Pulmonology Flashcards by Erika Gleva

what is the most common patient complaint with emphysema?

shortness of breath

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at what age should vaccinations for pneumococcal pneumonia begin?

65 years old

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prolonged expiration (low FEV1) should make you think of what diagnosis?

asthma or COPD

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hampton’s hump on cxr should make you think of what diagnosis?

pulmonary embolism

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how long after administering a PPD should it be read?

48-72 hours

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a patient without a functioning spleen is more susceptible to what type of organisms ?

encapsulated organisms most commonly strep pneumonia and H. flu

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what is the most cause of pneumonia in children less than 1?

Respiratory syncytial virus (RSV)

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what is the treatment of pneumocystis jeroveci pneumonia ?

bactrim

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what occupations are associated with berylliosis?

aerospace and nuclear plant workers.

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what CXR finding might make you think of berylliosis?

diffuse infiltrates with hilar adenopathy

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what is the gold standard for diagnosis of a pleural effusion?

thoracocentesis

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when performing a decompression for a tension pneumothorax where do you put the needle?

2nd intercostal space at the mid-clavicular line.

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Oseltamivir (Tamiflu) may be given to children

above what age?

1 year old

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Zanamivir (Relenza) may be give to children above what age?

7 years old

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An HIV patient with ground glass appearance on CXR should make you think of what diagnosis?

Pneumocystis jiroveci pneumonia (PJP used tp be know as PCP).

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A noncaseating granuloma should make you think of what diagnosis?

sarcoidosis

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A pearl formation on CXR should make you think of what diagnosis?

squamous cell lung cnacer

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Ghon or Ranke complexes on CXR should make you think of what diagnosis?

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A Westermark sign on CXR should make you think of what diagnosis?

pulmonary embolism

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mesothelioma is most commonly found in what lung location?

80% are found in the pleural lining

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what CXR finding might make you think of mesothelioma?

pleural thickening, remember 80% are found in the pleura lining

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

asthma

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What organism is the most common cause of pneumonia in a patient with cystic fibrosis?

pseudomonas

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a college student presents with pneumonia. why two organisms should you be thinking of?

chlamydia and mycoplasma

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at what size induration would a PPD be positive for an HIV patient?

5mm

You suspect a pneumothorax. What instructions should go along with the order for a chest x-ray?

It should be an end expiratory view in order to look for visceral pleural air.

list the three most commonly used medical treatments for COPD?

oxygen, ipratropium and albuterol

List 4 medications which may cause asthma

beta blockers, NSAIDs, ACEI, ASA

Nodular opacities in the upper lung field should make you think of what diagnosis?

silicosis

what is the initial treatment for active TB?

INH+RIF+PZA+EMB x several months typically followed by INH+RIF once sensativities come back.

casearing granulomas should make you think of what diagnosis?

Blue bloater refers to the characteristic physical exam finding of what disease?

chronic bronchitis

A contralateral mediastinal shift should make you think of what diagnosis?

tension pneumothorax

what is the best test to diagnose bronchiectasis?

What are the main side effects of isoniazid?

hepatitis and peripheral neuropathy

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

rifampin

ethambutol has what two major side effects?

optic neuritis, red green vision loss

If you see a question with anything to do with rats and the patient has pneumonia, what organism should you be thinking of?

yersinia pestis

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

Haemophilus influenzae

where is a pan coast tumor found on chest X-ray?

at the apex of either the right or left lung

will evidence of TB be seen more frequently in the upper or lower lung lobes on CXR?

upper

a pt has pneumonia with rust colored sputum. what is the most likely diagnosis?

strep pneumonia

coal miners lung often shows nodular opacities in what lung fields?

upper lung fields

When you step up the diagnosis from intermittent asthma to mild persistent asthma what medication should you add?

an inhaled steroid like fluticasone

any question about rabbits and pneumonia should make you think of what diagnosis?

tularemia

dullness to percussion should make you think of what diagnosis?

lobar pneumonia

a young child presents to the ER in a tripod position. what is the most likely diagnosis?

epiglottitis

at what size induration should a PPD be positive for a healthcare worker?

10mm

List six extra pulmonary complications of lung cancer.

SPHERE - SVC syndrome, Pancoast tumor, Horner's syndrome, Endocrine problems, Recurrent laryngeal symptoms, Effusions (exudative).

Currant jelly sputum should make you think of | what diagnosis?

klebsiella pneumoniae

what happens to total lung capacity in sarcoidosis?

it goes down

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

Linear opacities at the bases with pleural plaques.

Tympany to percussion should make you think of what diagnosis?

large pneumothorax

what are the three most common cancers to metastasize to the lungs?

breast, liver and colon

a thumbprint sign on x-ray should make you think of what two diagnoses?

lateral C-spine = epiglottitis. abdominal = intestinal ischemia

a barrel chest should make you think of what diagnosis?

emphysema

are the lungs noisy or quiet in COPD?

quiet

list four indications for the flu vaccine.

child 6-59 months, pregnant female, healthcare worker, age greater than 50.

post tussive rales should make you think of what diagnosis?

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

emphysema

Rhonchi or wheezes that clear after coughing suggest what diagnosis?

bronchitis or atelectasis

does FEV1 go up or down with asthma?

it goes down

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

Capatilise acute respiratory distress syndrome (ARDS).

what is the most common cause of bronchiectasis?

cystic fibrosis

what is the gold standard for the diagnosis of cystic fibrosis?

sweat chloride test

an exudative pleural effusion should make you think of what diagnosis?

TB, lung cancer

what is the treatment for epiglottitis?

2nd or 3rd generation cephalosporin(cefttriaxone). macrolides may also be used (clindamycin)

transudative pleural effusions should make you think of what diagnosis?

congestive heart failure

what two lung cancers are typically found centrally on chest x-ray?

small cell lung carcinoma and squamous cell

what two lung cancers are typically found peripherally on chest x-ray?

adenocarcinoma and large cell

pertussis is most commonly treated with what antibiotic?

erythromycin

list the four most common sites lung cancer will metastasize to.

bone, brain, adrenals and liver

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

sarcoidosis

what is erythema nodosum?

tender red nodules usually found on the shins

a thin looking heart and flattened diaphragm on car should make you think of what diagnosis?

emphysema

if you see a question with an alcohol who has been diagnosed with pneumonia what is the most likely organism?

klebsiella

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

bronchiectasis and idiopathic pulmonary fibrosis

paradoxical pulses may be found in what pulmonary disorder?

asthma

An older patient presents with pneumonia and diarrhea. What is the most likely diagnosis?

legionella pneumonia

eggshell opacities on CXR should make you think of what diagnosis?

silicosis

list three causes of decreased tactile fremitus.

COPD, Asthma, pleural effusion, pneumothorax

hyperresonance to percussion should make you think of what diagnosis?

emphysema, pneumothorax, asthma

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

Pneumonia, fibrosis, CHF, Bronchitis

Does total lung capacity go up or down in COPD?

it goes up

List three things that should be in you differential if you hear wheezes on a lung exam?

asthma

What is it called when a patient says "ee" but on auscultion you here "ay"?

egophony

a physical exam finding of ego phony should make you think of what diagnosis?

lobar pneumonia

CXR shows vascular redistribution and blurred vascular outlines. what is the most likely diagnosis?

CHF