Respiratory 4

Question 1

a risk factor for allergic rhinitis is if serum IgE is >100 before what age?

Answer 1

age 6

Question 2

what is the most common allergic dz in the US

Answer 2

allergic rhinitis

Question 3

what class of allergic rhinitis is symptoms <4 weeks

Answer 3

intermittent

Question 4

what class of allergic rhinitis is symptoms >4 days/ week AND >4 weeks

Answer 4

Persistent (primary perennial)

Question 5

allergic rhinitis is considered moderate-severe if what at least 1 of what three symptoms are found

Answer 5

Sleep disturbances, Troublesome symptoms
Impairment of daily activities, leisure, and/or sport
Impairment of school or work

Question 6

a central mediator in both the early and late allergic response
Released from presensitized mast cells upon allergen exposure and causes acute symptoms of allergic rhinitis: sneezing, rhinorrhea, itchy nose, nasal congestion

Answer 6

Histamine

Question 7

when is histamine released from basophils?

Answer 7

Late phase

Question 8

Who is at greatest risk of asthma?

Answer 8

65 years and above

Question 9

What are some symptoms of asthma?

Answer 9

Recurrent wheeze
recurrent shortness of breath
cough
recurrent chest tightness

Question 10

what is the inflammation like in asthma?

Answer 10

histamine release

basophil release

Question 11

what cells produce mucous and cause plugging

Answer 11

goblet cells

Question 12

does normal spirometry to lack of reversibility rule out asthma?

Answer 12

No

Question 13

will asthmatics have low diffusion capacity?

Answer 13

No (will be abnormal with emphysema)

Question 14

what are leukotriene meds used for?

Answer 14

add to albuterol for exercise induced

add if they have allergies

Question 15

indicated in for adults and adolescents (12 years of age and above)
with moderate to severe asthma who have a positive skin test or in vitro reactivity to a perennial aeroallergen
whose symptoms are inadequately controlled on inhaled corticosteroids.

Answer 15

Omalizumab

Question 16

may be more beneficial in children, exercise induced

Answer 16

mast cell stabilizers (cromolyn, nedocromil)

Question 17

patients with nasal polyps are more likely to be sensitive to what?

Answer 17

ASA and NSAIDs

Question 18

in an asthma exacerbation, what is the pH initially?

Answer 18

respiratory alkalsosis

Question 19

if the pH is decreased in an asthma exacerbation what can that indicate?

Answer 19

impending respiratory failure

Question 20

is wheezing a good sign in asthma?

Answer 20

Yes, because silent chest is worse during exacerbation

Question 21

most common cancer for men?

Answer 21

prostate

Question 22

exposure to what can cause lung cancer?

Answer 22

Asbestos
Radon
uranium

Question 23

Tumors that originate in the _______ can attain a very large size before producing symptoms

Answer 23

periphery

Question 24

When tumors arise in a _______ region of the lung symptoms arise early.

Answer 24

central

Question 25

what is the most common type of histology of central tumors?

Answer 25

squamous cell

Question 26

most common symptoms of lung cancer

Answer 26

hemoptysis chest pain dyspnea (COPD association) weight loss

Question 27

Edema in the face, neck, arms, JVD

Answer 27

Superior Vena Cava Syndrome

Question 28

first thing for evaluation of lung cancer

Answer 28

CXR (can't see lesions <5 mm)

Question 29

CT with or without contrast is best for lung cancer.

Answer 29

With contrast and look at liver and adrenals (metastasis)

Question 30

what is the most common classification of lung cancer?

Answer 30

Non-small cell | small cell is the worst though

Question 31

Stage one is a tumor less than what size?

Answer 31

<3 cm

Question 32

only way to cure lung cancer?

Answer 32

removal of the cancer

Question 33

what do you do for stage III NSCLC

Answer 33

Non-resectable Stage IIIa and IIIb | Combined chemo-radiation improves survival

Question 34

Tx for stage IV NSCLC

Answer 34

Chemotherapy improves survival (by 20-40% at 12 months) and QOL if good performance status

Question 35

Small Cell Cancer is very _________, surgery usually not an option.

Answer 35

chemosensitive

Question 36

which type lung cancer do you do surgery on?

Answer 36

non small cell

Question 37

Isolated rounded lesion in the lung parenchyma, usually < 3 cm

Answer 37

Solitary pulmonary nodule

Question 38

when is a pulmonary nodule more likely to be malignant

Answer 38

>3cm older age smoking history increasing in size

Question 39

where are lymphomas seen?

Answer 39

anterior or middle mediastinum

Question 40

what is a slow growing malignant tumor with a good survival rate?

Answer 40

Carcinoid tumor

Question 41

If a lesion is stable in size for _________ years, it is likely not malignant.

Answer 41

2-3 years

Question 42

Benign causes of pulmonary nodules

Answer 42

Granulomas (tb, spores from forest) | hamartomas

Question 43

If it is metastasis to the lung, what will you usually see

Answer 43

multiple cancers