Medicine shelf quizlet

Question 1

Bilateral Hilar Adenopathy

Answer 1

think Sarcoidosis!! (non caseasting granulomas, interstitial lung disease, hypercalcemia and erythema nodosum)

Question 2

Asbestosis: 1) location in lung 2) type of cancer risk 3) gross physical findings 4) histo findings 5) at risk population

Answer 2

• LOWER lobes
• mesothelioma & bronchogenic carcinoma
• pleural calcifications (plaques)
• asbestosis fiber=dumb bell
• shipyard workers, insulation, brake lining

Question 3

Patient is a sand blaster/miner/glass or pottery worker…at risk for what lung disease?

Answer 3

SILICOSIS-Fibrosis of UPPER lobes of lungs

Question 4

What are patients with Silicosis at risk for?

Answer 4

Pulmonary TB (b/c of egg shell calcifications of upper lung fields provide “nest” for TB)

Question 5

COAL Miner’s Disease

Answer 5

• IgA and IgG increased with decreased C3
• positive ANA
• small round nodular densities
• “CAPLAN SYNDROME”if with RA of lung

Question 6

PULMONARY HYPERTENSION IS DEFINED AS:

Answer 6

PULMONARY ARTERY PRESSURE >25MMHG OR >35MMHG DURING EXCERCISE (nml: 10-14mmHg)

Question 7

What are results of Pulmonary Hypertension?

Answer 7

Atherosclerosis, intimal fibrosis of pulmonary arteries

Question 8

Treatment for Pulmonary Hypertension?

Answer 8

1st: IV prostacyclins or other VASODILATORS (adenosine, NO)
2nd: Calcium Channel Blocker
3rd: for Thromboprophylaxis: Warfarin

Question 9

2ndary causes of Pulmonary Hypertension

Answer 9

1) COPD
2) Mitral Stenosis
3) Systemic Sclerosis (Scleroderma)
4) L–>R shunt (ASD/VSD)
5) Sleep Apnea or High altitude
6) Recurrent Thromboembolism

Question 10

First step in Diagnosing Pulmonary Hypertension

Answer 10

Echo and Swan Ganz Catheter (shows RVH and high PAP)

Question 11

Besides ECHO and Swan Ganz Cath- Other diagnostic findings in Pulmonary Hypertension

Answer 11

EKG-Rt axis deviation, evidence of RVH and RA enalrgement

Labs-polycythemia

Question 12

Common respiratory conditions in HIV patients

Answer 12

1) CD4<50 Mycobacterium Avium-intracellulare
3) CMV - intranuclear inclusion bodies
4) Aspergillosis fumigatus-pleuritic pain, hemoptysis, infiltrates on imaging

Question 13

only 2 rx that are proven to reduce MORBIDITY and MORTALITY in COPD patients:

Answer 13

1) O2 therapy (if o2 sat<60 w/ cor pulmonale)

2) Smoking Cessation