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Question 1

What are the risk factors for DVT?

Answer 1

Virchow Triad: Stasis, endothelial injury, and hyper coagulability

Question 2

What is the criteria for exudative effusion?

Answer 2

Pleural/serum protein > 0.5

Pleural/serum LDH > 0.6

Question 3

What are the causes of exudative effusion?

Answer 3

Think of leaky capillaries.

Malignancy, TB, bacterial or viral infection, pulmonary embolism (PE) with infarct, and pancreatitis.

Question 4

What are the 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 patients having an asthma exacerbation may indicate ___.

Answer 5

Fatigue and impending respiratory failure.

Question 6

What is the treatment for acute asthma and COPD exacerbations?

Answer 6

B2 agonists and corticosteroids for both

Add in anticholinergics and antibiotics for COPD exacerbation

Question 7

What presents with dyspnea, lateral hilar lymphadenopathy on chest radiograph, noncaseating granulomas, increased ACE, and hypercalcemia?

Answer 7

Sarcoidosis

Question 8

PFT:

low FEV1/FVC

Answer 8

PFT of obstructive pulmonary disease

Question 9

PFT:

High PEV1/FVC; low TLC

Answer 9

PFT of restrictive pulmonary disease

Question 10

What presents as a honeycomb pattern on chest radiograph?

Answer 10

Diffuse interstitial pulmonary fibrosis

Question 11

What is the treatment for diffuse interstitial pulmonary fibrosis?

Answer 11

Supportive care

Antifibrotic agents may help

Question 12

What is the treatment for SVC syndrome

Answer 12

Radiation

Question 13

What is the treatment for mild persistent asthma

Answer 13

Inhaled B-agonists and inhaled corticosteroids

Question 14

What is the treatment for COPD exacerbation?

Answer 14

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

Question 15

What is the treatment for chronic COPD?

Answer 15

Smoking cessation, home O2, B-agonists, systemic or inhaled corticosteroids, flu and pneumococcal vaccines

Question 16

What acid-base disorder do you get in COPD?

Answer 16

Respiratory alkalosis with hypoxia and hypocarbia

Question 17

What non-small cell lung cancer (NSCLC) is associated with hypercalcemia?

Answer 17

Squamous cell carcinoma (SCC)

Question 18

What lung cancer is associated with SIADH?

Answer 18

Small cell lung cancer (SCLC)

Question 19

What lung cancer is associated with Lambert Eaton syndrome?

Answer 19

SCLC

Question 20

What lung cancers are highly related to cigarette exposure?

Answer 20

SCLC, SCC

Question 21

A tall Caucasian man presents with shortness of breath. What is the dx/ treatment?

Answer 21

Spontaneous pneumothorax

Spontaneous regressions; supplemental O2 may be helpful

Question 22

What is the treatment of tension pneumothorax?

Answer 22

Immediate needle thoracotomy (over diagnostic)

Question 23

What characteristics favour carcinoma in an isolate pulmonary nodule?

Answer 23

1) Age > 45-50
2) Tobacco use
3) Lesions new or larger in comparison to old films
4) Absence of calcification or irregular calcification
5) Size > 2cm
6) Irregular margins

Question 24

What condition presents with hypoxemia and pulmonary edema, with normal pulmonary capillary wedge pressure (PCWP)?

Answer 24

ARDS

Question 25

What condition presents with pulmonary fibrosis, pleural plaques, bronchogenic carcinoma (mass in lung field), mesothelioma (pleural mass)?

Answer 25

Sequelae of asbestos exposure

Question 26

A patient has an increased risk of ___ infection with silicosis?

Answer 26

Mycobacterium tuberculosis

Question 27

What are the causes of hypoxemia?

Answer 27

1) Right to left shunt
2) Hypoventilation
3) Low inspired O2 tension
4) Diffusion defect
5) V/Q mismatch

Question 28

What are the classic chest radiographic findings for pulmonary edema?

Answer 28

1) Cardiomegaly
2) Prominent pulmonary vessels
3) Kerley B lines
4) “Bat’s wing” appearance of hilar shadows
5) Perivascular and peribronchial cuffing

Question 29

What are the chest radiographic findings suggestive of PE?

Answer 29

1) Westermark sign

2) Hampton hump