Respiratory

Question 1

best test to Dx COPD

Answer 1

spirometry

Question 2

drug induced pleural dz

Answer 2

amiodarone
bleomycin
bromocriptine
cyclophosphamide
MTX
minoxidil
mitomycin

Question 3

drug induced lupus pleuritis

Answer 3

hydralazine
procainamide
quinidine

Question 4

nursing home pt in hospital w/ pneumonia, cover for… and tx with..

Answer 4

MRSA: vanc or linezolid

pseudomonas: need 2!
1) cephalosporin (cefepime, ceftazidime) OR carbapenem (imipenem, meropenem) OR pip/tazo
2) fluoroquinolone (levofloxacin, cipro) OR aminoglycoside (gent, trobra, amikacin)

Question 5

nursing home pt w/ pneumonia but tx as outpatient

Answer 5

ceftriaxone and azithromycin

Question 6

PFT shows flattening of inspiratory loop

Answer 6

vocal cord dysfunction

Question 7

differential for rhonchi

Answer 7

heart failure
ILD
infxn

Question 8

pneumothorax, cutoff for chest tube vs repeat CXR in 1-2 days

Answer 8

20% collapse

Question 9

acute bronchitis usually caused by

Answer 9

viruses

Question 10

AECOPD tx

Answer 10

oxygen
ATBs
bronchodilators
systemic corticosteroids

Question 11

solitary nodule on CXR, next step?

Answer 11

CT

Question 12

pt w/ CAP, check urine for what bugs?

Answer 12

Legionella and Strep pneumo

Question 13

PFT of asthma

Answer 13

decr FEV1, NL FVC

Question 14

features of malignant pulmonary nodules

Answer 14

> 10 mm, irreg border, ground glass appearance, no calcs or eccentric calks, doubling time of 1 month-1yr

Question 15

total # of days corticosteroids for COPD exacerbation

Answer 15

5 days

Question 16

ADR of inhaled corticosteroids

Answer 16

incr risk of pneumonia

Question 17

best tx for allergic rhinitis

Answer 17

intranasal glucocorticoids

Question 18

tx of asthma exacerbation if albuterol doesn’t work

Answer 18

oral corticosteroids

Question 19

management of small pneumothorax

Answer 19

analgesics and FU within 72 hours

Question 20

management of pneumothorax > 15%

Answer 20

chest tube

Question 21

smokers and pneumonia vaccine

Answer 21

all smokers between age 19 and 64 should get PCV23

revaccinate after 5 years if chronic renal failure, asplenia, or immunocompromised

Question 22

tx of CAP as outpatient

Answer 22

azithromycin (covers mycoplasma)

Question 23

tx of pleurisy

Answer 23

NSAID

Question 24

preferred site for emergency airway

Answer 24

cricothyroid membrane

Question 25

asthma categories and specifics

Answer 25

mild intermittent: day 2 / wk, night > 2 nights / month PEF or FEV1 80+
mod persistent: daily, night > 1 night/wk, PEF or FEV1 60-80
severe persistent: continuous daytime, frequent nighttime, PEF or FEV1 60 or less

Question 26

what med to add if asthmatic can’t do inhaled corticosteorid

Answer 26

leukotriene receptor antagonist

Question 27

only tx to improve the natural history of COPD

Answer 27

supplemental oxygen

Question 28

obstructive lung dz, bronchial wall thickening, luminal dilation

Answer 28

bronchiectasis

Question 29

length of steroid tx for AECOPD

Answer 29

5 days

Question 30

what improves outcomes in pts with ARDS

Answer 30

low tidal volumes