Rapid Review: Pulmonary

Question 1

Risk factors for DVT

Answer 1

Stasis, endothelial injury, and hypercoagulability (Virchow’s triad)

Question 2

Criteria for exudative effusion

Answer 2

Pleural/serum protein >.5; pleural/serum LDH >.6

Question 3

Causes of exudative effusion

Answer 3

Think of leaky capillaries (usually due to inflammation). Malignancy, TB, bacterial or viral infection, PE with infarct, and pancreatitis

Question 4

Causes of transudative effusion

Answer 4

Think of intact capillaries. CHF, liver or kidney disease, and protein-losing enteropathy.

Question 5

Normalizing PCO2 in a patient having an asthma exacerbation may indicate?

Answer 5

Fatigue and impending respiratory failure

Question 6

Sarcoidosis

Answer 6

Dyspnea, lateral hilar lymphadenopathy on CXR, noncaseating granulomas, increased ACE, and hypercalcemia

Question 7

PFTs of obstructive pulmonary disease

Answer 7

Decreased FEV1/FVC (though usually still some decrease in FVC)

Question 8

PFTs of restrictive pulmonary disease

Answer 8

Increased FEV1/FVC, decreased FVC, no decrease in FEV1, decreased TLC

Question 9

Honeycomb pattern on CXR. Treatment

Answer 9

Diffuse interstitial pulmonary fibrosis. Supportive care; steroids may help.

Question 10

Treatment for SVC syndrome

Answer 10

Radiation

Question 11

Treatment for mild persistent asthma

Answer 11

Inhaled Beta agonists and inhaled corticosteroids

Question 12

Treat for COPD exacerbation

Answer 12

O2, bronchodilators, antibiotics, corticosteroids with taper, smoking cessation

Question 13

Treatment for chronic COPD

Answer 13

Smoking cessation, home O2, Beta agonists, anticholinergics, systemic or inhaled corticosteroids, flu and pneumonia vaccines

Question 14

Acid-base disorder in PE

Answer 14

Respiratory alkalosis with hypoxia and hypocarbia

Question 15

Lung cancer associated with hypercalcemia

Answer 15

SCC

Question 16

Lun g cancer highly related to cigarette exposure

Answer 16

Small cell

Question 17

A tall caucasian man presents with acute shortness of breath. Diagnosis? Treatment?

Answer 17

Spontaneous pneumothorax. Spontaneous regression; supplemental O2 may be helpful.

Question 18

Treatment of tension pneumothorax

Answer 18

Immediate needle thoracostomy

Question 19

Characteristics favoring carcinoma in a pulmonary nodule

Answer 19

Age>45-50, lesions new or larger, absence of calcification or irregular calcification, size >2, irregular margins

Question 20

ARDS

Answer 20

Hypoxemia and pulmonary edema with normal pulmonary capillary wedge pressure

Question 21

Sequelae of asbestos exposure

Answer 21

Pulmonary fibrosis, pleural plaques, bronchogenic carcinoma, mesothelioma

Question 22

Increased risk of what infection with silicosis?

Answer 22

Mycobacterium tuberculosis

Question 23

Causes of hypoxemia

Answer 23

Right to left shunt, hypoventilation, low inspired O2 tension, diffusion defect, V/Q mismatch

Question 24

Classic CXR findings of pulmonary edema

Answer 24

Cardiomegaly, prominent pulmonary vessels, Kerley B lines, “bat’s wing” appearance of hilar shadows, and perivascular and peribronchial cuffing

Question 25

Westermark’s sign and Hamptom’s hump

Answer 25

CXR findings suggestive of PE