Diagnostics / Assessment

Question 1

Atelectasis

Answer 1

CXR
SpO2 <90%
Hypoxemia
Diminished and crackles

Question 2

Influenza

Answer 2

RT-PCR viral cultures
Rapid 15 minute test

Question 3

PNA

Answer 3

CXR
CBC (high WBC)
Sputum culture
Bronchoscopy

Further dx:
Blood cultures
Thoracentesis
CRP
Procalcitonin

Question 4

CURB-65

Answer 4

(To hospitalize PNA)
Confusion
BUN over 19
Respiration over 30
BP systolic under 90 or diastolic under 60
Age over 65

Question 5

TB

Answer 5

TST/Mantoux
IGRA
T-SPOT
CXR
Sputum bacteriologic 3 days

Question 6

Opiate withdrawal assessment

Answer 6

Resting pulse rate
Sweating
Restlessness
Pupil size
Aches
Runny nose
GI
Tremors
Yawning
Anxiety and irritability
Goosebumps

Question 7

COPD

Answer 7

H and P
ABG
CXR
CT
A1 antitrypsin screening
Spirometry PFTs

Question 8

Cor pulmonale

Answer 8

CXR
R sided cardiac catheterization*
Echo
BNP

Question 9

Who needs lung cancer screenings?

Answer 9

Annually adults 55-80 with smoking hx
30 pack year hx
Currently smoke
Quit < 15 years ago

Question 10

NSCLC examples

Answer 10

Squamous cell carcinoma (slow)
Adenocarcinoma (moderate)
Large cell carcinoma (rapid)

Question 11

Lung cancer

Answer 11

CXR
CT
Fiberoptic bronchoscopy
PET scan
Lung biopsy

Question 12

TNM staging

Answer 12

For NSCLC
Tumor size, location, invasion
Node invasion
Metastasis

Question 13

Obesity

Answer 13

Hip to waist ratio
Labs: cholesterol, triglycerides, fasting BG, HA1C, liver

Question 14

LFTs

Answer 14

AST, ALT
GGT, GGTP, LDH
Protein
Bilirubin
Clotting factors
Alkaline phosphatase
Ammonia
Lipids

Question 15

Liver assessment

Answer 15

Health hx
Toxins
Alcohol
Drugs
Lifestyle
Skin
Neuro
Palpate and percussion

Question 16

Ascites assessment

Answer 16

Girth and weight daily
Striae, distended veins, hernia
Percuss for dullness and wave
Fluid and lyte imbalance

Question 17

Hepatic encephalopathy

Answer 17

EEG
LOC
Fluid, lyte, ammonia levels

Question 18

Eye assessment

Answer 18

Hx
Acuity with Snellen and Rosenbaum
Finger count
Look at external structures for irritation
Assess pupils
Ocular movements
Look for ptosis and nystagmus

With low vision: glare, color, refraction, coping, functional ability

Question 19

Glaucoma

Answer 19

Tonometry for IOP
Ophthalmoscopy to inspect optic nerve disc
Central visual field testing

Question 20

Cataracts

Answer 20

Ophthalmoscope
Slit lamp
Inspection

Question 21

Retina detachment

Answer 21

Acuity
Ophthalmoscope
Slit lamp
Stereo fundus photography
Angiography
Tomography
US

Question 22

Esophageal varices

Answer 22

Endoscopy (NPO til gag returns)

Question 23

Confirms acsites

Answer 23

Ultrasound