TB, PE, Sleep Apnea DSA

Question 1

necrotizing granulomatous disease with ziehl-neelsen staining

Answer 1

mycobacterium tuberculosis

TB

Question 2

primary TB

Answer 2

Dx - tuberculin skin test
-fever, SOB, non-prod cough, erythema nodosum

CXR opacities in midlung with hilar lymphadenopathy

Question 3

ghon complex

Answer 3

primary TB

-small calcified scar in midlung fields and associated hilar node

Question 4

ranke complex

Answer 4

late fibrocalcific lesions of lung and hilar node

Question 5

progressive primary TB

Answer 5

failure to develop immunity

-children, elderly, immunocompromised

Question 6

reactivation TB

Answer 6

pulmonary, pleural, miliary, meningitis, pericarditis, lymphadenitis, peritonitis, GI, renal, vertebral osteomyelitis

Question 7

miliary TB

Answer 7

small dots everywhere

Question 8

latent TB diagnosis

Answer 8

PPD induration based on patient risk

interferon gamma release assay IRGA

Question 9

active TB diagnosis

Answer 9

acid fast sputum smear and culture

Question 10

latent TB infection Tx

Answer 10

INH for 6-9 months

Question 11

active TB infection Tx

Answer 11

INH, rifampin, ethambutol, pyrazinamide for 2 months

followed by INH/rifampin for 18 weeks

Question 12

pulmonary embolism

Answer 12

obstruction of pulmonary a by material traveled to lung

DVT, fat, amniotic fluid

Question 13

venous thromboembolism

Answer 13

3rd most common cause of CV death after MI and stroke

Question 14

risk fx for venous thromboembolism

Answer 14

age, obesity, cancer, surgery, immobile

virchows triad

Question 15

hypercoag

Answer 15

factor V mutation
protein C
protein S
antithrombin III

Question 16

dyspnea, tachypnea, hypoxemia, pleuritic chest pain, cough, anxiety, syncope, split second heart sound, leg swelling

Answer 16

PE

Question 17

D-dimer

Answer 17

PE test

Question 18

CT pulmonary angiography

Answer 18

for PE

Question 19

V/Q scan

Answer 19

inhale xenon or technetium

IV technetium albumin

results - high, intermediate, or low probability

for pt allergic to contrast or during pregnancy

Question 20

ultrasound of lower extremities

Answer 20

for DVT

Question 21

PE EKG

Answer 21

S1Q3T3 pattern, RBB, limited sensitivity

more commonly - sinus tachycardia

Question 22

Tx for PE

Answer 22

anticoag - heparin, low MW heparin, warfarmin, rivaroxaban

if severe - thrombolytics

Question 23

cyclic obstruction of upper airways during sleep with disturbed sleep
-daytime sleepy and loud snoring

Answer 23

sleep apnea

Question 24

obstructive apnea

Answer 24

absent airflow for at least 10 seconds with continued vent effort

Question 25

hypopnea

Answer 25

partial obstruction

Question 26

dx of sleep apnea

Answer 26

polysomnohraphy

-EEG, EKG, resp effort, O2 levels, electro-oculography

Question 27

tx for sleep apnea

Answer 27

CPAP
O2
weight loss
tracheostomy

Question 28

prognosis of sleep apnea

Answer 28

increased risk of long term mortality in middle aged men

high risk - with HTN association