Respiratory

Question 1

Lung Cancer symptoms

Answer 1

cough in smoker or former smoker
hemoptysis and dyspnea may accompany cough
Dull, achy, persistent chest pain.

Question 2

Horner Syndrome

Answer 2

Pupil ocnnstriction with ptosis associated with lung cancer

Question 3

Screening test for lung cancer

Answer 3

Low dose computed tomography of the lung for adults 50-80 who are chronic smokers or who quit in the past 15 years

Question 4

Symptoms of acute carbon monoxide poisoning

Answer 4

Headache (most common sympto)
Nausea, malaise, dizziness.
May resemble viral URI.
CHerry red appearance of skin and skin.
Severe toxiccity: seizures, syncompe, coma.

Question 5

Diagnosis of acute carbon monoxide poisoning

Answer 5

elevated carboxyhemoglobin level measured by cooximetry of ABG

Question 6

Pulmonary emboli

Answer 6

sudden dyspnea and coughing, pink tinged frothhy sputumi.
Tachycardia, pallor, feelings of impenndign doom.

Question 7

COPD diagnosis

Answer 7

Post albuterol FEV1/FVC <0.7 (lung function less than 70%) is daignosis for COPD.

Question 8

Chronic bronchitis definition

Answer 8

coughing with excessssive mucus production for at leastt 3 months for 2 consecutive years

Question 9

Emphysema definition

Answer 9

prolonged expiratory phase

Question 10

Oxygen therapy for COPD

Answer 10

if PaO2 < 88%, if on airplane, and supplement with vit c, e, zinc and selenium

Question 11

Exacerbation Tx

Answer 11

Vitals (pulse sat)
Send to hospital if increased dyspnea and sputum)
SABA mainstay, add SAMA if need be. Can add oral glucoocorticod such as prednisone for 5 days.
Chest x ray to exclude pneumonia, PE, pneumothorax
Suspect bactrial hemophelius influenzae pneumonia if with fever, purulent sp[utum
Treatment: macrolide (azithromycine/clindamycin). If pseudomnnoous, then give cephalosporin like cefdinir.

Question 12

Treatment of CAP without sig comorbidities

Answer 12

Oral doxycycline OR azithromycin, clarithromycin, erythromycin OR amoxicillin.

Remember (AABCDE)
Amoxicillin, azithromycin, clarithromycinn, doxycycline erythromycin

Question 13

Treatment of CAP with signficant comorbidities

Answer 13

Respiraotry fluoroquinolone OR doxy PLUS augmentin

Question 14

CAP findings

Answer 14

Tachypnea
Crackles or rales
Consolidation
Pleuritic Friction Rub – sharp pain witth with deep breatht, movement cough

Question 15

CURB 65

Answer 15

Confusion
Blood urea nitrogen greater than 19 (renal dysfunction or dehydration)
Respiratory rate >30
BP less than 90/60
Age 65 older

Question 16

Meaning of Curb 65

Answer 16

0-1: treat outpatient w/ oral antibiotics
2: consider short stay in hospital or watch v closely as outpatientt
3-5: requires hospitalizaiton