Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

USMLE Step 2 > pulm > Flashcards

pulm Flashcards

(64 cards)

Start Studying
1
Q

when do you NOT tap a pleural effusion

A

too small ( <1 cm)
loculated
CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

exudative effusion assoc with…..

A

malignancy
TB
PNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

asthma diagnosis with PFTs

A

FEV1 inc by 12% with albuterol (200 ml inc)

FEV1 dec by 20% with methacholine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

TLC is inc in COPD because of…..

A

inc in residual volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how would you treat an asthma and COPDer not controlled on albuteral differently?

A

asthma –> ICS

COPD –> anticholinergic (ipratropium, tiotropium) –> ICS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

most likely presentation of bronchiectasis

A
  • recurrent episodes of very high volume purulent sputum production
  • mostly related to CF

MUST be dx with CXR or CT –> “tram tracks”= thickened bronchi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

bugs not gram stainable in PNA

A

mycoplasma
chlamydophila
legionella
coxiella

**also generally assoc with DRY COUGH and BILATERAL infiltrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

PNA tx for previously healthy/ no recent abx use?

A

macrolide or doxy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

PNA tx for comorbidities or abx in last 3 months?

A

resp FQ –> levo or moxi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how can you use vitals to quikcly differentiate croup from epiglotitis?

A

croup= dec O2 sat (if mild, give steroids; if severe, give raecemic epi)

epiglottitis= impending dec O2 sat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

management of epiglottitis

A

INTUBATE

  • -> ceftriaxone 7-10 days
  • —–> rifampin for close contacts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

empiric therapy for retropharyngeal abcess

A

iv amp sul

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

MOST COMMON CAUSE OF CAP INCLUDING HIV PATIENTS (WITH GOOD CD4 COUNT)

A

strep pneumo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

ludwigs angina

A

rare, often fatal, soft tissue neck infx (cellulitis)

predisposing factors: otodontic infx and diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

when should you get a PET for lung nodule?

A

> 1cm

pulm nodules are evaluated with Chest CT!! no xray.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

most common lung cancer in smokers

A

Squamous

sCuamous cell –> Ca!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what skin finding can be associated with mycoplasma PNA

A

erythema multiforme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

positive PPD with negative chest xray?

A

9 months INH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

when do you do sx tx in croup vs racemic epi?

A

racemic for moderate to severe –> stridor at rest, retractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

most common bugs in bacterial rhinosinusitis

A

h flu

strep pneumo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

pavalizumab

A

monoclonal RSV antibody that supplies passive immunity to AT RISK babies (premies with BPD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

pseduomonas is a grem negative rod?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

hyponatremia, patchy bilat cxr, diarrhea?

A

legionella

tx with FQ or macrolide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

tissue dense upper lobe mass seen on CXR that can be moved with change in position?

A

chornic pulmonary aspergilloma that has seeded in an old TB cavity

+galactomannin test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
erythromycin in infants less than one?
can cause hypertrophic pyloric stenosis ***ie use azithromycin for pertussis
26
Pleural effusion: ADA, Triglycerides
TB, chylothorax
27
three things that can acutely change plateau pressure in ICU?
pneumo (deep sulcus sign on CXR) pulm edema abdominal compartment syn
28
what are CURB65 criteria
``` Confusion Urema (BUN>30) Resp distress BP (systolica < 90) >65 yo ```
29
define HAP
PNA 48 hours after admission or with in 90 days of hospitalization more likely to be GNR rods!! --> e coli, PSA
30
best antibiotics for lung abscess
clinda, pen
31
PCP PNA - dx - tx - alt tx
dry cought, bilat infiltrates in patient with CD4 <200 -dx: LDH is always elevated!! tx: TMP/SMX - --> add steroids if severe - --------> use atovaqonue, dapsone or clinda/ primaquine if sulfa allergy * *cannot use dapsone in G6PD
32
what are adverse effects of TB tx?
rifampin --> red body secretions (benign) isoniazid --> peripheral neuropathy (use pyridoxine) pryainamie --> hyperuricemia (tx if symptomatic) ethambutol --> optic neuritis/ color vision (decrease dose in renal failure) ***they all raise LFTs! only d/c if 3-5x upper limit of normal
33
most approp next step in the high risk or "intermediate" pulm nodule
high risk= resect!! intermediate --> sputum cytology, bronchoscopy (central), transthoracic needle bx (peripheral)
34
pres and work up for restrictive lung dz
look for PE signs like loud P2 clubbing of the fingers high resolution CT scan is better than Xray but lung bx is the best
35
in ILD, granulomas are seen in bx of.....
berylliosis (assoc with electronics) tx with steroids!! this is the most likely pneumoconiosis to respond (albeit just a little) you can also try azathioprine
36
sarcoidosis can present with and is best treated by?
SOB with non productive cough - erythema nodosum and lymphadenopathy!! - parotid enlargment - faicla palsy - heart block, restrictive cardiomyopathy - CNS - uveitis tx with prednisone
37
indicatoins for IVC filter
- CI to to use of anticoagulants (CNS bleed, GI bleed) - reccureent emboli on NOAC - RV dysfunciotn on echo
38
indications for thrombolytics in PE?
hemodynamically unstable | acute RV dysfunction
39
parameters sufficient for lobectomy in lung cancer?
FEV1 >1.5L DLCO >60% of predicted consider wedge resection if above are below cut offs
40
unilateral foul smelling nasal discharge with no other sx in a young child
foreign body
41
order of surgical W's
w1nd (12-48 hours) wa2er (day 3 UTI) wound walking (7-10 days)
42
order of mechincal ventilation vs surgery in CDH
intubate, stabilize, operate at 24-48 hours
43
in V/q mismatch, Aa grad....... in alveolar hypovent, Aa grad.....
increase! stays the same
44
signs and sx of hemothorax
dullness to percussion, tracheal dev to other side, tachy, hypotension, FLAT neck veins
45
initial steps to take in hemoptysis
place bleeding lung in dependent position | --> bronch to locate/ stop bleed
46
penetrating trauma with object still in place:
surgery
47
60% of patients with flail chest who are NOT responding to O2 supplement
intubate --> PPV! PPV has a splint effect on the flail segment, and pain prevents deep adequate resps
48
diffuse patchy infiltrate on CXR after blunt trauma to chest that gets WORSE with fluids
pulmonary contusion --> damaged vasculatre
49
physical location of croup
narrowing of subglottic larynx
50
how to tell OHS from OSA
elevated bicarb!! with diurnal hypercapnia and resp acidosis suggests that the problem is chronic
51
explain mech for cor pulomale
in COPD, chronic hypoxia leads to hypoxic vasoconstriction which increases PVR and overtime leads to R heart failure
52
lung disease pattern seen in diffuse systemic sclerosis?
restrictive! decreased diffusion capacity
53
asbestosis
shipyard workings FIRST BRONCHOGENIC CARCINOMA then mesothelioma
54
first step in management of RDS in neonate
CPAP to inc peep!! if that fails, intubate and give surfactant
55
magnesium in asthma?
only used in acute exacerbations after several FAILED rounds of albuterol while you wait for steroids to kick in it helps relax muscles and reduce vasoscpasm
56
samter's triad
astham/bronchosinusitus + nasal polyps + ASPIRIN!!! ghat causes a PSEUDO allergic (pseudo type 1 hypersensitivity)
57
hypercalcemia in SqCC of the lung?
paraneoplastic syndrome --> PTHrP --> inc PTH --> inc Calcium, decreased phosphate **this is the only paraneoplastic syn assocaited with SQUAMOUS. the others are assoc with small cell
58
non allergic asthma
gnerally presents >age 40, triggered by viral illnesses and exercise probably in a COPD like picture
59
infant that turns blue with feeding and pink when crying?
think choanal atresia (bony or membranous obstruction of nasal passages) --> can only breathe through their mouth bilateral presents immediately!! unilateral can come in childhood
60
when does surfactant completely develop?
34 weeks --> on CXR, see diffuse reticular opacities with air bronchograms
61
non smoker women are most likely to get what cancer
adenocarcinoma
62
describes correlations of glucose levels in pleural effusions
>60= normal 30-60= TB, malignant effusion, etc <30= empyema or rheumatoid pleurisy
63
paraneoplastic syndrome of SMALL cell lung cancer
SIADH ACTH Lambert Eaton Cerebellar degeneration
64
diagnostic confirmation of sarcoidosis is with...?
lung bx showing non caseating granulomas

USMLE Step 2 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions