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USMLE STEP 2 CK RETAKE > Pulmonology > Flashcards

Pulmonology Flashcards

1
Q

Asthma Dx Tests

A

PFTs,
FEV1/FVC decreased
Reversible and inducible

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2
Q

Asthma Presentation

A

Wheezing, SOB, Cough
Asthma, Atopy, Allergies
Hyperresonance

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3
Q

If asthma suspected with normal PFT what do you do

A

Methylcholine challenge test

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4
Q

If asthma is suspected and PFT is abnormal what do you do

A

Give albuterol, if there is improvement asthma is confirmed

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5
Q

Asthma Category 1, Intermittent

A

daytime-<2/wk
Nighttime-<2/month
FEV1-80%

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6
Q

Asthma Category 2, Mild Persistent

A

daytime-<1/day, >2/wk
Nightime-<1/wk, >2/mon
FEV1-80%

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7
Q

Asthma Category 3, Moderate Persistent

A

daytime->1/day
Nightime->1/wk
FEV1-60-80%

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8
Q

Asthma Category 4, Severe Persistent

A

daytime->1/day
Nightime-Frequent
FEV1-<60%

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9
Q

Asthma Category 5

A

Refractory, requires oral steroids

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10
Q

Asthma Category 1 Tx

A

Short acting Bronchodilator- Albuterol

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11
Q

Asthma Category 2 Tx

A

SABA + Inhaled Corticosteroid (-asone)

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12
Q

Asthma Catgory 3 Tx

A

SABA + ICS or LTA + LABA

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13
Q

Asthma Category 4 Tx

A

Increase the dose of the ICS

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14
Q

Lung Cancer Work up

A
  1. CXR
  2. CT SCAN
  3. Biopsy
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15
Q

Lung CA Biopsy methods

A

Bronchoscopy- when the mass is in the bronchus
CT guided percutaneous-when the lesion is peripheral
VATS when the lesion is in the middle of the lung

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16
Q

Who needs Lung CA Screening

A

Low dose CT scan yearly
Age 55-80
30 pack year history
quit smoking <15 years

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17
Q

Pulmonary nodule, probably benign

A

<8mm, smooth, no smoking, calcified, age <45

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18
Q

Pulmonary nodule, Probably malignant

A

> 2 cm, Spiculated, Smoking, Age >70

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19
Q

Pulmonary Nodule Workup

A
  1. Check old films, see if size has changed
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20
Q

Small Cell Cancer
Location
Paraneoplastic syndromes
Tx

A

Central
AcTH (Cushing)
SIADH
Chemo/radiation

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21
Q

Squamous Cell CA
Location
Paraneoplastic Syndromes
Tx

A

Central
PTHrP- causes hypercalcemia
Resection, then chemo/radiation

22
Q

Adenocarcinoma
Location
Pathology

A

usually non-smokers or those exposed to asbestos

Peripheral

23
Q

Carcinoid

A

Serotonin syndrome
5HIAA in the urine
flushing, wheezing, diarrhea

24
Q

LIGHTS CRITERIA

A

LDH >2/3 Upper limit of normal
LDHf/LDHs >0.6
TPf/TPs >0.5
if any are positive it is an exudate

25
Q

causes of transudative pleural effusion

A

CHF, Nephrosis, Gastrosis, Cirrhosis,

26
Q

Causes of exudative pleural effusion

A

Malignancy, Pneumonia, TB

27
Q

Elevated ADA in pleural effusion

A

Tuberculosis

28
Q

Pleural Effusion Workup

A 
1. Imaging 
Lateral decubitus x-ray 
US
CT
2. Septations present-thoracostomy 
fails thoracotomy
29
Q

Pleural effusion with CHF

A

Diuresis first if that fails then thoracentesis

30
Q

When is V/Q Scan used in PE

A

If patient has a normal chest x-ray and abnormal kidneys

31
Q

When do you use IV contrast CT

A

Normal Kidneys

32
Q

COPD Management

A

Corticosteroids ICS, Oral, IV
Oxygen keep O2 sat 88-92, given if SpO2 <88% PaO2 <55
Prevention
Dilators-short acting, long acting, oral
Experimental
Rehab

33
Q

COPD Treatment

A

SABA as needed, then LAMA (Tiotropium), LABA (olol), ICS, PDE4 Inhibitors, Steroids

34
Q

COPD Exacerbation workup

A

CXR, ABG, ECG

35
Q

COPD Exacerbation Tx

A

Antibiotics: Doxycycline, Azithromycin
Bronchodilators: Albuterol, Ipratropium

36
Q

ARDS, what is the PCWP & LV Fxn

A

PCWP-Normal

LV Fxn-Normal or increased

37
Q

ARDS Patient

A

Very sick patient as in
Septic shock, TRALI, Near drowning
P/A <200
CXR- pulmonary edema

38
Q

ARDS Tx

A

Intubation

39
Q

ARDS Ventilator settings

A

CO2- Low Tidal Volume
High Respiratory Rate
PEEP

40
Q

Interstitial Lung Disease Pt Hx

A

Chronic, Insidious
Hypoxemia
Dry Cough, Dry Crackles,
PFT- restrictive pattern

41
Q

Interstitial Lung Disease Dx Workup

A

CXR
High res CT (Ground Glass Appearance
FEV1/FVC is elevated or normal

42
Q

Interstitial Lung Disease Tx

43
Q

Causes of Interstitial Lung Disease

A

Sarcoidosis, SLE, RA, Systemic Sclerosis, Asbestosis, Pneumoconiosis
Drug induced=blemomycin, Amiodarone, Radiation

44
Q

Sarcoidosis Pt Hx

A

Hx- Bilateral lymphadenopathy
heart block
bells palsy
erythema nodosum

45
Q

Sarcoidosis Dx Work up

Tx

A 
CXR 
CT 
PFT 
Biopsy-non-caseating granulomas 
Tx-Steroids
46
Q

Asbestosis Hx, Dx

A 
Shipyards, Construction 
Pleural plaques on x-ray 
Dx: Imaging 
Biopsy- barbell bodies 
Tx: Stop Smoking
47
Q

Silicosis Hx

A

Sandblasting, Rock quarries

48
Q

Berylliosis Hx

A

Aeronautics, Electronics

49
Q

Coal Miners Lung Hx

A

Coal miner

50
Q

Hypersensitivity Pneumonitis Hx

A

24-48 hrs after exposure, then resolves after being away from exposure for 24-48 hrs

USMLE STEP 2 CK RETAKE (15 decks)

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