Uworld Respiratory Flashcards

0
Q

Next steps depending on the risk of a solitary pulmonary nodule?

A

Low risk: serial CT scans

Intermediate risk:
1. If 1 cm – PET scan

High risk: surgical excision

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1
Q

Assessment of malignancy risk for solitary pulmonary nodule? (Diameter, age, smoking, smoking cessation, nodule characteristics)

A

Low risk: less than 1.5 cm, less than 45 years, never, quit in seven years ago, smooth

Intermediate risk: 1.5 to 2.2 cm, 45 to 60 years, less than 20 per day, quit less than seven years ago, scalloped

High risk: > 2.3 cm, >60 years, >20 per day, never, Corona Radiate/spiculated

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2
Q

Peak airway pressure?

A

Resistive pressure (flow x resistance) + Plateau pressure

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3
Q

Plateau pressure?

A

Elastic pressure + PEEP

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4
Q

Elastic pressure?

A

Tidal volume / compliance

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5
Q

Causes of Increased peak pressure with normal plateau pressure?

A

Bronchospasm, mucous plug, biting ET tube

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6
Q

Causes of increased peak pressure and increased plateau pressure

A

Pneumothorax, pulmonary edema, pneumonia, atelectasis

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7
Q

Shunt versus dead space?

A

Perfusion without ventilation (atelectasus) versus Ventilation without perfusion (PE)

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8
Q

In ventilation, goal FiO2 level?

A

50 to 60%

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9
Q

Bacterial causes of empyema?

A

Strep pneumonia, staph aureus, Klebsiella

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10
Q

Patient with PE. Best way to anticoagulate?

A

Start heparin and warfarin. Stop heparin in 5 to 6 days.

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11
Q

Recurrent bacterial infections in an adult patient indicates? Work up?

A

Humoral immunity defect. Quantitative measurement of serum immunoglobulin levels

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12
Q

Wedge shaped pleural-based opacification on x-ray signifies?

A

PE

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13
Q

Diarrhea increases chance of what pulmonary pathology?

A

PE via dehydration

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14
Q

Patient with dry cough, weight loss, pain in the right arm?

A

Pancoast tumor

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15
Q

90% of PEs come from which veins?

A

Deep veins (iliac, femoral, popliteal)

16
Q

Can present with erythema multiforme and interstitial infiltrates?

A

Mycoplasma pneumonia

17
Q

Patient with parapneumonic effusion. Aspiration result that would necessitate chest tube for drainage?

A

Empyema. pH <7.2

18
Q

Common causes of hemoptysis?

A
  1. Pulmonary (bronchitis, PE, bronchiectasis, PNA, lung cancer)
  2. Cardiac (mitral stenosis)
  3. Infectious (tuberculosis, aspergillosis, lung abscess)
  4. Hematologic (coagulopathy)
19
Q

Pickwickian syndrome? Leads to?

A

Obesity hypoventilation syndrome – obesity impedes expansion of chest and abdominal wall doing breathing. Leads to chronically elevated PaCO2.

20
Q

pH ranges of pleural effusions?

A

7.64 – normal pleural fluid pH

<7.2 indicates empyema

21
Q

Glucose level <60 in pleural effusion suggests what causes?

A

Parapneumonic effusion, tuberculosis, rheumatoid arthritis

22
Q

Indicators of a severe asthma attack?

A
  1. Normal/increased PCO2
  2. Speech difficulty
  3. Diaphoresis
  4. Cyanosis
23
Q

Theophylline mechanism of action? Toxicities?

A

1 Bronchodilation via phosphodiesterase inhibition
2. Increased diaphragm contraction via increased calcium uptake through adenosine channels

Toxicity:

  1. CNS stimulation (headache, insomnia, seizures)
  2. Cardiac toxicity (arrhythmia)
  3. G.I. disturbances (n/v)
24
Q

Antimuscarinics used in COPD?

A

Ipratropium and Tiotropium

25
Q

Complications of ventilation with a high PEEP?

A

Alveolar damage, tension pneumothorax, hypotension

26
Q

Lofgren’s syndrome?

A

Erythema nodosum, hilar lymphadenopathy, migratory polyarthralgias, fever

27
Q

Most common adverse associated with inhaled steroids?

A

Oral thrush

28
Q

When to use non-invasive positive pressure ventilation?

A

When pt is refractory to medical therapy but not crashing (before intubation)

Specifically, when pH25

29
Q

SVC syndrome?

A

Dyspnea
Venous congestion
Swelling of head, neck and arms

30
Q

ARDs vs Cardiogenic pulmonary edema?

A

Wedge pressure < 18 in ARDs

31
Q

Causes of exudative effusions?

A
  1. Infection
  2. malignancy
  3. pulmonary embolism
  4. connective tissue disease
  5. iatrogenic
32
Q

COPD, when does oxygen have a mortality benefit?

A

PaO2 55

Cor pulmonale

34
Q

Complications of PEEP?

A

Alveolar damage, tension pneumothorax, hypotension

35
Q

dyspnea from long standing HTN leads to? Tx?

A

Left sided heart failure. Nitroglycerin