Pulm l

Question 1

FEV1 / FVC
if high, think
if low, think

Answer 1

high, restrictive (hard to get air in)

low, obstructive (hard to get air out)

Question 2

% PPV
if higher think
if lower think

Answer 2

normal is obstructive

lower, restrictive

Question 3

silhouette sign - see with

Answer 3

pneumonia

Question 4

TB primary infx XRAY

secondary infx XRAY

Answer 4

primary - upper lobes, pleural effusion, hilar nodes

secondary - small calcifications in LU & nodes, or NORMAL

Question 5

Non-sedating antihist vs sedating

does not cross BBB vs does

Answer 5

non-sedating - allegra (fexofenadine), claritin (loratadine, desloratadine) - H-1 antag
sedating - diphenhydramine (benadryl), chlorpheniramine - H-1 R antag; CI CNS depression, MAO-I

Question 6

Emergency Bronchodilator

Answer 6

Atropine, then EPI

Question 7

alpha-1 agonists for nasal congestion
1. oxymetazoline
2. phenylephrine hydrochloride
3. pseudoephedrine 
CI?

Answer 7

CI - severe HTN, MAO-I

ADR’s: anaphalyxis, asthma, HA,

Question 8

Glucocorticoids end in ?
ADR’s
fxn for asthma?

Answer 8

-sone, -zone, -onide
ADRS: water retention, CV probs, osteoprosis, peptic ulcers
used in conjunction w bronchodilators for LU
BLOCKS PHOSPHOLIPASE A2 in membrane blocking production of arachondic acid

Question 9

if atropine is used as an emergency bronchodilator, what Rx use atropine as an anticholinergic bronchodilator?

Answer 9

IPRATROPIUM BROMIDE
TIOTROPIUM BROMIDE
(parasympatholytic)
does not tx acute asthma

Question 10

types of rescue inhalers

Answer 10

epi, ALBUT

Question 11

what is mometasone?

Answer 11

inhaled corticosteroid powder for asthma

Question 12

what is salmeterol?

Answer 12

serevent dikus
B2 agonist
BB warning!!! increase risk of asthma related death
long acting

Question 13

montelukast pharm

Answer 13

leukotriene R antag

Question 14

dextromethorphan fxn

Answer 14

robitussin
central acting
antitussive

Question 15

how long after chronic cough should you xray?

Answer 15

> 8 weeks

Question 16

viral resp infx
sharp pain worse w deep breath or cough
friction rub “leathery sound

Answer 16

pleurisy

Question 17

pneumonia vs effusion

hear increased or decreased sounds?

Answer 17

pneumo decreased

effusion increased

Question 18

bronchiolitis
xray?
eti?
what to know

Answer 18

viral
hyperinflation, peri-bronchial infiltrate
deadly in children and elderly

Question 19

Pneumonia in alcoholics get which kind?

Answer 19

klebsiella consildated

Question 20

pneumonia in diabetics get which kind?

Answer 20

e coli consolidated

Question 21

atypical pneumonia is seen as what on xray? caused by what?

Answer 21

BL DIFFUSE INFILTRATE

mycoplasma, chlamydia, viral

Question 22

Hospital Acq Pneumonia appears how long after admission?

what kind of bug?

Answer 22

about 3 days
gram neg is about half of em
strep is MC community acq

Question 23

smelly rusty sputum

Answer 23

LU abscess

tx like lobar pneumonia

Question 24

Aspergillosis on xray

Answer 24

solitary lesion 3-5mm in diameter

found in dirt

Question 25

``` Cryptococcla Pneumonia Rx Dx Xray complications ```

Answer 25

``` yeast pigeon poo MENINGITIS so much R/O XRAY - solitary nodule DX biopsy and culture Rx amphotericin ```

Question 26

Histoplasmosis xray dx

Answer 26

atypical presentation - patchy infiltrates, hilar adenopathy; cavitations, fibrosis flu-like sxs sputum culture or biopsy

Question 27

flu-like sxs hemoptysis dry cough mississippi, SE US, africa

Answer 27

Blastomycosis pneumonia

Question 28

Valley Fever | xray

Answer 28

``` coccidioidomycosis can be bad! * no hemoptysis RASH, fever, erythema nodosum XRAY - non specific infiltrate hilar adenopathy ```

Question 29

flu-like, rash, erythema nodosum, no hemoptysis

Answer 29

coccidiodomycosis "valley fever"

Question 30

MC secondary to EMPHYSEMA | genetic cause of emphysema

Answer 30

reactive polycythemia alpha 1 anti trypsin xu normal pCO2

Question 31

if acute exacerbation of chronic bronchitis, think

Answer 31

bacterial so tx w antibiotics

Question 32

Bronchiectasis ETI WHAT IS IT xray

Answer 32

many things like tumors, foreign body, mucus (CF), external compression IRREVERS DILATATION OF BRONCHIOLES SEE HONEYCOMBING, loss of LU vol

Question 33

Cryptogenic organic pneumonia sxs what happens xray

Answer 33

rapid dry cough inflam, scarring, alveoli xray - see widespread white patchees

Question 34

Sarcoidosis xray

Answer 34

BL hilar adenopathy reticulonodular infiltrate

Question 35

Goodpasture syndrome ssx

Answer 35

hemoptysis & hematuria | bc basement membrane of both LU and Kidneys affected

Question 36

Wegeners ssx what is it

Answer 36

vascular dz increased ANCA ssx: freq URI and sinusitis

Question 37

alveoli filled w eosinophilic debris

Answer 37

Silicosis

Question 38

ARDS

Answer 38

medical emergency very sick | eti many things, chemical inhal

Question 39

Cheyne Stokes

Answer 39

CHF and neuro | altered tachypnea and apnea

Question 40

Cough w progressively worsening sputum production, SOB, F, Chills

Answer 40

TB

Question 41

Smoker - what kind of LU cancer?

Answer 41

small cell lung cancer

Question 42

F, cough, chest pain, hemoptysis, rash | SW United States

Answer 42

Coccidiomycosis

Question 43

usu only in immunocomp ppl | otitis externa, runny nose, fever

Answer 43

aspergillosis

Question 44

alpha 1 anti trypsin xu | when to check for this?

Answer 44

suspected COPD if no smoking hx