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PLABABLE 2.0 > Respiratory Medicine > Flashcards

Respiratory Medicine Flashcards

1
Q

Caused by hypersensitivity-induced lung damage due to variety of inhaled organic particles

A

Extrinsic Allergic Alveolitis

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2
Q

Farmer + Dyspnea + Cough + DIffuse micronodular shadowing

A

Extrinsic Allergic Alveolitis

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3
Q

Other name for Extrinsic Allergic Alveolitis

A

Hypersensitivity Pneumonitis

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4
Q

In extrinsic allergic alveolitis, what findings will you appreciate?

  1. CXR
  2. bronchoalveolar lavage
  3. Blood
A
  1. Diffuse micronodular shadowing
  2. Lymphocytosis
  3. No eosinophilia
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5
Q

A tumor in the apex of the lung causing Horner’s syndrome (miosis, anhidrosis, ptosis)

A

Pancoast Tumor

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6
Q

Pancoast Tumor, a carcinoma that occurs in the apex of the lung, causes compression of what structures structures which result in the following signs:

  1. Hoarseness
  2. Ipsilateral ptosis
  3. Ipsilateral miosis
  4. Ipsilateral anhidrosis
  5. SVC syndrome
  6. Sensorimotor deficits
A
  1. Recurrent laryngeal nerve
    2-4. Stellate ganglion
  2. Superior vena cava
  3. Brachial Plexus
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7
Q

What type of pneumothorax occcurs in tall, young males with no apparent reason?

A

Primary Spontaneous Pneumothorax

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8
Q

Diagnostic and Management for primary spontaneous pneumothorax

A

Erect CXR
<2cm - conservative management (give O2 supplement)
>2 cm (or distressed) - aspirate with needle

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9
Q

Management for secondary spontaneous pneumothorax

A

<1cm - conservative management (O2 supplement)
1-2cm - needle aspiration
>2 cm - chest drain

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10
Q

Management for Tension Pneumothorax

A

Needle Decompression

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11
Q

Percussion and Auscultation findings of CONSOLIDATION

A

Dull, crackles

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12
Q

Percussion and Auscultation findings of PLEURAL EFFUSION

A

Dull, Decreased breath sounds

Trachea Away from effusion

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13
Q

Percussion and Auscultation findings of ATELECTASIS

A

Decreased breath sounds

Trachea TOWARDS collapsed lung

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14
Q

Percussion and Auscultation findings of TENSION PNEUMOTHORAX

A

Hyperresonant, Reduced breath sounds

Trachea Displaced away from affected side

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15
Q

CAP needing antibiotics + PCN allergic or Taking Warfarin

A

Doxycyline or Clarithromycin

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16
Q

CAP needing antibiotics + PCN allergic + taking warfarin + taking statins

A

Doxycycline

Remember Clarithromycin-statin can cause rhabdomyolysis

17
Q

Warfarin + (Clarithromycin OR Doxycycline) interaction

A

Increases the anticoagulation effect of warfarin —> Monitor INR

18
Q

Prophylactic antibiotic for HIV patient whose CD4 <50

A

Azithromycin

19
Q

Prophylactic antibiotic for HIV patient whose CD4 <200

A

TMP-SMX

20
Q

Most accurate test to diagnose Bronchopleural Fistula

A

CT

21
Q

A patient scores >4 in Two-level Wells score. What’s the next step?
What if patient did not score >4?

A

Arrange for CTPA

D-dimer. If positive, then arrange for CTPA

22
Q

CTPA could not be done to a patient since patient has an allergy to a contrast media (or with renal impairment)

A

Do V/Q scan

23
Q

What initial investigation should be done on a pregnant patient if PE is being suspected?

A

CXR - to rule out other causes of dyspnea like pneumonia or pneumothorax.

24
Q

In a pregnant patient, CXR is abnormal and PE is being suspected, what is the imaging modality of choice?

A

CTPA

25
Q

In a pregnant patient, CXR is normal yet PE is still being suspected, what is the imaging modality of choice?

A

V/Q scan

26
Q

Pulmonary embolism is being suspected on a hemodynamically stable patient, however, CTPA is still not being done. What should be done?

A

Apixaban or Rivaroxaban

27
Q

In terms of imaging investigations for PE in pregnancy, what are the differences between a CTPA and a V/Q scan?

A

CTPA - good for baby, bad for mommy since it had higher radiation to maternal breast tissue (increased risk of BRCA for mom)

V/Q - more risk of radiation to fetus but lower radiation to maternal breast tissue (increased risk of childhood cancer)

28
Q

Suspected PE + Pregnancy + with symptoms of DVT

Next investigation?

A

Duplex ultrasound

If confirmed: continue LMWH therapeutic dose

29
Q

Blood works findings in a patient with Legionella pneumonia

Treatment?

A

(LOW) Sodium, Albumin, Lymphocytes

and Elevated Liver Enzymes

30
Q

Small cell Lung CA, in terms of:

  1. Association with smoking
  2. Central or peripheral
  3. Paraneoplastic ssx
A
  1. Associated with smoking
  2. Central
  3. SCLC - SIADH, Cushings, Lambert-Eaton Myasthenic Syndrome, Clonus or Central
31
Q

FVC and FEV1/FVC of obstructive diseases?

Examples of Obstructive Diseases

A

FVC > 80%
FEV1/FVC < 0.7

Asthma, COPD, Cystic Fibrosis, Bronchiectasis

32
Q

FVC and FEV1/FVC of Restrictive diseases?

Examples of Restrictive Diseases

A

FVC < 80%
FEV1/FVC > 0.7

Pulmonary Fibrosis
Interstitial Lung Disease
Neuromuscular Diseases
Thoracic cage deformities

33
Q

Cough + DOB + hemodynamic or respiratory compromise + post-thoracic sx + pneumonectomy or lobectomy + X-ray (high-fluid level that is normal and low air-fluid level that is abnormal)

A

Bronchopleural Fistula

34
Q

Anticipatory Meds given and for what indication?

A

SC MORPHINE
- for pain and breathlessness

SC HALOPERIDOL
- for n/v

SC MIDAZOLAM
- for anxiety, delirium and agitation

SC HNBB
- for death rattle

35
Q

Non-blanching rash in a pediatric age group + isolated thrombocytopenia

A

ITP

36
Q

Immediate treatment for management of acute exacerbation of asthma in adults

A

O2 sat goal of 94-98%
Salbutamo 5mg nebulized with O2
Hydrocortisone 100mg IV or Prednisolone 40-50mg PO

37
Q

Childhood asthma: child is on a very low dose ICS and using SABA ≥ 3x/week

A

Add a LABA

***For a child < 5 y/o, add LTRA instead

38
Q

Childhood asthma: child is on a very low dose ICS + LABA and using SABA ≥ 3x/week

A

Increase ICS dose

39
Q

Screening test for tuberculosis in a patient with BCG vaccine

A

IFN-gamma testing (Do not do Mantoux testing as Mantoux testing may be positive in a patient who had a BCG vaccine)

PLABABLE 2.0 (33 decks)

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