Pnemonia

Question 0

S. Pneumonia chest x-ray finding lab finding

Answer 0

Lobar infiltrate splitting lobar pneumo
Dullness to percussion
Elevated WBC
Gram + encapsulated lancet diplodocci

Question 1

Most common CAP

Answer 1

Pneumococcal pneumonia

Question 2

S pneumo tx

Answer 2

1st PCN

2nd azithro

Question 3

Hemophilus influenza

Answer 3

Hib
Gram - bacillus 
COPD HIV
Cxr-patchy alveolar infiltrates 
Tx- ceftriaxone
Azithro 2nd

Question 4

Nesseria gonorrhea pneumo

Answer 4

Gram - diplococcus

Question 5

Staph aureus pneumo

Answer 5

After surgery or after viral infection

Associated with empyema formation

Question 6

Mycoplasma pneumo

Answer 6

<40 age fall 
Bullous myringitis 
Confused with uri 
CXR- Patchy infiltrates 
Tx- azithro 
Doxy 2nd

Question 7

Increase tactile fremitus

Answer 7

Inside lung
Pneumo
Atelectasis
Lung tumor
PE

Question 8

Decrease tactile fremitus

Answer 8

Outside lung 
Pneumothorax
Pleural effusion 
Asthma 
COPD

Question 9

Asthma

Answer 9

Mild - 2x/wk tx- low dose inhaled corticosteroids - cromolyn
Moderate - daily sx daily use of beta 2 agonist tx-low to medium dose inhaled corticosteroids and long acting beta2 agonist
Severe -continual sx limited physical activity -tx- high dose corticosteroids long acting beta2 agonist oral steroids

Question 10

CEA elevated

Answer 10

Adenocarcinoma not on mesothelioma

Question 11

Small cell carcinoma

Answer 11

No surgery
Central originate large airways
Fast spreading
Paraneoplastic syndromes -SIADH and ACTH

Question 12

Most common paraneoplastic finding in lung CA?

Answer 12

Hypercalcemia

Question 13

Most common cause of lower respiratory tract infection in children?

Answer 13

RSV

Which major role in pathogenesis of asthma bronchiolitis age 2-6 months

Question 14

Confirm RSV

Answer 14

Nasopharyngeal secretions RSV antigen test

Question 15

Bronchiolitis

Answer 15

Sx wheezing cough low grade fever nasal flaring and retractions
Sx resolve 5-7 days
Tx early palivizumab antiviral and steroid

Question 16

Influenza A and B tx

Answer 16

Oseltamivir (tamiflu)

Question 17

Epiglottis

Answer 17

2-6 yrs
Hemophilus influenza
Lateral neck x-ray thumb sign
Tx- iv steroids emergency tracheostomy - bag mask resp arrest

Question 18

Croup

Answer 18

Parainfluenza most common
RSV or influenza AB
Age 6mth-3yrs
Tx- humidified O2 and slbuterol and steroids

Question 19

Pertussis

Answer 19

Bordella pertussis

Tx- erythromycin

Question 20

Diphtheria

Answer 20

Grayish membrane posterior pharynx scraped off bleeds

Tx-erythromycin

Question 21

Carcinoid syndrome

Answer 21

Carcinoid tumor in small intestine, colon, bronchial tubes, appendix 
Secrete excessive - hormone serotonin 
Sx- bright red facial flushing 
Diarrhea 
Wheezing

Question 22

Carcinoid syndrome dx

Answer 22

5-HIAA serotonin levels urine elevated
Heart valve lesions
Niacin deficiency -pellagra
Tumor prevents the body from making niacin

Question 23

Bronchiectasis

Answer 23

Recurrent inflammation or infection of the airways

CF or inhalation foreign object

Question 24

Sarcoidosis a multi system dz

Answer 24

Sx- fever fatigue wt loss malaise erythema nodosum Hilary adenopathy Dx- tissue bx noncaseating granulomas Elevated ACE ESR Tx oral prednisone and ACE inhibitors

Question 25

Pneumoconiosis

Answer 25

Coal dust or metal fragments >50 CXR -restrictive pattern Tx- albuterol atrovent combivent steroids

Question 26

Hyaline membrane dz also known as | Infant respiratory distress syndrome IRDS

Answer 26

Lack of pulmonary surfactant Premature infant Low 02 respiratory acidosis Chest X-ray ground glass