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Mccqe1 Red Star Questions > Pulmonology > Flashcards

Pulmonology Flashcards

1
Q

Can severe coughing cause pneumothorax? How?

A

Causes subcutaneous emphysema,air leaks into the chest->pneumothorax

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2
Q

Rx for pneumonia in cystic fibrosis

A

Iv cefepime - MSSA,P. Aeruginosa

Iv vancomycin-MRSA

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3
Q

Complication of subclavian CV catheter

A

Tension pneumothorax

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4
Q

C/f of tension pneumothorax

A 
Decrease Bp
JVP
u/l absent breath sounds 
Tracheal deviation 
Rapid onset acute dyspnea,chest pain
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5
Q

How to know it’s faulty intubation and not pneumothorax ?

A

U/l breath sounds,hypoxia

But no tachycardia

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6
Q

Increase in pulmonary vascular resistance seen in…..

A

Acute P.E

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7
Q

Acute onset dyspnea and chest pain s/o……

Other findings of P.E

A

P.E

Tachypnea
Tachycardia
Low grade fever

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8
Q

2 poor prognosis of P.E

A

Decrease in SaO2, A.F

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9
Q

DLCO finding in asthma and COPD

A

Asthma: normal

COPD : increased

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10
Q

Rx for ARDS

A

Intubation

MV( low TV high PEEP-permissive hyoercapnia)

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11
Q

ARDS Vs volume overload-diff?

A

PCWP : normal for ARDS

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12
Q

Signs of pulmonary HTN (6)

A 
Left parasternal lift 
Rt sided heave 
Loud P2
Rt sided S3
RHF
pansystoli TR
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13
Q

Scleroderma seen in limited vs diffuse systemic sclerosis

A

Limited: head and tip of UE

Diffuse: trunk &UE

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14
Q

Sms of P.jiroveci pneumonia

A

SOB
Non productive cough
Fever

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15
Q

Formula for peak airway pressure

A

Resistive pressure + plateau pressure
Resistive pressure: flow x resistance
Plateau pressure: elastic pressure + PEEP

Elastic pressure = Tv/ compliance

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16
Q

If peak pressure is increased but Plateau pressure normal s/o (3)

A

Mucus plug
Bronchospasm
Biting tube

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17
Q

If both peak pressure and plateau pressure are increased s/o (5)

A 
Pneumothorax 
P.edema
Pneumonia 
Atelactasis 
Rt mainstem intubation
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18
Q

Drugs when given along with theophylline that can cause its toxicity .

A 
CYP inhibitors 
Verapamil 
Cimetidine 
Ciplox 
Erythromycin 
Clarithromycin
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19
Q

Cardiac probs with theophylline toxicity

A

Multifocal atrial tachycardia

Premature ventricular beats

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20
Q

C/f of eosinophilic Granulomatosis (3)

A

Nasal polyps
Asthma
Eosinophilia

Seen in churg Strauss syndrome

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21
Q

C/f of severe combined immunodeficiency (4)

A

Recurrent diarrhoea
Failure to thrive
Recurrent infections

Infants should undergo stem cell transplantation; else they die within 1 yr age.

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22
Q

Define HPOA

A

Hypertrophic osteoarthropathy + clubbing + lung probs: Ca,bronchiectasis etc

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23
Q

Conditions where DLCO is normal (4)

A

Asthma
OHS
Myasthenia gravis
ALS

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24
Q

Large anterior mediastinal mass with increase beta HCG, AFP s/0…..

A

Non-seminomatous Lung cancer

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25
Q

Dx for primary mediastinal tumor

A

Bx + testicular USG

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26
Q

Anterior mediastinal mass in hogkins lymphoma involves …..

A

Cervical
Supraclavicular
axillary LN

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27
Q

Rx for P.E plus bleed is…

A

IVC filter

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28
Q

Highly characteristic feature of Wegners granulomatosis is…..

A

Tracheal narrowing and ulceration

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29
Q

Ab with wegners is…..

A

PR3 ANCA

30
Q

Rx for wegners

A

High dose GC ,cyclophosphamide, rituximab

31
Q

2 important things to determine etiology of hyponatremia

A

Serum osmolality

ECF volume

32
Q

Rx for flail chest

A

Pain meds,O2

PAP- to improve paradoxical resp motion

33
Q

Tachypnea with severe cyanosis in newborn is……

CXR…..

A

Persistent pulm HTN

CXR: clear lungs +
decreased pulm vascularity

34
Q

Tachypnea that begins shortly after birth, resolved by day 2….. CXR….

A

Transient Tachypnea of newborn

CXR: b/l peri hilar streaks

35
Q

PFT in ILD

A

Increased FEV1/FVC

Decreased DLCO,TLC,RV

36
Q

How does pulmonary edema decrease lung ventilation?

A

By decreasing pulmonary compliance->restrictive pattern

37
Q

MV paO2 Vs SaO2 values

A

PaO2: 55-80 mmHg
SaO2: 88-95%

38
Q

Risk factors for transient Tachypnea of newborn (3)

A
  1. C.S
  2. Prematurity
  3. Maternal DM
39
Q

RDS CXR features

A

Decrease lung volume
Ground glass opacities
Air bronchogram

40
Q

M.c presentation of pancoast tumor

A

Shoulder pain

41
Q

What is seen in C8-T2 involvement in pancoast tumor?

A

Weakness and atrophy of intrinsic hand muscles

42
Q

CXR findings of bronchiectasis vs chronic bronchitis

A

Bronchiectasis: dilated conducting airways

Chronic bronchitis:
prominent bronchovascular markings
Flattened diaphragm

43
Q

FVC in bronchiectasis vs chronic bronchitis

A

Bronchiectasis: (<80%> decreased

Chronic bronchitis: (>95%) increased

44
Q

CXR features of emphysema

A

Decreased vascular markings

Hyperinflated lungs

45
Q

Hypoxemia in CB vs emphysema

A

CB: increased

Emphysema: mild

46
Q

Basilar lucency in CXR in a young patient should prompt….

A

ATT

47
Q

Risk factors for bronchial obstruction secondary to atelactasis

A

H/o FB aspiration
Malignancy
Severe pneumonia

48
Q

Mgt of spontaneous pneumothorax vs tension pneumothorax

A

Spontaneous:
Small (<2cm): observe
Large: needle thoracotomy

Tension:
Urgent needle aspiration

49
Q

CXR of spontaneous pneumothorax

A

Visceral pleural line

Absent lung marking

50
Q

What is diffuse alveolar hypoventilation?

Causes?

A

Diffuse alveolar hypoventilation:
All alveoli damaged-decrease TV,RR

Causes:
Narcotic use
Neuromuscular weakness

51
Q

Complication of PAP (3)

A

Alveolar damage
Pneumothorax
Hypotension

52
Q

How is high PEEP bad for ARDS?

A

Lung collapse,poor oxygenation
PEEP—> decrease wob, increase FRC
Pneumothorax—> decrease RV filling
—> decrease bp, increase HR.
—> decrease venous compliance
Leading to increase venous stiffness,CVP also rises

53
Q

Recurrent pneumonia on same side s/o….

A

Adenopathy, neoplasm
FB
Bronchiectasis

54
Q

Rx of bronchiolitis & prevention

A

Rx: supportive

Prevention : palivizumab

55
Q

Palivizumab is given for…..(3)

A
  1. Premature (<29weeks)
  2. Chronic lung disease of prematurity
  3. Hemodynamically significant congenital heart disease
56
Q

Complication of bronchiolitis (2)

A

Apnea (<2mo old)

Respiratory failure

57
Q

Main sms of sinusitis

A

Purulent rhinorrhoea

Facial pain

58
Q

How does maternal hyperglycemia cause ARDS?

A

Causes fetal hyperinsulinemia

59
Q

GERD exacerbates asthma sms. How?

A

Micro aspiration of gastric contents
Increase vagal tone
Bronchial Hyperreactivity

60
Q

CXR features of pleural mesothelioma vs bronchogenic ca

A

Pleural mesothelioma: u/l pleural prob
U/l large pleural effusion

Bronchogenic Ca:
B/l pleural plaques + atelactasis

61
Q

Diastolic collapse with
Increase RV pressure
Decrease RV pressure

A

Increase: cardiac tamponade

Decrease: hypovolemic shock

62
Q

Signs of post nasal drip

A

Oropharyngeal cobblestoning on P.E

63
Q

Risk factor for
Chronic pulmonary aspergillosis
Invasive aspergillosis

A

Chronic pulmonary aspergillosis:
Cavitary TB

Invasive : GC,neutropenia,HIV

64
Q

Pulmonary nodules with ground glass opacities seen in…..

A

Invasive aspergillosis

65
Q

Tests for invasive aspergillosis vs chronic pulmonary aspergillosis

A

Invasive: cell wall bio markers
(Galactomann, beta glucan)

Chronic pulmonary: aspergillosis IgG serology

66
Q

Aspergillosis with weight loss

A

Chronic pulm aspergillosis

67
Q

Why is the goal for spo2 in COPD at 90-95%?

A

Else there will be hypercapnia secondary to:

Increase dead space perfusion
Decrease alveolar ventilation and affinity for oxyhb to CO2.

68
Q

CXR features of histoplasmosis

A

B/l mediastinal /hilar LAD

Focal reticulonodular infiltrates

69
Q

CXR features of coccidiomycosis

A

U/l infiltrate and I/L hilar LAD

70
Q

Bx findings of histoplasmosis vs coccidiomycosis

A

Histoplasmosis: granulomas
Narrow based budding yeasts

Coccidiomycosis: sperules and endospores

71
Q

Decrease in FE urea (<35%) is used as an indicator for…..

A

Decreased renal perfusion in patients taking diuretics

Mccqe1 Red Star Questions (7 decks)

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