Pulmonary Tx

Question 1

Bronchiectasis

Answer 1

bronchodialtors, oxygent, +/- antibiotics

Question 2

Cystic Fibrosis

Answer 2

hydration, humidification, O2, antibiotics, lung transplant

Question 3

acute bronchitis

Answer 3

cough suppressants for adults, expectorants, albuterol, antibiotics if indicated

Question 4

influenza

Answer 4

antibiotic ineffective
A- ramantadine (resistance concern)
A&B- oseltamivir, zanamivir

Question 5

RSV/ acute bronchiolitis

Answer 5

supportive care, hydration, humidified air, O2, +/- bronchodialtors, consider ribacvarin, +/- steroids (avoid in infants?)

Question 6

Tracheobronchitis

Answer 6

supportive care, humidified air, cough suppressants, reassurance, steroids for croup in kids?

Question 7

Pertussis/ Whooping Cough

Answer 7

macrocodes, Tmp/smx, treat contacts

Question 8

Tuberculosis

Answer 8

latent- isoniazid for 9 mo

active- 6-9 mo combo therapy

Question 9

Community acquired Pneumonia

Answer 9

appropriate antibiotics, O2

CURB65

Question 10

Atypical Pneumonia

Answer 10

mycoplasma or legionaella- macrolide
Chlamydia- doxycycline
Influenza A/B- oseltamivir, zanamivir, peramivir IV

Question 11

Viral Pneumonia

Answer 11

Symptomatic

RSV: ribavirin

Question 12

Herpesvirus- acyclovir

Answer 12

CMV- ganciclovir

Question 13

Histoplasmosis pneumonai

Answer 13

amphotericin B, itraconazole

Question 14

Coccidiomycosis

Answer 14

FLuconazole, amphotericin B

Question 15

Balstomycosis pneumonia

Answer 15

itraconazole

Question 16

Cryptococcosis

Answer 16

IV amphotericin B and PO flucytosine

Question 17

aspergillosis

Answer 17

any anti fungal

Question 18

pneumocystis Jirovicci

Answer 18

SMP/TMX, clindamycin

Question 19

Aspiration pneumonia

Answer 19

CAP- ampicillin/sulbactam, quinolone, third gen cephalosporin
HAP- pip/tazo, quinolone, third gen cephalosporin and linda/metro

Question 20

ARDS

Answer 20

treat underlying problem, stabilize trauma, antibiotics for sepsis, high flow O2 with positive pressure, diuretics

Question 21

Pneumoconiosis

Answer 21

supportive care, smoking cessation, consider steroids

Question 22

Pleural effusion

Answer 22

thoracocentesis, pleurodesis if chromic

chest tube

Question 23

Pneumothorax

Answer 23

if small with mild symptoms will resolve with time. large- may need surgery
tension- large bore needle decompression asap, chest tube when stable

Question 24

PE

Answer 24

oxygen, rest, antic coag- first LMWH or UH, then warfarin
Massive- streptokinase, altepace, urokinase thrombolytic
surgery- IVC filter, thrombectomy

Question 25

Pulmonary Hypertension

Answer 25

CCB, diuretics, sildenafil, bosentan, +/- anticoagulants

Question 26

Cor pulmonale

Answer 26

correct hypoxemia and acidosis, O2, diuretics | surgery- biventricualr pacing, VAD, transplant

Question 27

Interstital lung disease

Answer 27

consider steroids, immunosuppression

Question 28

idiopathic pulmonary fibrosis

Answer 28

consider steroids, immunosuppression

Question 29

Sarcoidosis

Answer 29

90% respond to steroids, monitor with ACE levels, many are sx free within a few years

Question 30

ANtiGBM/ goodpastures

Answer 30

plasmapheresis, steroids, dialysis, nephrectomy

Question 31

Granulomatosis with Polyangitis/ wegeners

Answer 31

cyclophosphamide and steroids

Question 32

Kyphoscolisis

Answer 32

Corrective intervention if curve is over 40degrees, mechanical ventilation support

Question 33

solitary pulmonary nodule

Answer 33

thoracocsopy/ thoracotomy with biopsy

Question 34

Hamartoma

Answer 34

often needs surgery due to size

Question 35

Sleep apnea

Answer 35

weight reduction, avoid alcohol and sleep meds, nighttime CPAP, surgery if severely sx