Respiratory

Question 1

Complications of superior sulcus / pancoast tumor

Answer 1

1. Shoulder pain
2. Brachial plexus deficits (hand weakness, numbness)
3. Horner syndrome (ascending sympathetics)
4. Hoarseness (recurrent laryngeal nerve)
5. SVC syndrome

Question 2

Tests to get in a patient with new erythema nodosum

Answer 2

CXR, PPD, and ASO titer (associated with sarcoidosis, TB, and streptococcal infections)
(Also associated with Behcet disease and IBD, but if no symptoms don’t need to screen)

Question 3

Criteria for home O2 in COPD

Answer 3

89% or less if have cor pulmonale, right heart failure, or polycythemia (hct >55%).
Otherwise 88% or less.

Question 4

Theophylline toxicity

Answer 4

CNS stimulation (HA, insomnia, seizure), GI (N/V), arrhythmias

Question 5

Index of severity in ARDS

Answer 5

PaO2 / FiO2 (must be <300)

Question 6

O2 saturation goal in ARDS

Answer 6

88-92%

Question 7

Ventilation strategy recommended in ARDS

Answer 7

Low tidal volume ventilation

Question 8

Patient has subcutaneous emphysema after a severe coughing episode. What do you do next?

Answer 8

CXR to check for pneumothorax

Question 9

Pleural findings that differentiate complicated parapneumonic effusion from uncomplicated

Answer 9

Very acidic (pH <7.2), low glucose (<60), tons of WBC (>50,000)