Pulmonology

Question 1

describe low V:Q ratio

Answer 1

low ventilation with increased/normal perfusion

Question 2

describe high V:Q ratio

Answer 2

are with decreased perfusion compared to ventilation

Question 3

central chemoreceptors in the ___?

Answer 3

medulla

Question 4

peripheral chemoreceptors in the ___ and ___

Answer 4

carotid and aortic bodies

Question 5

volume of air in/out of lungs during normal breathing

Answer 5

TV

Question 6

volume of air in lungs after maximal exhalation

Answer 6

residual volume

Question 7

volume of air that can be forced out at the end of expiration

Answer 7

expiratory reserve volume

Question 8

volume of air that can be further inhaled at the end of inhalation

Answer 8

inspiratory reserve volume

Question 9

max volume of air that can be exhaled after max inspiration

Answer 9

Vital capacity (IRV + TV + ERV)

Question 10

volume of air in lungs after max inspiration

Answer 10

total lung capacity (VC + RV)

Question 11

volume of air that can be exhaled at the and of 1 sec forced expiration

Answer 11

FEV1

Question 12

volume of air that can be expelled from max inflated lung with pt breathing as hard and fast as possible

Answer 12

FVC

Question 13

MC causes of bronchiactasis

Answer 13

CF (pseudomonas)

H. influenza

Question 14

MC cause of massive hemoptysis

Answer 14

bronchiactasis

Question 15

lab study findings in pt with sarcoidosis

Answer 15

increased ACE

Hypercalcemia

Question 16

tx of sarcoidosis

Answer 16

steroids
methotrexate (if steroid resistant)
hydroxychloroquin (chronic disfiguring features)

Question 17

egg shell calcification at hilum

nodular opacities in upper lobes

Answer 17

silicosis

Question 18

small upper lobe nodules
hyperinflation
caplan syndrome (pneumoconiosis + RA)

Answer 18

coal workers lung (black lung)

Question 19

works in electronics, aerospace, ceramics or tool/dye manufacturing

Answer 19

berylliosis

Question 20

cotton exposure

Answer 20

byssinosis

Question 21

bronchogenic carcinoma

malignant mesothelioma os pleura

Answer 21

asbestosis

Question 22

PNA, fever, HA in a person who has been working with birds

Answer 22

Psittacosis (chlamydophila psittaci)

Question 23

tumor originating from the pleura

Answer 23

mesothelioma

Question 24

acute inflammation of the costochondral, costosternal oor sternoclavicular joints that is worse with breathing, coughing and upper limb movements

Answer 24

costochondritis & Tietze syndrome

Question 25

gold standard tx for pleural effusion

Answer 25

thoracentesis | chest tube if empyema + IV abx

Question 26

meds used for pleurodesis

Answer 26

talc doxy bleo (toxic so not used as commonly)

Question 27

pink-purple well vascularized central tumor that may secrete serotonin, ATCH, ADH, MSH

Answer 27

bronchial carcinoid tumors

Question 28

MC ca caused by smoking and found in the periphery of lung

Answer 28

adenocarcinoma

Question 29

centrally located lung CA associated with cavitary lesions, hypercalcemia, pancoast syndrome (

Answer 29

squamous cell

Question 30

very aggressive form of non-small call lung CA

Answer 30

large cell (anaplastic)

Question 31

centrally located lung CA with early metastasis

Answer 31

small cell

Question 32

what endocrine abnormalities are common with small cell lung CA

Answer 32

SIADH | hyponatremia

Question 33

gold standard for dx pulm htn

Answer 33

R sided heart catheterization

Question 34

gram + cocci, mc cause of CAP with rusty sputum

Answer 34

strepococcus pneumoniae

Question 35

gram negative rods | 2nd MC cause of CAP (esp with lung dz)

Answer 35

haemophilus influenzae

Question 36

MC cause of atypical pna, associated with bullous myringitis

Answer 36

mycoplasma pna

Question 37

PNA + GI sxs (increased LFTs, N/V/D) associated with contaminated water supply tx?

Answer 37

legionella levofloxacin, azithromycin

Question 38

gram + cocci in clusters | Pna that usualyl occurs after viral illness

Answer 38

staph aureus

Question 39

gram - rods upper lobe PNA associated with ETOHics currant felly sputum Tx?

Answer 39

klebsiella cefotaxime

Question 40

organisms associated with aspiration PNA Tx?

Answer 40

anaerobes clinda, metro, amox/clav

Question 41

gram - rods | immunocompromised

Answer 41

pseudomonas

Question 42

MC cause of viral PNA in children

Answer 42

RSV

Question 43

MC cause of viral pNA in adults

Answer 43

influenza

Question 44

fungal/parasite pna in immunocompromised host who desats with ambulation Tx?

Answer 44

pneumocystis jirovecii Bactrim

Question 45

MC cause of hospital acquired PNA

Answer 45

pseudomonas

Question 46

PNA associated with hoarsness tx?

Answer 46

chlamydial erythromycin

Question 47

CAP outpt Tx

Answer 47

macrolide or doxy | FQ for those with comorbidities

Question 48

CAP inpt Tx

Answer 48

B lactam + macrolide | or FQ

Question 49

CAP in ICU tx

Answer 49

B lactam + macrolide | or B lactam + FQ

Question 50

HAP tx

Answer 50

antipsudomonal B lactam and AG or FQ - vanc for MRSA - levo or azithro for legionella

Question 51

gold standard TB test

Answer 51

acid-fast smear + sputum cx

Question 52

when is CXR used for TB

Answer 52

to exclude active TB and as yearly screen for Pts with known + PPD or active TB

Question 53

how long is TB tx performed

Answer 53

6 months

Question 54

TB med with orange color secretions and thrombocytopenia

Answer 54

rifampin

Question 55

TB med associated with hepatitis and peripheral neuopathy

Answer 55

isoniazid give with B6

Question 56

TB med associated with hepatits, hyperuriemia and photosensitive dermatologic rash

Answer 56

Pyrazinamide

Question 57

TB med assocaited with optic neuritis and peripheral neuropathy

Answer 57

ethambutol

Question 58

Dx and tx for pertussis

Answer 58

PCR of nasopharyngeal swab | Macrolide

Question 59

tx for epiglottitis

Answer 59

maintain airway | ceftriaxone or cefotaxime

Question 60

what is the cause of croup Tx?

Answer 60

parainfluenza virus type 1 humidified air, dexamethasone, epinephrine (for stridor at rest)