Pulmonary

Question 1

s/s of acute bronchitis

Answer 1

cough > 5 days, wheezing, dyspnea

Question 2

Tx of acute bronchitis

Answer 2

supportive:
OTC expectorants (guafenesin)
humidifier
hydration

Question 3

bronchiolitis s/s

Answer 3

difficulty feeding, cyanosis, wheezing, coughing

Question 4

tx of bronchiolitis

Answer 4

supportive

Question 5

tx of pertussis

Answer 5

macrolide

Question 6

MC cause of croup

Answer 6

parainfluenza virus

Question 7

s/s of croup

Answer 7

barking cough, stridor on inspiration, hoarseness

Question 8

tx of croup

Answer 8

oral steroids (dexamethasone)
stridor at rest–> add nebulized racemic epinephrine

Question 9

RSV s/s

Answer 9

prolonged expiration, grunting, retractions, crackles

Question 10

RSV dx

Answer 10

PCR of nasopharyngeal swab

Question 11

tx of RSV

Answer 11

supportive
hospitalize and supplemental O2–> if O2<90-92

Question 12

s/s of TB

Answer 12

fever, WL, night sweats, hemoptysis

Question 13

tx of TB

Answer 13

active- PIER (6mo or 9mo regimens)
latent- RIF and/or INH

Question 14

+ PPD >15mm

Answer 14

no RFs

Question 15

+ PPD >10 mm

Answer 15

healthcare worker
crowded living conditions
born in high TB country
<4 yrs old
injection drug user

Question 16

+ PPD >5 mm

Answer 16

HIV+
contact w/ someone w/ active TB
organ transplant
immunocompromised
previously had TB

Question 17

typical pneumonia pathogens

Answer 17

strep pneumoniae
h flu
kelbsiella
staph aureus

Question 18

atypical pneumonia pathogens

Answer 18

mycobacterium
legionella
chlamydia
viruses

Question 19

rust colored sputum and rigors is characteristic of pneumonia due to what pathogen?

Answer 19

strep pneumo

Question 20

alcoholics are at increased risk of pneumonia due to what pathogen?

Answer 20

klebsiella

Question 21

tx of outpatient CAP

Answer 21

macrolide
amoxicillin
doxycycline

Question 22

tx of inpatient CAP

Answer 22

macrolide + beta lactam OR respiratory fluoroquinolone

Question 23

pneumonia admission criteria

Answer 23

CURB65
AMS
uremia
RR>30
BP <90 systolic or <60 diastolic
65+

Question 24

nosocomial pneumonia treatment is based on:

Answer 24

MRSA
Multiple drug resistance
Mortality
Antibiograms

Question 25

chronic bronchitis s/s

Answer 25

cough and sputum production for 3+ mo for 2 consecutive years

Question 26

GOLD criteria

Answer 26

2+ exacerbations or any hospitalizations--> group E 0-1 exacerbations - mMRC 0-1--> group A -mMRC 2+--> group B

Question 27

GOLD tx

Answer 27

group E- LABA + LAMA - eos>300 add ICS group A- bronchodilator group B- LABA + LAMA

Question 28

bronchiectasis s/s

Answer 28

foul smelling purulent sputum cough hemoptysis

Question 29

Dx of bronchiectasis

Answer 29

HRCT- bonchoarterial dilation ratio >0.8 in children and 1-1.5 in adults CXR- tram track markings

Question 30

tx of bronchiectasis

Answer 30

airway clearance techniques inhaled bronchodilators

Question 31

s/s of asthma

Answer 31

wheezing breathlessness that's worse at night

Question 32

Dx of asthma

Answer 32

FEV1/FVC <0.70 bronchoprovocation--> >20% worsening bronchodilator--> >12% improvement

Question 33

step 1 asthma criteria

Answer 33

s/s: 2 or less/ wk night s/s: 2 or less/ mo FEV1: >80%

Question 34

step 1 asthma tx

Answer 34

PRN low dose ICS + LABA

Question 35

step 2 asthma criteria

Answer 35

s/s: 2-7/ wk night s/s: 3-4/ mo FEV1: >80%

Question 36

step 2 asthma tx

Answer 36

PRN low dose ICS + LABA

Question 37

step 3 asthma criteria

Answer 37

s/s: daily night s/s: >1/wk FEV1: 60-80%

Question 38

step 3 asthma tx

Answer 38

low dose ICS +LABA

Question 39

step 4 asthma criteria

Answer 39

s/s: all day night s/s: nightly FEV1: <60%

Question 40

step 4/5 asthma tx

Answer 40

medium-high dose ICS +LABA may add LAMA

Question 41

obstructive sleep apnea s/s

Answer 41

snoring witnessed breath pauses insomnia daytime sleepiness

Question 42

Dx of obstructive sleep apnea

Answer 42

PSG: >5 episodes (symptomatic) or >15 episodes (asymptomatic)

Question 43

Tx of obstructive sleep apnea

Answer 43

CPAP

Question 44

triad of obesity hypoventilation syndrome

Answer 44

obesity sleed disordered breathing chronic hypercapnia

Question 45

s/s of obesity hypoventilation syndrome

Answer 45

HA peripheral edema polycythemia

Question 46

Tx of OHS

Answer 46

CPAP