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PANCE > Pulm > Flashcards

Pulm Flashcards

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1
Q

Paratracheal lymphadenopathy
Elevated ACE levels

MC in african american

A

Sarcoidosis

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2
Q

Very aggressive lung cancer

median survival untreated is 6-18 weeks

A

small cell lung cancer

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3
Q

dilated thickened bronchi
tram-tracks
ring like markings

A

bronchiectasis

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4
Q

MC pathogen in pts with cystic fibrosis

A

pseudomonas

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5
Q

does a pulm effusion have decreased or increased tactile fremitus

A

decreased

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6
Q

DOC for pulmonary legionelliosis

A

azithromycin

(can also give FQs or tetracyclines)

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7
Q

______ most commonly presents as a solitary, peripheral lesion on chest radiograph. It is sometimes associated with an ipsilateral pleural effusion.

A

adenocarcinoma

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8
Q
  1. asthma
  2. nasal polyps
  3. ASA/NSAID allergy
A

Sumter’s triad

IgE mediated

*also associated w eczema

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9
Q

strongest predisposing factor for asthma

A

atopy

(atopic triad= wheeze, eczema, seasonal rhinitis)

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10
Q

with asthma, generally get and FEV1/FVC ratio of…

A

<75%

a greater than 10% increase FEV1 after bronchodilation therapy is supportive of diagnosis

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11
Q

symptoms <2 days a week

<2 monthly night symptoms a month

A

intermittent

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12
Q

>2 days a week

3-4 monthly night time symptoms

A

mild

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13
Q

daily symptoms

>1 night per week, but not nightly symptoms

A

moderate

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14
Q

continuous symptoms

almost nightly night time symptoms

A

severe

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15
Q

drug class:

salmeterol
formoterol

A

LABA

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16
Q

what do you need to monitor with leukotriene modifiers (ie montelukast)

A

LFTs

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17
Q

bronchodilator NOT to be used acutely

narrow therapeutic window: arrythmias, seizures

A

theophylline

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18
Q

bronchodilator

MOA: decreased Ca mediated smooth muscle contraction

*can also be used to prevent pre term labor

A

Magnesium

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19
Q

when do you give a COPD person supplemental O2

A

SpO2 < 88%

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20
Q

productive cough for greater or equal to 3 months for 2 consecutive years

A

chronic bronchitis

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21
Q

hyperresonance
resp alkalosis
mild hypoxemia

A

emphysema

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22
Q

rales, crackles, rhonchi
resp acidosis
increased Hct/RBCs
severe hypoxia and hypercapnia

A

chronic bronchitis

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23
Q

contraindications of anticholinergics (tiotropium, ipratropium)

24
Q

good antibiotic for acute COPD exacerbations

*anti-inflammatory properties in the lung

25
MC cause of bronchiectasis
cystic fibrosis
26
DOC for bronchiectasis if suspected pseudomonas (ie in a CF patient)
fluoroquinolone Zosyn Aminoglycoside Cephalosporin
27
CF pt with... daily chronic cough with thick, mucopurulent and foul smelling sputum hemoptysis persistent crackles
bronchiectasis **image of choice - CT**
28
CT showing: tram tracks signet ring sign
bronchiectasis tx must cover psuedomonas if CF patient
29
``` meconium ileus pancreatic insufficiency (exocrine dysfxn) ```
CF
30
bilateral hilar LAD R paratracheal LAD ground glass appearance +/- eggshell calcifications \*restrictive PFTs (increased or normal FEV1/FVC ratio)
sarcoidosis tx= observe or steroids
31
true or false... MC mets for lung cancer are **brain, bone, liver, lymph nodes, adrenals**
true
32
MC type of lung cancer \*locally spreads \*surgery is 1st line **can get pancoast syndrome**
Non small cell | (88%)
33
EARLY METS!! with ths lung cancer often have mets at presentations **management-chemo and radiation**
Small cell
34
seen with non-small cell lung ca 1. shoulder pain 2. horners syndrome (miosis, ptosis, anhydrosis) 3. atrophy of hands, arms
Pancoast syndrome (horners syndrome due to compression of sympathetic)
35
MC cause of transudative pleural effusions
CHF also caused by: nephrotic syndrome, cirrhosis
36
due to inflammation protein \> 0.5 LDH \> 0.6 or \> 2/3 upper limit norm
Exudative pleural effusion
37
MC CXR= normal but, may see: Westermarks sign Hamptons Hump
PE
38
sinus tach S1Q3T3
PE
39
top 2 pathogens causing CAP
1. s.pneumoniae 2. H. influenzae
40
MC pneumonia in alcoholics
klebsiella
41
MC pneumonia in immunocompromised
pseudomonas
42
which type of penumonia... tx: macrolide or doxy
outpatient CAP
43
which type of pneumonia... tx= beta lactam (ceftriaxone) + macrolide or doxy OR broad spectrum FQ (levo, moxi)
inpatient CAP
44
tx for aspiration pneumonia
clinda or augmentin +/- flagyl
45
what indurated PPD size is positive for: HIV, immunocompromised close contact to active TB patient CXR showing old TB
5 mm
46
what indurated PPD size is positive for: recent immigrants IV drug users DM, CKD, silicosis Kids under 4 health care workers
10 mm
47
indurated PPD size for gen pop
15 mm
48
RIPE treatment for TB
* *R**ifampin * *I**NH * *P**yrazinamide * *E**thambutol
49
SEs of: rifampin INH pyrazinamide ethambutol
rifamin- thrombocytopenia, orange INH- hepatitis, peripheral neuropathy pyrazinamide- hepatitis, hyperuricemia ethambutol- optic neuritis
50
true or false streptomycin can be used for TB and has the SE of ototoxicity
true
51
cyclic breathing in response to **increased CO2** increases in resp plus gradual decreases in resp with a period of apnea 15-60 seconds
cheyne- stokes
52
quick, shallow breaths of equal depth with irregular periods of apnea
biot's
53
deep, rapid, continuous respirations ## Footnote **result of metabolic acidosis**
kussmauls
54
disruption or obstruction of thoracic duct \*leakage of lymphatic fluid of intestinal origin
chylothorax
55
high triglyceride content (\>110) turbid or milky white appearance
chylothorax \*chest, neck or abdominal surgery increases risk
56
DOC for primary pulmonary HTN
CCBs

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