Pulmonology

Question 1

Asthma Exacerbation

Answer 1

Symptoms: SOB, cough, wheezing

Diagnosis: Clinical, ABG if necessary, CXR

Management: Solumedrol, duonebs/pulmicort/brovana, antibiotics, O2. May need O2, steroid taper, and inhalers at discharge (SABA and steroid)

Complications: Respiratory failure

Specialist and role: Pulm if O2 requirements are high

Question 2

COPD exacerbation

Answer 2

Symptoms: SOB, cough, wheezing

Diagnosis: Clinical, ABG if necessary, CXR shows flattened diaphragm, may see bullae on CT if emphysema

Management: Solumedrol, duonebs/pulmicort/brovana, antibiotics, PPV if hypercapnic. May need O2, steroid taper, and inhalers at discharge (SABA and LAMA)

Complications: Respiratory failure, hypercapnic encephalopathy

Specialist and role: Pulm if O2 requirements are high

Question 3

Pleural Effusion

Answer 3

Symptoms: SOB, cough, pleuritic chest pain

Diagnosis: CXR or CT chest, thoracentesis with fluid studies for lights criteria. Usually no need for diagnostic thora if CHF suspected

Management: Treat underlying cause. Thoracentesis with cxr following if symptomatic, talc pleurodesis, indwelling catheter, chest tube, or VATS. Diuretics if fluid overload and antibiotics if empyema

Complications: Cardiac tamponade and shock

Specialist and role: IR/Pulm for drainage

Question 4

Pulmonary edema

Answer 4

Symptoms: SOB, may have swelling/JVD too

Diagnosis: CXR or CT chest plus crackles on exam, TTE to identify cause

Management: Diuresis with IV lasix, O2

Complications: Respiratory failure

Specialist and role: Cardiology if CHF

Question 5

OSA

Answer 5

Symptoms:

Diagnosis:

Management:

Complications:

Specialist and role:

Question 6

Interstitial Lung Disease

Answer 6

Symptoms:

Diagnosis:

Management:

Complications:

Specialist and role:

Question 7

Pulmonary Embolism

Answer 7

Symptoms:

Diagnosis:

Management:

Complications:

Specialist and role:

Question 8

ARDS

Answer 8

Symptoms:

Diagnosis:

Management:

Complications:

Specialist and role:

Question 9

Pnuemothorax

Answer 9

Symptoms:

Diagnosis:

Management:

Complications:

Specialist and role:

Question 10

Hemothorax

Answer 10

Symptoms:

Diagnosis:

Management:

Complications:

Specialist and role:

Question 11

Chylothorax

Answer 11

Symptoms:

Diagnosis:

Management:

Complications:

Specialist and role: