Pulmonary

Question 1

Tx of malignant pleural effusion with nonexpandable lung. What about expandable lung?

Answer 1

Indwelling pleural catheter for nonexpandable. IPC or talc pleurodesis for expandable lung.

Question 2

Clinical presentations of sarcoid that do not require biopsy:

Answer 2

• Stage I (bilat hilar adenopathy) without symptoms of malignancy
• Loefgren syndrome
• Heerfordt syndrome

Question 3

Characteristics of pleural effusion with chylothorax:

Answer 3

Triglycerides >120

Usually high protein and low LDH

Question 4

Characteristics of cholesterol effusion:

Answer 4

Pleural fluid cholesterol >200

Question 5

Pure ground glass pulm nodule > 6 mm: follow up imaging recs from flieshner:

Answer 5

CT at 6-12 minths, then every 2 years for 5 years.

Question 6

Increased jugular venous distention, persistently split S2, and tricuspid regurgitant murmur suggest what?

Answer 6

Pulmonary hypertension

Question 7

Pleural studies indicating a complicated parapneumomoc effusion:

Answer 7

PH<7.2 or glucose <40 or microorganisms on gram stain or culture.

Question 8

Determine if patient with COPD is safe to fly:

Answer 8

Resting pulse ox: if <92% and not normally on oxygen, rx 2L oxygen for flight.
Pulse ox 92-95% may need more testing (high altitude simulation test)
Parients on >4L oxygen should not fly.