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Shelf - FM > Respiratory (43) > Flashcards

Respiratory (43) Flashcards

1
Q

Dx:

distress, dysphagia, dysphonia, drooing

A

epiglottitis

“thumb sig” on XR

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2
Q

MCC of epiglottitis?

A

Hib

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3
Q

MCC of bronchiolitis in children

A

RSV

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4
Q

MCC of illness that causes “steeple sign” dt subglottic narrowing.

A

Croup, caused by parainfluenza virus

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5
Q

MCC of pharyngitis

A
  1. MC viral (rhino)

2. MC bacterial strep pyogenes (Grp A)

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6
Q

differentiating factor b/w viral v. bacterial pharyngitis

A

both fever –> bacterial if anterior cervical LAD and/or tonsillar erythema/exudates

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7
Q

What is the dx:
asthmatic pt with recurrent exacerbations of fever, cough, dyspnea. bronchiectasis (dilation of airways), causing expectoration of brown mucus plug. Peripheral eosinophilia

A

aspergillus - Allergic BronchoPulmonary Aspergillosis (ABPA)

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8
Q

dx first test for ABPA

A

skin prick for HSR

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9
Q

dx criteria for chronic bronchitis.

classic color on exam

A

> 3mo for 2 years in a row of productive cough, as well as evidence of airway obstruction on PFT (FEV1/FVC blue bloaters (fat, cyanotic)

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10
Q

major distinguishing factor b/w asthma and chronic bronchitis

A

asthma is reversible after bronchodilator therapy

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11
Q

CT imaging reveals expiratory trapping within bronchioles, bronchial wall thickening, gropund glass ocpacities thorught all lung fields. rare cause of cough in adults.

A

bronchiolotis obliteras (dt inflammation or fibrosis)

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12
Q

abnormal enlargement and permanent destruction of airspace distal to bronchioles iwth no evidence of fibrosis. common cause of chronic cough. non cyanotic, RR high, thin with inc AP ches diameter.
CT: large bullae, flat diaphragm, enlarged airspace.

A

emphysema

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13
Q

Cough, dyspnea, excess production of foul purulent sputum for mo-years. May complain of hemoptysis, dyspnea, pleuritic chest pain, wheezing, wt loss, fatigue. Not relieved by tx for pneumonia or obsructive lung diseases (asthma/bronchitis/COP)

CXR: dilated and thickened airways.

CT: airway dilatation and bronchial thickening in presence of mucus plugs or debris and post-obstructive air trapping “signet ring sign”

A

bronchiectasis

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14
Q

First step in management of children with epiglottitis

A

endotracheal intubation

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15
Q

Intermittent asthma classifications

Sx:
Nighttime awakenings:
Use of SABA: 
Normal activity interfered with?
PFTs
Exacerbations/yr requiring oral systemic CS:
A

Sx: 80%)

Exacerbations/yr requiring oral systemic CS: 0-1

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16
Q

Mild persistent asthma classifications

Sx:
Nighttime awakenings:
Use of SABA: 
Normal activity interfered with?
PFTs
Exacerbations/yr requiring oral systemic CS:
A

Sx: >2x/wk but not daily
Nighttime awakenings: 3-4x/mo
Use of SABA: >2x/wk
Normal activity interfered with? minor limitations
PFTs normal
Exacerbations/yr requiring oral systemic CS: > or = 2 / yr

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17
Q

Moderate persistent asthma classifications

Sx:
Nighttime awakenings:
Use of SABA: 
Normal activity interfered with?
PFTs
Exacerbations/yr requiring oral systemic CS:
A

Sx: daily
Nighttime awakenings: at least 1/wk, not daily
Use of SABA: daily
Normal activity interfered with? some limitation
PFTs 60-80%
Exacerbations/yr requiring oral systemic CS: > or = 2 / year

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18
Q

Severe persistent asthma classifications

Sx:
Nighttime awakenings:
Use of SABA: 
Normal activity interfered with?
PFTs
Exacerbations/yr requiring oral systemic CS:
A 
Sx: thorughout day
Nighttime awakenings: nightly
Use of SABA: several times per day
Normal activity interfered with? extreme limitation
PFTs  or = 2 exacerabations
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19
Q

Most appropriate first test for someone suspected to have AAT

A

genetic

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20
Q

child with hx of recurrent OM presents with new onset unilateral conductive hearing loss (weber localizes to bad, rinne: negative = bone conduction > air = sound not heard)). PE shows white mass located behind intact TM

A

congenital cholesteatoma

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21
Q

Middle age women complains of pulsatile tinnitus and gradual, painless hearing loss. Pulsating reddish-blue mass seen behind intact tympanic membrane

A

glomus tumors

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22
Q

weber: sound hear best in normal hear
rinne: positive = air>bone conduction = sound still heard

A

sensorineural hearing loss

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23
Q

dx: a single, discrete inhalation exposure
dx: multiple exposures

A

single = reactive airway dysfunction syndrome (RADS)

multiple = irritant-induced asthma

24
Q

bronchiolar lavage reveals what predominant cells in reactive airway dysfunction syndrome (RADS)

A

neutrophils

25
Q

positive acid fast bacilli on sputum culture

A

TB

26
Q

seated/standing aspiration pneumonia - what lobe?

A

right lower lobe

27
Q

supine aspiration pneumonia - what lobe?

A

right upper lobe

28
Q

MC pathogens of OM

A
  1. strep pneumo
  2. Hi
  3. Moraxella
29
Q

Give ampicillin for OM when?

A

only first line tx if middle ear inflammation or very severe infective sx

first line is supportive

30
Q

MCC of hypercalcemia (bones, groans, abdominal moans, psychiatric overtones)

A

SCCa - MALIGNANCY (hyperCa = >10.2)

31
Q

MC ECG finding in Pulmonary Embolism

A

Most common is SINUS TACHYcardia

S1Q3T3 is often found

32
Q

Dx: Egophony, dullness to percussion, fever, productive cough/sweats/rigors/preceding URI, pleuritic chest discomfort

A

pneumonia

CXR first

33
Q

When does exercise induced asthma peak?

A

10-15min after completion of exercise

34
Q

Non-vigourous infants born with meconium should be handled how?

A

intubation and endotracheal suctioning

35
Q

clinical sx of infectious mono are present. next step in diagnosis

A

CBC and heterophile ab test

36
Q

unexplained hypoNa is typically caused by SIADH dt….?

A

Small cell Ca of lung (euvolemic hypoNa)

37
Q

environmental exposure:

  • “honeycombing” =
  • “black lung” =
  • noncaseating granulomas and hilar/mediastinal lymphadenitis =
A
  • “honeycombing” = asbestos
  • “black lung” = coal (pneumoconiosis)
  • noncaseating granulomas and hilar/mediastinal lymphadenitis = beryllium
38
Q

Mainstay of tx for acute asthma exacerbation (@)

A
  1. oxygen
  2. SABA
  3. oral CS***
39
Q

Dx: nasal polyps, aspirin intolerance, asthma

Dx: Test:

A

Aspirin Exacerbated Respiratory Disease (AERD) - this is Samter’s triad

Dx test is oral aspirin challenge test (or ibuprofen or NSAID - any COX-1 inhibitor)

40
Q

Foamy macrophages are actually

A

lipid laden

41
Q

MCC of lipoid pneumonia

A

inappropriate use of petroleum jelly or mineral oil (for constipation)

42
Q

Ohio and MS river valley + lung, think what microbe

A

histo

43
Q

Southwest USA + lung, think what microbe

A

coccidioides

44
Q

Dx and management: 6yo w/ 11d productive cough w/ green sputum and persistent compalints of facial pain. Daycare w/ other kids w/ sx. T 100.5, HR 90, frontal sinus tenderness, purulent nasal dicharge.

A

Dx: bacterial rhinosinusitis
Tx: amoxicillin-clavulanate

45
Q

dx? 10 days of sinusitis sx, 4 days purulent sputum, and/or persistent unilateral facial pain

dx? 10 days of sinusitis sx, 4 days purulent sputum, and/or persistent facial pain, fever >102F, sx intensify after 7d

A

viral rhinosinusitis (>influenza>parainfluenza)

bacterial sinusitis (strep pneumo)

46
Q

bacterial sinusitis tx in:

  • kid allergic to penicillin (amoxicillin)
  • adult allergic to penicillin (amoxicillin)
A
  • kid - give levofloxacin or 3rd gen cephalosporin

- adult - give doxycycline (teeth discoloration in kids)

47
Q

think ____ when presented w/ asthma sx (SOB during daily jog) that fail to respond to asthma therapy and spirometry showing flattened inspiratory flow loop w/ normal FVC and FEV1/FVC ratio

A

vocal cord dysfunction

48
Q

Dx and tx:

presence of fever, notable tonsillar exudate, tender anterior cervical adenopathy, absence of cough.

A

strep pharyngitis

begin antibiotics

49
Q

best annual screening recommendation for pt 55-80y w/ 30-pack-yr smoking and have smoked w/in last 15y

A

low dose CT

50
Q

difference bw healthcare-associated pneumonia (HCAP) v. CAP

A

HCAP = non-hospitalized pts who have extensive contact w/ healthcare facilities. (IV or wound care w/in last 30d, live in nursing care, hospitalized for >2d in past 90d, hospital HD clinic in past 30d

51
Q

Dx?
blunt chest trauma.
chest pain, SOB, decrased/absent breath sounds, dullness to percussion, derased tactile fremius, decrased vocal resonance on affected side.

A

hemothorax (blood in pleural cavity)

52
Q

MCC of congenital sensorineural hearing loss and deaefness. mom presents with mono-like infxn.

A

CMV

53
Q

loops, salicylates, aminoglycosides (i.e. gentamycin), chemotherapy - all can cause?

A

ototoxicity

54
Q

ECK finding in Pulm embolism

A

sinus tachy

s1Q3,invertedT3

55
Q

First line tx of Group A strep

A

Penicillin V

56
Q

first line tx for respiratory tract infections, human/animal bites,
second line tx for bacterial OM

A

amoxicillin- clavulanate

Shelf - FM (14 decks)

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