PULM Flashcards
1
Q
What is pneumoconiosis?
A
inflammation of the lungs d/t inhaled dust particles
2
Q
Which pneumoconiosis causes diffuse infiltrates and hilar lymphadenopathy?
A
berylliosis
3
Q
Which pneumoconiosis has upper lobe opacities in CXR?
A
Coal workers
4
Q
Which pneumoconiosis has egg shell calcifications on CXR?
A
silicosis
5
Q
How do you differentiate between lofgrens syndrome and sarcoid?
A
lofgren is short term and acute; sacroid is chronic
6
Q
What DVT area can commonly lead to PE?
A
ABOVE knee
7
Q
What disorder should be considered in YA (20-30yo) with severe emphysema?
A
alpha 1 antitrypsin deficiency
8
Q
Diffuse ground glass but no pulmonary nodules on CXR?
A
interstitial lung disease
9
Q
Diffuse ground glass with pulmonary nodule on CXR?
A
lung CA
10
Q
What type of pneumonia should be considered with a patient exposed to bat/bird droppings in Mississippi?
A
histoplasmosis
11
Q
What drug classes can be used to tx klebsiella pneumonia?
A
cephalosporin, aminoglycoside, fluoroquinolone
12
Q
What drug classes can be used to tx legionella pneumonia?
A
fluuroquinolone and macrolides
13
Q
What hx wold be indicative for legionella pnuemonia?
A
traveling with mist environment (cruise ships, AC)
14
Q
What hx would be indicative for klebsiella pneumonia?
A
alcoholics, DM, severe COPD
15
Q
What other bacterial pneumonia could a patient with pseudomonas pneumonia have?
A
s. aureus pneumonia
16
Q
How many and what types of abx should be used for pseudomonas pneumonia?
A
at least 2 abx; anti-pseudomonal beta-lactam + anti-psuedomonal quinolone/aminogylcoside OR anti-quinolone +anti aminoglycoside
17
Q
How should MRSA pneumonia be tx’d?
A
cipro OR levofloxin + vancomycin
18
Q
How should a patient in ICU be treated with s. pneumonia or non MRSA?
A
beta lactum + macrolide OR fluoroquinolone
19
Q
How should a patient in non ICU be treated with s. pneumonia or non MRSA?
A
beta lactum + macrolide
20
Q
How should a patient in outpatient with comorbidites be treated with s. pneumonia or non MRSA?
A
beta lactum + macrolide OR fluroquinolone doxycycline
21
Q
How should a patient in outpatient that is healthy should be treated with s. pneumonia or non MRSA?
A
macrolide OR fluoroquinolone doxycyline
22
Q
What to suspect with young patient who has been exposed to rodent feces who presents with CHF-like sx?
A
hantavirus
23
Q
What factors pre-dispose children from IRDS type 2?
A
c section, DM mothers
24
Q
What type of IRDS can occur in full term babies?
A
type 2
25
What type of IRDS can occur in premature babies?
type 1
26
Incomplete lung development d/t congenital malformation?
pulmonary hypoplasia
27
Long term inflammation that leads to scarring d/t severe resp distress or mechanical ventilation?
broncho-pulmonary dysplasia
28
What abx is strongly associated with hypertrophic pyloric stenosis?
macrolides, esp clarithomyocin
29
Where does the CA associated with absetosis like to grow?
base of the lungs
30
CXR looks like CHF but pulm wedge pressure is normal?
ARDS
31
Patient has SOB and works at radiation plant?
berylliosis
32
What labs are elevated in sarcoidosis?
4x ACE levels; ESR
33
1wk postpartum and now has SOB + tachycardic?
PE
34
Class 5 pulmonary HTN cause?
sarcoidosis
35
Class 4 pulmonary HTN cause?
PE
36
Class 3 pulmonary HTN cause?
COPD
37
Class 2 pulmonary HTN cause?
L heart probs: mitral stenosis, mitral rergug, LVH
38
Class 1 pulmonary HTN cause?
congenital defect: VSD, ASD, PDA
39
R HF d/t long COPD?
cor pulmonale
40
Only med that improves morbidity and mortality in COPD?
O2
41
Bloody pleural effusion is concerning for?
CA
42
Med of choice for COPD exacerbation?
ipratropium
43
What is the most aggressive lung CA?
small cell
44
What is the common CA in non-smokers?
adenocarcinoma
45
"Cinnamon breath" is associated with what infxn?
TB
46
Ethambutal has what ADR?
optic neuritis
47
What is given to patient to prevent neuropathy from isoniazid?
B6
48
Older lesions from old TB will show at which part of the lung?
lower lobes
49
What lab is elevated in PJP pneumonia?
LDH
50
What do you expect in a young patient who does IV drug use, CXR with diffuse infiltrates + hypoxia?
PJP pneumonia
51
What pneumonia do you expect from a patient who has been exposed to AC vents and spas?
Legionella
52
Most common bacterial infection associated with ventilators?
Psuedomonas
53
Bacterial pneumonia that is caused after a flu?
S. aureus
54
What pneumonia is associated with diarrhea and low Na?
legionella
55
First episode of wheezing in children?
bronchiolitis
56
Wet cough and foul smelling sputum in child?
bronchiectasis
57
Flu can be treated with oseltamivir within what window period?
48hrs
58
Tx for berylliosis?
chronic steroids
59
How high does pulmonary pressure need to be to dx pulmonary HTN?
25 at rest
60
What CA is a patient at risk with abstesosis?
mesothelioma
61
Chronic dry cough dyspnea fatigue and clubbing; CXR shows fibrosis and CT shows honeycombing?
idiopathic pulmonary fibrosis
62
CXR shows bilateral adenopathy and non caseating granulomas?
sarcoidosis
63
Gold standard for pulm HTN?
R heart cath
64
CXR with ARDS?
b/l infiltrates; like CHF
65
Patients with asthma, FEV1 to FVC will be?
66
R sided pleural effusion is associated with?
CHF or cirrhosis
67
3 types of non small cell CA?
adenocarcinoma, squamous, large cell
68
What is recommened for first time positive PPD for healthcare workers?
isoniazid for 6months
69
Tx for histomplasmosis?
amphoterin B
70
Tx for fungal pneumonia in immunocompressed patient?
fluconazole or itraconazole
71
CXR shows RUL consolidation, organism most likely?
klebsiella
72
What pneumonia is associated with 'red currant jelly'?
klebsiella
73
What virus can lead to pneumonia after URI and associated with GI and diarrhea?
adenovirus
74
Rusty colored sputum?
strep pneumonia
75
Pink/salmon colored sputum?
staph aurues
76
Atypical pneumonia?
chlamydia, mycoplasma, legionella
77
Most common viral pneumonia?
influenza
78
Percussion over normal lungs sound like..?
resonance
79
How to prevent hyaline membrane dz in children?
antenatal steroids
80
Bug that causes whooping cough?
bordetella pertusiss
81
Steeple sign on CXR?
croup
82
How to tx croup?
azithormycin or clarithomycin
83
Bug that causes croup?
parainfluenzae type 1
84
Child with barking cough?
croup
85
Child has resp. distress, dyphagia, drooling; what to expect on CXR and dz?
CXR: thumbprint sign; dz - epiglottitis
86
Common cause of bronchiolitis?
RSV
87
Which pneumoconiosis has higher rate of getting TB?
silicosis
88
Where does mesothelioma present on CXR?
base of pleura
89
What is the normal blood pressure in the lungs?
15/5
90
ARDS CXR would look like?
CHF
91
Pt in a MVA has a tension pneumothorax, which way does the trachea deviate?
good lung
92
What is the diagnostic test of choice to dx cor pulmonale?
R heart cath
93
Most common cause of ARDS?
sepsis
94
What are the 3 types of COPD?
asthma, emphysema, chronic bronchitis
95
In addition to O2, ipratropium, what else should be given to all COPD exacerbations?
abx
96
Which lung CA is tx with chemotherapy only (no surgery)?
small cell
97
During lung exam, you can hear clearly when patient whispers?
consolidation
98
Which fungal pneumonia is likely to turn into meningitis in immunocompressed patients?
cryptococcal
99
If HIV pt is allergic to sulfa drugs?
pentamidine
100
Which pneumonia is associated with positive cold aggluntins?
mycoplasma aka walking pneumonia
101
Outbreak of the flu with diarrhea and nausea in boot camp is caused by what bug?
adenovirus
102
18yo male presents to office after flu like sx with productive sputum and CXR has large infiltrate, bug that caused this?
s. aureus
103
Common pneumonia after splenectomy?
strep pneumonia
104
Gold standard to dx pertussis?
cx
105
Premature baby is treated with corticosteroids and surfactant to prevent what?
infant respiratory distress syndrome
106
Bug for epiglottitis?
H. influenzae type B
107
14mo has runny nose, fever and wheezing, now with SOB, what is the bug?
RSV
108
A previously healthy 12-year-old boy presents to the emergency department with a three week history of a progressively worsening cough. He does not appear extremely ill. Oral temperature is 99.4 degrees F. Pulse oximetry results are 99% on room air. Physical exam is significant for a injected, bulging left eardrum, injection of the pharyngeal mucosa without exudates, and rales at the left posterior lung base. CXR shows a small area of patchy infiltrate but no evidence of effusion. Which of the following is the most appropriate therapy?
Outpatient treatment with oral doxycycline (Doryx)
109
A 77-year-old man who has been on ventilator assistance for 2 weeks now has an extensive right lower lobe pneumonia. Which of the following is the most likely organism causing the pneumonia?
Pseudomonas aeruginosa
110
A 77-year-old man who worked with asbestos in shipbuilding is at greatest risk of developing which of the following?
Mesothelioma
111
A 51-year-old man has hypercortisolism caused by ectopic ACTH production from a small cell carcinoma of the lung. Which of the following is the most likely abnormal laboratory value to be noted?
Hypokalemia
112
Which of the following statements is true concerning the physiologic difference between a freshwater drowning versus a salt water drowning?
Fresh water in the lungs is rapidly absorbed, diluting the plasma, and causing intravascular hemolysis and cardiac arrhythmia
113
When evaluating arterial blood gas results, which of the following test results is the best indicator that your patient is hyperventilating?
Decreased pCO2
114
Ipratropium therapy is initiated in a 71-year-old woman who has chronic obstructive lung disease. Which of the following is the pharmacologic action of this medication?
Anticholinergic
115
A 60-year-old man has a 2 week history of progressive weakness without nausea or vomiting. Serum sodium concentration is 124 mEq/L. Chest radiography shows a hilar mass with mediastinal adenopathy. Which of the following is the most likely diagnosis?
Small cell carcinoma
116
Which of the following are the organisms most likely to produce epiglottitis in children under the age of three years?
H influenza b and s. Pneumonia
117
A 14-year-old asymptomatic boy has recently immigrated from a country known to have a high incidence of tuberculosis. After evaluation, latent tuberculous infection is diagnosed for which isoniazid therapy is initiated. The patient and parents should be advised that which of the following are the most likely symptoms to represent and adverse effect of the isoniazid?
Anorexia, dark urine, nausea
118
A 45-year-old male presents with a 40 pack year smoking history complaints of a chronic cough productive of mucopurulent sputum. The cough has been present for the past 3 years, but he attributed it to a “smoker’s cough”. He has been coughing up a lot of sputum lasting all winter long for the past 2 years. He denies any hemoptysis, weight loss or chest pain. Physical examination reveals a moderately obese male in no acute respiratory distress. Lung fields reveal presence of scattered rhonchi and wheezes. There is 1+ peripheral edema. Which of the following is the most likely diagnosis?
Chronic bronchitis
119
A 14-year-old girl has asthma that is triggered by exposure to certain pollens. Which of the following is the mechanism of action of cromolyn sodium?
Mast cell stabilizer
