Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IM AOA Inservice > Pulm/CC > Flashcards

Pulm/CC Flashcards

1
Q

Name the 2 reasons for hypoxia with a normal A-a gradient.

A

Decreased FiO2

Hypoventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Name the 3 reasons for hypoxia with abnormal or increased A-a gradient.

A

V/Q mismatch
Shunt
Decreased diffusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Patient presents with hypoxia and a normal A-a gradient when taking opiates/benzos?

A

Central respiratory depression (neuro disorder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What drug causes foamy changes in lamellar inclusions on a BAL?

A

Amiodarone induced disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How to interpret PFTs?

A 
Obstructive: FEV1/FVC < 0.7
Mild FEV1> 80% = GOLD I
Moderate FEV1 50-79% = GOLD II
Severe FEV1 30-49% = GOLD III
Very severe FEV1 < 30% = GOLD iV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the only medication known to improve survival in COPD?
How does pulm rehab contribute?

A

Oxygen

Pulm rehab decreases healthcare costs and quality of life but does not impact survival

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name the hierarchy of asthma control inhalers?

A

Albuterol ICS LABA

And you can step down therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What BP med is best for asthma patients?

A

CCB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do you diagnose asthma on PFTs?

A

Methacholine challenge test. 12% reversability and a 200cc increase with bronchodilators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Test question - you have a pregnant patient admitted for asthma, now improved, what do you do on discharge?

A

Send home on ICS as 30% will get worse with pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do you diagnose exercise induced asthma and what is the treatment?

A

Exercise challenge test

albuterol 15-30 minutes before exertion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What the diagnosis? Young smokers with bulloous COPD, famhx liver/lung disease

A

Alpha 1 anti-trypsin deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What testing do you perform for alpha 1 AT? What is the treatment?

A

serum level testing; genetic testing of Pi locus

Tx: weekly alpha 1 antiprotease infusions, does not treat liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What’s the diagnosis? Plumber with GI plaquing and pleural thickening on CXR?

A

mesothelioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What’s the diagnosis? Young AA female with skin lesions on anterior legs, cough, dyspnea, uveitis.

A

Sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Young AA female with pleural effusion that on tap is lymphocyte predominant

A

Sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What’s the diangosis? Arthritis, erythema nodosum, b/l hilar lymphadenopathy

A

Lofgren’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What’s the diagnosis? anterior uveitis, parotid gland enlargement, facial palsy, fever

A

Heerfordt syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What’s the diagnosis? Premenopausal women, pneumothorax, chylous effusion (TG> 110), tuberous sclerosis. CXR with diffuse honeycombing

A

Lymphangioleioyomatosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What’s the next best step after diagnosis LAM?

A

always image the kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What’s the diagnosis? Upper respiratory tract dx, sinusitis, glomerulonephritis and ILD.

A

Granulomatosis with polyangiitis (Wegners)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the serology markers for Wegners?

A

c-ANCA & anti-PR3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What’s the diagnosis? Upper respiratory tract dx, sinusitis, glomerulonephritis, ILD but (-) ANCA

A

Glomerular basement membrane disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What’s the diagnosis? URI, asthma, eosinophilia

A

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What’s the serology for Churg-strauss?

A

p-ANCA, anti-MPO assay positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What’s the diagnosis? Female patient with RA, weight loss, low fevers, dry cough for 2 months, failed treatment with multiple rounds of abx

A

Cryptogenic Organizing pneumonia

CXR often with migratory consolidations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Treatment for COP?

A

steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What’s the diagnosis? Allergic rxn to aspergillus, chronic cough, mucus plugging, recurrent pulmonary infiltrates with eosinophilia, elevated IgE > 1000
Usually presents as difficult to control asthma

A

allergic bronchopulmonary aspergillosis (ABPA)

29
Q

What is the order of diagnosis for ABPA?

What is the treatment?

A
  1. Eosinophilia
  2. Aspergillus antigen skin prick test
  3. IgE > 1000
  4. Serum specific A fumigatus antibody testing
  5. Galactomannon test
    Tx: Steroids + itraconazole
30
Q

What are 2 markings you can see on imaging with suspected PE?

A

Westermark sign: lack of vascular markings downstream of embolism
Hampton’s hump: wedge shaped defect from infarction just above the diaphragm

31
Q

Management of a clinically unstable patient suspected of having PE?

A

tPA

32
Q

what are the relative contraindications and absolute contraindications for thrombolytics?

A

Surgery within 10 days is a relative contraindication

Intracranial/intraspinal surgeries are absolute

33
Q

What are the Wells criteria and number ranking?

A 
Clinical signs/symptoms of DVT: +3
PE is #1 diagnosis OR equally likely: +3
HR > 100: +1.5
Immobilization at least 3 days OR surgery in the previous 4 weeks: +1.5
Previous diagnosis PE or DVT: +1.5
Hemoptysis: +1
Malignancy w/ treatment within 6 months or palliative: +1
Low risk <2
Moderate risk: 2-6 pts
high risk: >6 points
34
Q

What’s the diagnosis? RLL infiltrate, consolidation, patient incapacitated

A

aspiration syndromes > 48 hrs before infection leading to chemical pneumonitis, cavitary/empyema

35
Q

Treatment for aspiration syndromes?

A

Always think anaerobes. Amox-clavulanate (Augmentin), amp-sulbactam (Unasyn), clinda

36
Q

What are Light’s criteria?

A

Exudative effusion if:

  • fluid prot/serum prot > 0.5
  • fluid LDH/serum LDH > 0.6
  • fluid LDH > 2/3 upper limits of normal
37
Q

What are causes of exudative vs transudative effusions?

A

exudative: PNA, CA, PE
transudative: HF, cirrhosis, nephrotic syndrome/ESRD

38
Q

Pleural effusion with adenosine deaminase

A

TB

39
Q

Pleural effusion with glu<60, glu<30?

A

<60: infectious, TB, RA, malignancy

<30: empyema, PE

40
Q

pleural effusion in an AAF with increased lymphocytes =

A

sarcoidosis

41
Q

Indications for CT on pleural effusions?

A

pH < 7.2, glucose < 60, positive cx or gram stain; loculated pleural thickening

42
Q

What’s the diagnosis? Immunocompromised patient with septate hyphae at narrow/acute angles?

A

Aspergillosis

Tx: Voriconazole IV

43
Q

PNA: alcoholic, currant, jelly sputum

A

Klebsiella

44
Q

PNA: Gram stain with GN diplococci, COPD-er

A

Moraxella catarrhalis

45
Q

PNA: rust colored sputum, lancet shaped G+ diplococci

A

streptococcus pneumonia

46
Q

PNA: reverse bat wing, infiltrate spares hilum

A

eosinophilic PNA

47
Q

PNA in a young patient and can cause elevated d-dimer

A

mycoplasma pneumoniae

48
Q

PNA with pharyngitis, hoarsness, CAP in patients > 65 y/o

A

Chlamydophila pneumoniae

49
Q

PNA from inhaled contaminated water, diarrhea, confusion

A

legionella

50
Q

Patient presents with green sputum, alcoholic with dental caries

A

Bacteroides, Tx: clinda

51
Q

Which is the most likely in an aspiration PNA isolate?

A

Haemophilus aegyptius

52
Q

URI symptoms unresponsive to cipro

A

Bordatella pertussis

53
Q

Southwest US fungus

A

Coccidioides

54
Q

Southern/Midwestern US fungus

A

Histoplasmosis

55
Q

Mid-Atlantic/Central/SE US fungus; broad based budding yeast

A

Blastomyces dermatitidis

56
Q

PNA in immunosuppressed patients, AIDS

A

PJP

Diagnose with GOmori methenamine silver stain (GMS)

57
Q

In active Tb, give INH with ____ to prevent ____

A

pyridoxine (B6) to prevent neuropathy

58
Q

Patient with resistant HTN, next step?

A

PSG

59
Q

Lung cancer most associated with non-smokers and CEA tumor marker?

A

adenocarcinoma

60
Q

Lung cancer that is cavitary and can cause hypercalcemia

A

squamous cell

61
Q

Lung cancer associated with SIADH, ectopic ACTH production, Eaton Lambert syndrome

A

SCLC

62
Q

What is the screening recommendation for lung cancer?

A

55-80 y/o with >30 pack year hx and currently smoking or has quit smoking in the last 15 years

63
Q

What’s the diagnosis? Asthma, allergic rhinitis, atopic dermatitis, food allergies, elevated IgE

A

Jobs Syndrome

64
Q

Pulm HTN WHO classification

A

WHO 1 = Idiopathic (autoimmune, heritable, drugs/toxins, HIV)
WHO 2 = cardiac related (left heart failure)
WHO 3 = pulmonary related (COPD, ILD)
WHO 4 = CTEPH
WHO 5 = miscellaneous / multifactorial (sarcoidosis, histiocytosis, vasculitis, ESRD on HD)
Treat underlying cause
WHO 2 = heart failure
WHO 3 = treat copd
WHO 4 = anticoagulation
Remember CTEPH is best confirmed with V/Q scan

65
Q

What’s the diagnosis? Aspirin provoked dyspnea, cough, nasal polyps, asthma

A

Samters syndrome
Avoid NSAIDs
Treat with montelukast

66
Q

Infusion that can cause hypotension, erythema, urticaria

A

Dilaudid

67
Q

Next best step in patient with Gram (-) sepsis with refractory hypotension despite negative cx

A

R/o adrenal insufficiency

68
Q

Drug for prevention of altitude sickness?

A

acetazolamide

69
Q

On CXR, with wide mediastinum, think ____

A

anthrax

IM AOA Inservice (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions