MKSAP

Question 1

Define heat stroke and what are the two types with risk factors

Answer 1

Temp >104 and encephalopathy

1. Exertional: athletes with hot and humid weather
2. Non exertional: old patients wuth anticholinergic or diuretics use

Question 2

TG level of pleural fluid in chylothorax

Answer 2

110

Question 3

Hallmark PE finding of DPLD

Answer 3

Normal pulse ox with rest and >4% drop in O2 sat with ambulation

Question 4

Two antifovrotic agents for IPF

Answer 4

Nintedanib and perfinidone

Question 5

What is HAPE

Answer 5

High altitude pulmonary edema —> develops due to rapid ascent above 2500 ft —> causes intense vasoconstriction and leads to pulmonary HTN and fluid leak into alveoli —> pneumonia

Question 6

Treatment of HAPE

Answer 6

Low altitude descent, O2 supplementation

Question 7

Medication used for HAPE prophylaxis

Answer 7

Acetazolamide

Question 8

What is the size cutoff to call it a pulmonary nodule upper limit

Answer 8

3 cm

Question 9

Size above which a pulmonary nodule is called a lung mass

Answer 9

3 can

Question 10

What is the first question to ask in evaluation of pulmonary nodules

Answer 10

Solid or sub solid?

Question 11

Solid pulmonary nodule <6mm follow up

Answer 11

None

Question 12

Solid pulm nodule 6-8 mm

Answer 12

CT at 6-12 months —> CT 1.5-2 years

Question 13

Solid pulm nodule >8 mm. Next step?

Answer 13

Evaluate risk of malignancy and obtain CT in 3 months, PET/tissue sampling

Question 14

Subsolid nodules are —- likely to be malignant

Answer 14

More

Question 15

I hat are the two types of subsolid nodules

Answer 15

GGO only and GGO with solid component

Question 16

A subsolid nodule with GGO developed solid component. Next step?

Answer 16

It is malignant

Question 17

Pure GGO nodule <6 mm. Follow up?

Answer 17

None

Question 18

Pure GGO >6mm

Answer 18

CT at 6-12 months —-> every 2 years for 5 years

Question 19

Part solid module <6mm

Answer 19

No follow up

Question 20

Part solid nodule >6 mm

Answer 20

CT 3-6 months —-> I’d stable —-> annual CT

Question 21

How do you differentiate between a complicated and uncomplicated para pneumonic effusion?

Answer 21

Ph <7.20 or evidence of microorganism on culture —> complicated

Question 22

Patient with anaphylaxis develops recurrent episode. Rx?

Answer 22

Epinephrine drip maybe required

Question 23

Side effect of monteluekast FDA black box warning

Answer 23

Depression and suicide

Question 24

What is Reynolds’s Pentad

Answer 24

Fever jaundice RUQ pain hypotension AMS

Question 25

What is the temp cut off for hyperthermic emergencies

Answer 25

>104

Question 26

What are the typical symptoms of hyperthermic emergencies

Answer 26

AMS, seizures Muscle rigidity and rhabdomyolysis ARDS Kidney dysfunction DIC

Question 27

Which symptom differentiates serotonin syndrome

Answer 27

Myoclonus and hyper reflexia

Question 28

Rx of NMS

Answer 28

Benzo, bromocriptine.

Question 29

Rx of serotonin syndrome

Answer 29

Benzodiazepine —> fails cypriheptadine

Question 30

I hen should we start parenetrral nutrition in ICU patients

Answer 30

Failed enteral nutrition - inability to achieve 60% of requirements in 7-10 days

Question 31

I’m Medical conditions assoicted with central sleep apnea

Answer 31

Heart failure and pain

Question 32

Indications of antibiotics in COPD exacerbation. Name 5

Answer 32

1. Increase sputum volume 2. Increased purulent 3. Increased DOE 4. Non invasive vent 5. Invasive vent

Question 33

Mesothelioma is linked to — exposure

Answer 33

Asbestos

Question 34

Pleural effusion from mesothelioma is —- in cytology and —— is neede d for diagnosis

Answer 34

Negative; transthoracic vidoscopic pleural biopsy

Question 35

3 DDx for exudative effusions

Answer 35

1. Infection 2. Malignancy 3. CTD

Question 36

Respirator indices s/o NM associated respiratory failure

Answer 36

Decrease in FVC of >20% in while supine compared to upright position and >50% decline in MIP/MEP

Question 37

Normal NIF

Answer 37

-100 to -150

Question 38

A patient with true aspiration pneumonitis rapidly improves within — hours and antibiotics can be —-

Answer 38

24; discontinued

Question 39

Empiric Rx of bronchiectasis exacerbation antibiotic

Answer 39

Ciprofloxacin x 14 days