Gram + cocci in pairs

A

strep pneumo

81
Q

MCC of CAP

A

strep pneumo

82
Q

yellow, green, blood tinged sputum

A

strep pneumo

83
Q

gram + cocci in clusters

A

staph aureus

84
Q

gram - bacilli (3)

A

klebsiella, h. flu, legionella

85
Q

Pneumonia associated with cavitary lesions in upper lobes

A

klebsiella

86
Q

currant jelly sputum

A

klebsiella

87
Q

MCC of atypical “walking” pneumonia

A

mycoplasma

88
Q

Pneumonia bug that’s hard to stain

A

Legionella

89
Q

Pneumonia assoc. with GI symptoms

A

legionella

90
Q

Pneumonia assoc. with contaminated water

A

legionella

91
Q

MCC HAP

A

pseudomonas

92
Q

MCC of viral pneumonia in infants?

A

RSV, parainfluenza

93
Q

MCC viral pneumonia in adults?

A

influenza

94
Q

HAP criteria?

A

> 48 hours after admission

95
Q

VAP criteria?

A

48-72 hours after intubation

96
Q

gold standard for diagnosis of pneumonia?

A

CXR

97
Q

Urinary testing is available for what pneumonia bugs?

A

strep pneumo and legionella

98
Q

CAP tx:

A

macrolide or doxy

99
Q

CURB-65:

A 
confusion
Urea (BUN) >19 
respiratory 30+ 
BP <90/<60 
Age: 65+
100
Q

CURB-65: 0-1

A

outpatient

101
Q

CURB-65: 2

A

inpatient vs. outpatient

102
Q

CURB- 3+

A

inpatient

103
Q

Reactivation TB is found in what aspect of lungs?

A

apical

104
Q

Primary TB is found in what aspect of lungs?

A

middle/lower

105
Q

If your two-step TB comes back positive, what do you have?

A

latent TB

106
Q

If you have a positive TB, what is the next step?

A

get CXR –> 3 acid fast smears

107
Q

Gold standard for TB

A

acid fast bacilli cultures

108
Q

CXR TB

A

hillar adenopathy

109
Q

Active TB tx:

A
  • Phase 1: Rifampin + Isoniazid + Pyrazinamide + Ethambutol x 2 months
  • Phase 2: INH + RIF x 4 months
110
Q

TB: HIV

A

5+ mm

111
Q

TB: organ transplant

A

5+ mm

112
Q

TB: IC

A

5+ mm

113
Q

TB: contact with TB

A

5+ mm

114
Q

TB: fibrotic changes on CXR consistent with TB

A

5+

115
Q

TB: Recent immigration (<5 years) from high prevalence country

A

10+

116
Q

TB: IVDA

A

10+

117
Q

TB: residence and employees of high risk congregate settings

A

10+

118
Q

TB: Mycobacteriology lab

A

10+

119
Q

TB: children <4 y/o

A

10+

120
Q

TB: infants, children, adolescents exposed to adults in high-risk categories

A

10+

121
Q

TB: those without RF

A

15+ mm

122
Q

SE of INH?

A

increased LFTS, hepatitis

123
Q

Purpose of latent TB tx?

A

helps decrease reactivation

124
Q

Latent TB tx?

A

INH x 9 months; Rifampin x 4 months

-Isoniazide + Rifapentine under DOT

Emergency Medicine (7 decks)

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