random Q&A

Question 1

most common initial presentation of rheumatic fever

Answer 1

polyarthritis

Question 2

most specific presentation of rheumatic fever

Answer 2

seydenham chorea

Question 3

reversibilit in asthma is demonstrated by

Answer 3

> 12% and 200mL increase in FEV1: 15min after an inhaled short acting b2-agonsit or;
after a 2 to 4week trial of oral corticosteroids (prednisone or prednisolone 30-40mg daily)

Question 4

putative mediators of asthma

Answer 4

SRS-A made up of leukotrienes C4, D4, E4

Question 5

most common side effect of theophylline

Answer 5

nausea, vomiting and headaches

Question 6

need for regular controller therapy

Answer 6

use of reliever medication >3x a week

Question 7

most common reason for non control of asthma

Answer 7

noncompliance with medication, usually ICS

Question 8

drugs that are safe for asthma in pregnancy

Answer 8

short acting B2- agonist
ICS
theophylline

Question 9

ratio if granular layer thickness VS thickness of the wall between the epithelium and the cartilage of the trachea and bronchi

Answer 9

Reid’s index (>0.4 in Chronic Bronchitis)

Question 10

most highly significant predictor of FEV1 (COPD)

Answer 10

pack years of cigarette smoking

Question 11

most typical finding in COPD

Answer 11

persistent reduction in forced expiratory flow rates

Question 12

type of emphysema most commonly associated with smoking

Answer 12

• centriacinar emphysema
• characerized by enlarged spaces found (initially) in association with respiratory bronchioles
• prominent in upper lobes and superior segments of lower lobes and often focal

Question 13

type of emphysema usually in pts with a1-AT deficiency

Answer 13

• panacinar emphysema
• char. by abnormally large air spaces evenly distributed within and across acinar units
• predilictions for lower lobes and involves the entire respiratory unit (resp bronchiole, alveolar duct and alveoli)

Question 14

newly develop clubbing of digits (NOT A SIGN OF COPD)

should alert an investigation

Answer 14

lung CA

Question 15

most common pathogenesis of pneumonia

Answer 15

aspiration

Question 16

main purpose of gram stain

Answer 16

ensure suitability sample for culture

Question 17

LIGHT’S CRITERIA

Answer 17

for diagnosis of exudate

• one or more of the ff:
• pleural fluid/serum protein ratio >0.5
• pleural fluid LDH/serum LDH ratio >0.6
• pleural fluid LDH>2/3 the upper limit of the normal for serum LDH

Question 18

indications for CT insertion:

Answer 18

-gross pus on thoracentesis
presence of organisms on G/S on pleural fluid
pleural fluid glucose <60mg/dl
pleural fluid pH below 7.2 in a setting of pneumonia

Question 19

to be adequate for culture, a sputum sample must have

Answer 19

> 25neutrophil and

<10 squamous cells per lpf

Question 20

leading cause of transudate pleural effusion

Answer 20

LV failure, cirrhosis

Question 21

leading cause of exudative pleural effusion

Answer 21

bacterial pneumonia, malignancy, viral infection, pulmonary embolism

Question 22

most common cause of chylous pleural effusion

Answer 22

malignancy

Question 23

3 tumors that cause ~75% of all malignant pleural effusion

Answer 23

lung CA
breast CA
lymphoma

Question 24

classic signs of PE

Answer 24

tachycardia, low grade fever, neck vein distention

Question 25

useful rule out test >95% of pts with normal levels (<500ng/mL) do not have PE

Answer 25

quantiative plasma D-dimer ELISA

Question 26

most frequently cited ECG abnormality in PE (in addition to sinus tachycardia)

Answer 26

S1Q3T3 sign (specific but insensitive)

Question 27

most common ECG abnormality in PE

Answer 27

T-wave inversion in leads V1 to V4

Question 28

ards

Answer 28

acute onset <24hours
bilateral patchy airspace disease
absence of left atrial hypertension (PCWP <18mmHG)
profound shunt physiology (PaO2/FiO2 <200)

Question 29

top 3 causes of ARDS:

Answer 29

gram (-) sepsis
gastric aspiration
severe trauma