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EOR: Family Medicine > Pulmonology > Flashcards

Pulmonology Flashcards

1
Q

> 12% increase in FEV1 after bronchodilator tx indicates…

A

Asthma

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2
Q

FEV1:FVC < 80% indicates…

A

asthma

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3
Q

Asthma would show a ____ FEV1 and ______ FEV1:FVC ratio

A

decreased

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4
Q

3 staples of asthma…

A

inflammation
hyperresponsiveness
reversible obstruction

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5
Q

Steps 1-6 of asthma Tx…

A

1: SABA
2: low dose ICS
3: low dose ICS + LABA + SABA
4: medium dose ICS + LABA
5: High dose ICS + LABA
6: high dose ICS + LABA + PO Steroids

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6
Q

cough > 5 days lasting 2-3 weeks

A

bronchitis

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7
Q

COPD = chronic cough that is productive of phlegm occurring on most days for _____ months of the year for ______ or more consecutive years

A

3 months

2+ years

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8
Q

3 hallmarks of COPD…

A

cough

sputum production

dyspnea

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9
Q

Dx of COPD (4)

A

PFTs

CXR

alpha antitrypsin

ABGs

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10
Q

PFTs in COPD show FEV1/FVC ratio…

A

< 0.7

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11
Q

CXR findings in COPD

A

perivascular markings

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12
Q

CBC findings in COPD…

A

increased H & H due to chronic hypoxia

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13
Q

Tx for mild COPD…

A

SABA

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14
Q

Tx for moderate/severe COPD

A

LABA +/- ICS

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15
Q

Inahler of choice for COPD…

A

ipratropium

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16
Q

single most important medication and lifestyle factor for COPD

A

Oxygen and smoking cessation

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17
Q

2 mandatory vaccines for COPD

A

pneumococcal, flu

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18
Q

Pt p/w:

Recurrent PNA
constitutional sxs
Hx of smoking

A

small cell lung CA

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19
Q

4 complications associated with small cell lung cancer

A

SVC syndrome

phrenic nerve palsy

recurrent laryngeal nerve palsy

horner syndrome

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20
Q

which lung CA complication?

obstruction of SVC by a mediastinal tumor, facial fullness, facial and arm edema, dilated veins over the anterior chest, arms, face; JVD

A

SVC syndrome

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21
Q

which lung CA complication?

hemidiaphragmatic paralysis…

A

phrenic nerve palsy

22
Q

which lung CA complication?

p/w hoarseness

A

recurrent laryngeal nerve palsy

23
Q

which lung CA complication?

invasion of the cervical sympathetic chain by apical tumor → unilateral facial anhidrosis (no sweating), ptosis, miosis

A

horner syndrome

24
Q

which lung CA complication?

proximal muscle weakness/fatigue, diminished DTRs, paresthesias (lower extremity

A

eaton-lambert syndrome

25
Q

Which lung CA?

Central mass, very aggressive
99% smokers
15% of cases
do not respond to surgery
mets at presentation
A

small cell

26
Q

Diagnostics for lung CA

A

CXR

Contrast CT

Bx

27
Q

This diagnostic is used to diagnose central tumors

A

fiber-optic bronchoscopy

28
Q

Which lung CA diagnostic?

suspicious masses, highly accurate for peripheral lesions

A

transthoracic needle bx

29
Q

3 types of non-small cell lung CA

A

SCC

Large Cell

adenocarcinoma

30
Q

Which lung CA?

most common (peripheral mass)

35-40% of cases of lung cancer

Associated with smoking and asbestos exposure

Location: Periphery

Paraneoplastic syndrome: Thrombophlebitis

A

adenocarcinoma

31
Q

Which lung CA?

fast doubling rates - responds to surgery

rare (only 5%)

Location: Periphery 60%

Paraneoplastic syndrome: Gynecomastia

A

Large cell

32
Q

Which lung CA?

hemoptysis

25-35% of lung cancer cases

Location: central mass

Paraneoplastic syndrome: hypercalcemia
Elevated PTHrp

A

squamous cell

33
Q

Tx for non-small cell lung CA…

A

surgery

34
Q

Which lung CA association?

shoulder pain

horner’s syndrome

brachial plexus compression

A

pancoast tumor

35
Q

MC cause of CAP…

A

S. pneumo

36
Q

Patient presents with:

fever then gradual onset of cough

SOB on exertion

sweats/chills/rigors

chest discomfort

A

CAP

37
Q

Outpatient CAP tx if no recent use of Abx w/in 90 days…

A

azithromycin 500 mg dose 1, then 250 mg x 4 days

or

Doxycycline 100mg PO BID x 5 days

38
Q

Outpatient CAP tx if Abx last 90 days, Age > 65, immunosuppression, comorbid illness

A

Moxifloxacin 400 mg PO daily, levofloxacin 750 mg PO daily x 5 days

OR

azithromycin + beta lactam

39
Q

ICU CAP tx if no recent use of Abx w/in 90 days…

A

Azithromycin or respiratory FQ (moxifloxacin, levofloxacin) plus Antipneumococcal β-lactam: cefotaxime, ceftriaxone

40
Q

Inpatient CAP tx if Abx last 90 days, Age > 65, immunosuppression, comorbid illness

A

IV macrolide plus IV β lactam (HD ampicillin 1-2 g q 4-6 h or Cefotaxime 1-2 g q 4-12 h or Ceftriaxone 1-2 g q 12-24 h)

41
Q

Inpatient CAP tx if no recent use of Abx w/in 90 days…

A

IV levofloxacin 750 mg daily or IV ciprofloxacin 400 mg q 8-12 h

42
Q

Pt. p/w:

fatigue, productive cough, night sweats, weight loss, post-tussive rales

A

TB

43
Q

Dx of TB…

A

sputum Cx

44
Q

CXR of TB…

A

cavitary lesions, ghon complex in apex of lungs

45
Q

Bx of TB

A

caseating granuloma

46
Q

Tx of TB: (+) PPD, CXR Neg

A

Isoniazid x 9 mo

47
Q

Tx of TB: (+) PPD and CXR

A

4 drugs x 8 weeks (RIPE) then RI x 16 weeks

48
Q

SFx of isoniazid and what can help prevent?

A

peripheral neuropathy

prevent with pyridoxine 25-50 mg QD

49
Q

SFx of Pyrazinamide

A

hyperuricemia, caution Gout

50
Q

SFx of ethambutol

A

optic neuritis
red-green blindness

((E = eye changes)

51
Q

What should be monitored during TB treatment?

A

serum creatininte

52
Q

TB prophylaxis for household members?

A

INH x 1 year

EOR: Family Medicine (14 decks)

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