PANCE Pulmonary 8/13/20 Flashcards

1
Q

what are the three components of samters triad 3

A
  • asthma
  • nasal polyp
  • asa allergy
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2
Q

what are the three components of asthma 3

A
  • airway hyper reacticity
  • bronchosonstriction
  • inflammation
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3
Q

what is the classic traid of asthma 3

A
  • dyspnea
  • wheezing
  • cough
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4
Q

what does the physical examination of the lung display 3 asthma

A
  • prolonged expiration
  • wheezing
  • hyperresonance
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5
Q

what is the gold standard for the Dx of asthma

A

PFT

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6
Q

what is the best way to determine the severity of an asthma exacerbation

A

peak expiatory flow rate

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7
Q

what are the three asthma admission criteria 3

A
  • PEFR > 50%
  • ER visit within the last 3 days
  • post treatment failure
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8
Q

what is the frequency of nighttime awakenings on the chart Per ?

A

per month

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9
Q

what is the FEV-1 for severe asthma

A

< 60%

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10
Q

what is the FEV-1 for moderate asthma

A

60-80%

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11
Q

what is the #1 RF for COPD

A

smoking

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12
Q

if someone < 40 years old has COPD what might you think about

A

alpha one antitripsan

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13
Q

pick puffer is associated with what pathology

A

emphasema

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14
Q

what is the most importnat factor is the prognosis of COPD

A
  • FEV1
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15
Q

what cardiac electrical abnormality is associated with COPD

A

Multi focal atrial tachycardia

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16
Q

what cardiac (non electrical) pathology is COPD associated with

A

R sided HF

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17
Q

what is the most importent step in managing COPD

A

smoking cessation

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18
Q

what are the best 2 meds to manage COPD

A
  • ipratriprium (atrovent)

- albuterol (proventil)

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19
Q

what two COPD groups get O 2

A
  1. O2 < 88%

2. cor pulmonalale

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20
Q

what pathology:

“ irreversible bronchial dialtaion 2nd dary to trans mural inflammation”

A

bronchietacsis

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21
Q

what are the MC causes of infections with CF

A

psudomonas

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22
Q

daily thick cough in a younger person what are you thinking

A

CF

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23
Q

what is the MC cause of massive hemoptyosis

A

bronchietacasis

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24
Q

what is the best study for dx of bronchietacasis

A

high resolution CT

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25
Q

what is the tx for mac (1+1)

A

clarithromycin + ethambutol

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26
Q

what is your got to abx for psudomonas

A

cipro

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27
Q

what are the three areas effected by CF

A

GI
pulmonary
infertility

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28
Q

non caseating granuloma formation in the lungs

A

sarcoidosis

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29
Q

what is an odd pathology that may happen with sarcoidosis

A

blindless

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30
Q

what skin condition can happen with sarcoidisis

A

erythema nodosum

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31
Q

what is pathopneumonic for sarcoid

A

Lupus perino

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32
Q

what type of disease is sarcoidosis (obstructive or restrictive)

A

restrictive

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33
Q

what lab value will be elevated with sarcoid

A

ace

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34
Q

“exaggerated T cell response with granuloma formation”

A

sarcoid

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35
Q

what are the 3 tx options for sarcoid

A

observation
oral steroids
hydroxychloraqiun

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36
Q

what 4 pathologies are associated with erythema nodosum and 1 medication class

A
  • TB
  • Cocci
  • Sarcoidosis
  • IBS
  • OCP
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37
Q

how do you tx IPF

A

lung transplant

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38
Q

what environmental lung disease is associated with

mining and quary work

A

slicosis

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39
Q

what environmental lung disease is associated with

egg shell calfifications in the upper portion of the lungs

A

silicosis

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40
Q

what environmental lung disease is associated with

  • electronics
  • arospace
  • light bulbs
A

berylliosis

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41
Q

what environmental lung disease is associated with

- cotton exposures

A

byssinosis

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42
Q

what area of the lung does asbestosis affect

A

lower lobe

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43
Q

what area of the lung does the lung plura affect

A

lung lining

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44
Q

what enviormental lung disease is known as the “monday fever”

A

byssinosis

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45
Q

hypersensitivity pneumonitis from nitrogen dioxide gas exposure from plant matter

A

silo filler disease

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46
Q

what is unique about tietze syndrome

A

tietze syndrome has swelling

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47
Q

what pleural effusion type is infectious

A

excutative

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48
Q

what is the MC cause of transudadtive plural effusion

A

CHF

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49
Q

what are the three components of lights criteria 3

A

> LDH >.6
LDH 2/3
protein .5

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50
Q

how to treat plural effusion 2

A
  • thoracocentesis

- chest tube

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51
Q

what is the best position for a CXR

A

lateral decubitius

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52
Q

for a tension pneumonia what direction are the vesicles pulled

A

to the opposite side

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53
Q

what are the three treatments for a penumothroax

A
  • observation
  • chest tube
  • needle aspiration (2ns ICS MCL)
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54
Q

how do you dx a pulmonary nodule

A

transthoracic needle aspiration

bronchoscopy

55
Q
what type of tumors may secrete
 serotonin 
ACTH 
ADH 
melanocyte
A

bronchial carcinoid tumor

56
Q

“pink purple well vascularized central tumor”

A

bronchial carcinoid tumor

57
Q

bronchial carcinoid tumor tx 2

A

octreotide

resection

58
Q

what are the two types of bronchiogenic carcinoma

A
  • non small cell

- small cell (oat)

59
Q

what are the 3 types of non small cell bronchiogenic carcinoma

A
  • adenocarcinoma (peripherial)
  • squamous (central)
  • large cell (anaplastic)
60
Q

what are the tx for the two types of bronchogenic carcinoma

A
  • non small cell
    surgical resection
  • small cell (oat)
    chemo, radiation
61
Q

what is the triad for a PE

A
  • dyspnea
  • plutitic chest pain
  • hemoptyosis
62
Q

what are the 2 bests tests for PE

A
  • helical CT

- pulmonary angiography

63
Q

“a normal CXR in the setting of hypoxia is highly suspicious of ?”

A

PE

64
Q

management of stable PE

A
  • anticoag

- IVC filter

65
Q

managemnet of unstable PE

A
  • thrombolytic tx

- embolectomy tx

66
Q

what are the 2 classic (not common) CXR findings for a PE

A
  • watermark sign

- hamptoms hump

67
Q

what are the 4 types of pulmonary HTN

A
  1. idiopathic
  2. due to left heart disease
  3. due to COPD
  4. due to PE
68
Q

what do you see on a CBC for pulm HTN 1

A

polycytemia with increased hematocrit

69
Q

what do you see on an EKG for pulm HTN 1

A

right axis deviation

70
Q

how do you dx pulm htn definitive 1

A

right heart cath

71
Q

how do you tx pulm HTN 1

A

CCB

72
Q

how do you dx mycoplasm pna on a gram stain

A

lacks cell wall

73
Q

what is the MC cause of cap

A

strep penumo

74
Q

what is the MC cause of viral pna in kids

A
  • RSV

- parainfluenza

75
Q

what pna is associated with HIV

A

PJP

76
Q

MC cause of viral PNA in adults

A

influenza

77
Q

what is gram (-) rods cause of of pna

A

psudomonas

78
Q

what lobe for aspiration pna

A

right lower

79
Q

what is the only pathology that has increased tacitile fermitis

A

PNA

80
Q

what lobe for klebsiella

A

right upper

81
Q

CAP tx 2

A

azithro OR doxcy

82
Q

HAP tx 2

A

Zosyzn + Levofloxacin

83
Q

when does someone get PPSV 23

A

> 65 years old

84
Q

do you need PCV 13

A

no

85
Q

“caseating granuloma”

A

TB

86
Q

are people with latent TB contagious

A

no

87
Q

how long after a TB infection is someones PPD +

A

2-4 weeks

88
Q

are people with reactivated TB contagious

A

yes

89
Q

what is the gold standard to dx TB

A

acid fast bacillious

90
Q

how do you TX TB

A

Rifampin
Isoniazid
Pyrazinimide
Ethambutol

91
Q

what is the SE of rifampin 2

A

thrombocytopenia

orange sweat

92
Q

what is the SE of isoniazid 2

A

hepatitis
peripheral nephropathy
(Give B6)

93
Q

what is a SE of ethambutol

A

optic neuritis

94
Q

“diffuse millet seeds”

A

milliary TB

95
Q

what lobes for primary TB

A

lower

96
Q

acute inflammation of trachea and bronchi

A

acute bronchitis

97
Q

what is the MC cause of acute bronchitis

A

adenovirus

98
Q

acute bronchitis tx

A

supportive

99
Q

how do you tx pertussis

A

macrolides (erythromyocyin)

100
Q

what phase of pertussis has a cough

A

paroxysmal

101
Q

” post coughing emesis”

A

wooping cough (pertissis)

102
Q

what is the CBC for pertussis

A
  • lymphocytosis
103
Q

how do you dx pertussis

A
  • PCR via nasal pharangeal swab
104
Q

what is the main pathogen for bronchiolitis

A

RSV

105
Q

what causes acute epiglottis

A

HIB

106
Q

“thumb sign”

A

acute epiglottis

107
Q

what are the 3 D’s

A

drooling
dysphagia
distress

108
Q

what are the two tx’s for epiglottitis

A

support the airway

ceftriaxone

109
Q

what pathology do you not want to use a tongue depressor with

A

epiglottitis

110
Q

“barking cough” Seal like

A

croup

111
Q

laryngotracheitis

A

croup

112
Q

what two pediatric respiratory pathologies is stridor associated with

A
  • croup

- epiglottitis

113
Q
  • croup tx
A

dexamethasone

114
Q

what influenza is more severe

A

A

115
Q

abrupt onset of myalgia what are you thinking

A

influenza

116
Q

what is the medication oseltamir used for

A

flu

117
Q

who should not get the intranasal flu vaccination 2

A

> 50

prego

118
Q

how do you dx forign body aspiration

A

bronchoscopy

119
Q

what is the MC cause of ARDS

A

sepsis

120
Q

hypoexia with 100% o2

A

ARDS

121
Q

on a chest X ray with ARDS what will you see

A
  • white out pattern that will spare the costophenic angles
122
Q

how do you tx ARDS

A

PEEP

123
Q

what is a polysomnography

A

sleep study

124
Q

How to you tx OSA

A

CPAP

125
Q

mild asthma tx 2

A

SABA + Low ICS

126
Q

mod asthma tx 3

A

SABA + Low ICS + LABA

127
Q

severe asthma tx 3

A

SABA + High ICS + LABA

128
Q

what is the gold standard for COPD dx

A

PFT

129
Q

cornerstone of tx for bronchiectasis

A

bacrium

130
Q

aspiration pneumo tx

A

clinda

131
Q

CAP ICU tx

A

ceftriaxone + levo

132
Q

L heart boarder what lobe

A

L lingular

133
Q

steeple sign

A

croup