Pulmonary

Question 1

Acute onset pleural effusion, ascites, LL edema in a medically free female after IVF

Answer 1

Ovarian hyperstimulation syndrome.
Rx: supportive

Question 2

Obstructive lung disease

Centrilobular emphysema seen in? usually effect which lobe?

Answer 2

Smokers, upper lobe

Question 3

Pulmonary hypertension

Patient with MPAP 40 And PCWP 28. Cause of P HTN?

Answer 3

High pulmonary venous return. 83 % of cases caused by HFpEF or HFrEF.
Rule: PCWP > 15 Indicates high pulmonary venous return

Question 5

Diagnostic criteria for OHS?

Answer 5

1) Presence of hypoventilation. PaCO2 > 45 At day time.
2) Rule out other causes of hypoventilation
3) Obesity BMI > 30

Question 6

Most common location for lung abscess?

Answer 6

Posterior segment of the right upper lobe

Question 7

Management options for lung abscess?

Answer 7

Clindamycin (superior to PCN)
AMP-Sulbactam
Others:
Carbapenem

Question 8

This skin lesion and lung disease

Answer 8

Sarcoidosis. Lupus pernio

Question 9

Management options for PJP?

Answer 9

Bactrim is first line
Others:
- Clinda + primaquine
- Dapsone + Trimethoprim
- Atovaqoune

Question 11

Thephiline side effects?

Answer 11

Ventricular arrhythmia, seizure (even in patient without history of seizure), confusion, tremor diarrhea, hyperglycemia and hypokalemia

Question 13

Eggshell calcification

Answer 13

Chronic silicosis. After 10 years of exposure.
VS
Acute: within 1 year. Shows peripheral and basilar ground glass opacity in ct

Question 14

Type of pneumonia observed in soldiers after they comeback from iraq and Afghanistan

Answer 14

Acute esonophilic pneumonia

Question 15

Chronic silicosis causes fibrosis mainly in upper or lower lobe?

Answer 15

Upper lobe. Eggshell calcification

Question 16

Stages of sarcoidosis in lung?

Answer 16

Question 17

Initial management of erythema nodusum in Sarcoidosis?

Answer 17

NSAIDs

Question 18

Triad for Heerfordt syndrom

Answer 18

Parotitis + Facial nerve palsy + Anterior uveitis.
Rx: NSAID’s

Question 19

known as ABVD (adriamycin, bleomycin, vinblastine, dacarbazine)
Which one of those can cause pulmonary toxicity after receiving this regimen in hodgkin lymphoma?

Answer 19

Bleomycin pulmonary toxicity usually after months to years. Relapse with stopping steroid

Question 20

True or false
Anti TNF assosiated with drug induced lupus

Answer 20

True

Question 21

What are the most common conditions associated with secondary pneumothorax?

Answer 21

COPD and PJP

Question 22

ARDS + Thrombocytopenia + hemoconentration

Answer 22

Hanta virus. One of the hemorrhagic viruses

Question 25

Diagnosis of Cystic fibrosis require?

Answer 25

2 documented test of sweat chloride test level >. 60 or identification of 2 CF genes + clinical syndrome

Question 26

First test to do in a patient without history of recurrent sinupulmonary infections, CT shows lower lobe bronchiectasis PFT shows obstructive disease with no reversibility?

Answer 26

Immunoglobulin. As in adults hypogammaglubenemia can cause bronchiectasis + recurrent abdominal infections

Question 27

Recurrent GI bleeding, epistaxis, oral and nasal hyperpigmentation with desaturation not improving with oxygen

Answer 27

hereditary hemorrhagic telangiectasia. AD disease. Main mechanism is AV Malformation

Question 28

Dyspnea, buccal mucosal hyperpigmentation, melena and epistaxis. Diagnosis and management

Answer 28

Heriditary hemorrhagic talangectasia. Management: embolization. Cause of hypoxia: AVM

Question 29

Nasal nitric oxide test is used as a screening test for?

Answer 29

Primary ciliary dyskinesia

Question 30

What parameters can improve survival in ARDS?

Answer 30

1) Low tidal volume 2) Prone position Note: - High PEEP improve oxygenation with no mortality benefit

Question 31

When to avoid home sleep apnea test and use in lab test?

Answer 31

1) Cardiopulmonary diseases 2) Mission- related 3) There is a suscpesion of non-respiratory sleep disorder like narcolepsy

Question 32

Patient with asthma intubated. After intubation the patient became hypotensive and this waveform showed. Next step?

Answer 32

1) Disconnect the ventilator. Or 2) Decrease minute ventilation (by decreasing respiratory rate or tidal volume) The goal is to decrease intrinsic PEEP caused by air trapping in obstructive lung disease

Question 34

Patients want to go for everest mountain. He is afraid from developing high altitude pulmonary edema. What medication can be given to avoid this condition?

Answer 34

Nifedipine. For High altitude cerebral edema: acetazolamide

Question 36

Management of exercise induce bronchocostriction?

Answer 36

Daily inhaled ICS And SABA PRN

Question 38

Which pulmonary hypertension medications you will avoid in pregnancy?

Answer 38

Endothelin receptor blocker is CI in pregnancy and interact with OCP. Ex: -Santan زنطان يزنط البيبي

Question 39

Which pulmonary hypertension medications is used for critical limb ischemia?

Answer 39

Prostacyclin analogue. That is why it increases risk of bleeding with the use of anticoagulation Ex: Lipoprost + EPOprestenol

Question 40

Which pulmonary hypertension medications causes blue vision?

Answer 40

PDE-5 inhibitors

Question 41

Which pulmonary hypertension medications should be avoided if the patient on cyclosporine?

Answer 41

ER-B