Pulmonology

Question 1

What are the criteria required to diagnose ARDS?

Answer 1

Diagnosing ARDS requires the following criteria to be met:

Hypoxemia

bilateral infiltrates on CXR

worsening symptoms within one week of pulmonary insult

Question 2

what pulmonary pathology(ies) have a decreased DLCO?

Answer 2

DLCO is a measurement of the lung’s ability to transfer gas from inhaled air to the RBC.

because of damage at the alveolar level, emphysema will show a decreased DLCO level.

Question 3

Patients with chronic asthma (with prolonged inhaled steroid use) or patients with CF with a chronic cough.

What is the most likely offending organism?

Answer 3

Patients with prolonged inhaled steroid use or CF are susceptible to ASPERGILLIOSIS

*the condition is called allergic bronchopulmonary aspergillosis

Question 4

What is the most common EKG finding associated with PE?

Answer 4

The most COMMON EKG finding associated with PE is

sinus tachycardia

Question 5

What is the most specific EKG pattern associated with PE?

Answer 5

The most specific EKG pattern associated with a PE is

S1Q3T3

but this pattern occurs in <10% of patients

Question 6

when do you screen for lung cancer?

Answer 6

Screen for lung cancer in patients 55-80 years old who have a 30 pack year history or have stopped smoking within the last 15 years.

Question 7

What is the obstructive pattern on PFT?

Answer 7

obstructive pattern:

decreased FVC

decreased FEV1

decreased FEV1:FVC

increased total lung capacity

Question 8

what is the restrictive pattern on PFT?

Answer 8

the restrictive pattern

decreased total lung capacity

decreaced FVC

normal FEV1:FVC

Question 9

parapneumonic effusions

Answer 9

parapneumonic effusions are common in patients with pneumonia who have been treated with abx.

Findings are: decreased lung sounds, decreased tactile fremitus

opacities on cxr with a blunted costophrenic angle.

Treatment is with: thoracocentesis

Question 10

What does waveform capnography measure?

Answer 10

waveform capnography measures the

expired CO2 (end tidal CO2)

Question 11

What is reading on waveform capnography indicates adequate chest compressions?

Spontaneous Return of Circulation?

Answer 11

a reading of 10-15 mmHg indicates adequate chest compressions

30-40mmHg on waveform capnography indicates a return of spontaneous circulation