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Pulmonology Flashcards

(75 cards)

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1
Q

Mild hypoxia SpO2 levels and who this is most common in

A

91-94%

Elderly, obese, smokers

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2
Q

Biggest contraindication for CT with contrast

A

Chronic or acutely worsening renal disease

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3
Q

What is the “5th vital sign”?

A

Arterial oxygenation measured by pulse oximeter

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4
Q

Is a total lung capacity <80% suggestive of obstructive or restrictive lung disease?

A

Restrictive

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5
Q

Three most common causes of cough

A

Infectious agents

Sinus drainage

Acid reflux

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6
Q

Diagnostic labs (3) used in patients with dyspnea

A

BNP

D-dimer

ABGs

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7
Q

Preferred imaging method for evaluating incidental pulmonary nodules

A

CT scan WITHOUT contrast

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8
Q

Is an FEV1/FVC ratio <70% suggestive of obstructive or restrictive lung disease?

A

Obstructive

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9
Q

Follow-up is not required for lung nodules of this size in patients 35 or older without symptoms or risk factors of lung cancer

A

<6mm

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10
Q

Which cause of dyspnea is of mixed origin (cardiac and pulmonary)

A

Pulmonary emboli

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11
Q

Normal ranges on ABGs for:
1.) pH
2.) PaO2
3.) PaCO2
4.) HCO3

A

1.) pH - 7.35 to 7.45
2.) PaO2 - 80 to 100 mmHg
3.) PaCO2 - 35 to 45 mmHg
4.) HCO3 - 22 to 26 mmHg

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12
Q

Spirometry improvement with bronchodilator administration is more common in COPD or asthma?

A

Asthma

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13
Q

When CT with contrast is contraindicated, what can be used to assess likelihood of PE?

A

V/Q scan (nuclear)

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14
Q

pH - 7.12
PaO2 - 95
PaCO2 - 44
PaHCO3 - 12

Diagnose me!

A

Metabolic acidosis, uncompensated

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15
Q

Name the three corners of Virchow’s Triad

A

Vascular injury

Circulatory stasis

Hypercoagulable state

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16
Q

Gold standard for evaluating a PE

A

CTPA

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17
Q

pH - 7.38
PaO2 - 86
PaCO2 - 46
PaHCO3 - 32

Diagnose me!

A

Metabolic alkalosis, fully compensated

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18
Q

S1Q3T3 EKG changes are suggestive of …

A

Pulmonary embolism

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19
Q

Breathing faster will increase or decrease PaCO2?

A

Decrease

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20
Q

A normal shaped, small-sized flow-loop pattern is suggestive of …

A

Restrictive lung disease

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21
Q

True or false. A negative d-dimer is sufficient to rule out DVT/PE

A

True

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22
Q

What might you see in a chest x-ray of a patient with acute heart failure?

A

Cardiomegaly
Cephalization (stag)
Interstitial edema
Vascular congestion
Pleural effusions

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23
Q

Three indications for chest CT angiography

A

PE

Aortic aneurysm

Aortic dissection

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24
Q

Common reasons (3) for anion gap to be elevated

A

Lactic acidosis

Renal failure

Ketoacidosis

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25
Two major types of CT with contrast
Helical and Axial
26
Diagnostic tests (7) used in patients with dyspnea
EKG Pulse oximetry CXR Ultrasound V/Q scan CT scan PFTs
27
Normal SpO2 levels
95-100%
28
This diagnostic lab test checks the function of a patient's lungs and how well they are able to move oxygen in to and CO2 out of the blood
ABGs
29
CBC findings with pulmonary hypertension
Polycythemia (chronic hypoxia)
30
Most common cause of hemoptysis
Infection (60-70%) (consider lung cancer though if patient is a big smoker)
31
ARDS would look like this on chest x-ray
Diffusely filled patchy infiltrates
32
Exudative effusions can be evaluated and empyema loculations can be broken up using this pulmonary procedure
Thorascopy
33
DLCO threshold for lung pathology
<80% = pathology (>80% = normal)
34
If a patient with tuberculosis symptoms has a positive IGRA test, how should you proceed?
Isolate patient Obtain chest x-ray Three sputum samples (NAAT on at least one but Acid-fast bacilli is gold standard) Still high suspicion but negative AFB = bronchoscopy with biopsies
35
This diagnostic lab is useful in patients with acute decompensated heart failure
BNP
36
Direct visualization of the larynx, trachea, and bronchi is done with this pulmonary procedure
Bronchoscopy
37
Most common sleep-related breathing disorder
Sleep apnea
38
The anion gap is most helpful in identifying the cause of ...
Metabolic acidosis
39
DLCO measure the lungs capability to ...
Perform gas exchange
40
PFT contraindications (6)
Anything that means they're not currently at respiratory baseline Exacerbation of acute severe asthma Respiratory distress Angina aggravated by testing Pneumothorax Ongoing hemoptysis Active TB
41
This type of lung condition is characterized by airflow limitation
Obstructive
42
Gold standard for pneumonia diagnosis
Chest x-ray
43
Order we evaluate arterial blood gases
1.) Look at pH 2.) Look at CO2 3.) Look for compensation
44
How is the anion gap calculated?
Cations (Na + K) minus Anions (Chloride + Bicarb)
45
pH - 7.52 PaO2 - 88 PaCO2 - 45 PaHCO3 - 33 Diagnose me!
Metabolic alkalosis, uncompensated
46
pH - 7.29 PaO2 - 82 PaCO2 - 62 PaHCO3 - 26 Diagnose me!
Respiratory acidosis, uncompensated
47
This diagnostic lab is used in cases of dyspnea to detect markers of coagulation and fibrinolysis
D-dimer
48
This score is used to assess chance of morbidity/mortality if patient has community acquired pneumonia
PSI/PORT score
49
50
In a suspected pulmonary neoplasm, the first thing you should look for is ...
Old films (old x-rays to compare to)
51
For solid lung nodules, growth is defined as ...
Increase in size of >2mm
52
The two PE risk calculators
Well's criteria Perc rule
53
Indications for PFTs
Diagnosing and monitoring disease course and response to therapy
54
Two main types of pulmonary diseases
Obstructive Restrictive
55
A scooped out, small flow-loop pattern is suggestive of ...
Mixed obstructive and restrictive lung disease
56
Severe hypoxemia SpO2 levels
<85%
57
Things measured during polysomnography testing
Apnea hypopnea index (AHI) - number of apneas per hour Sometimes Respiratory Disturbance Index is used (more sensitive, includes hypopneas and apneas) Oxygen desaturation
58
A scooped out, normal sized flow-loop pattern is suggestive of ...
Obstructive lung disease
59
True or false. Pneumothorax is best visualized on chest x-ray in the expiratory view
True
60
pH - 7.29 PaO2 - 90 PaCO2 - 20 PaHCO3 - 16 Diagnose me!
Metabolic acidosis, partially compensated
61
pH - 7.35 PaO2 - 90 PaCO2 - 48 PaHCO3 - 37 Diagnose me!
Respiratory acidosis, fully compensated (taken from slide 30 first example) Bicarb is more out of range, so I think it should be fully comp met. alkalosis
62
Most important part of a patient encounter when trying to diagnose a patient with dyspnea
Patient history!
63
Calcifications are best viewed with this type of CT scan
CT without contrast
64
Reasons (8) for D-dimer to be elevated
DVT PE Pregnancy Malignancy Surgery Infection Inflammation Smoking (she did say "just know lots of things elevate")
65
Describe initial diagnosis method for TB
1.) Consider TB skin test 2.) TB blood tests/IGRAs (T-SPOT or QuantiFERON) Consider IGRAs first if patient had bacille Calmette-Guerin (BCG) vaccine OR people who can't come back for skin test follow-up
66
Diagnostic therapy used in patients with dyspnea
Oxygen
67
Pulmonary embolism is present in this percentage of patients with DVT
60-80%
68
Diagnostic procedures (2)
Bronchoscopy Thorascopy (VATS)
69
In patients 35 or older without symptoms or risk factors of lung cancer, at what size should a lung nodule be followed up on?
>8mm
70
Biggest indication for DLCO testing
Restrictive (intrinsic) lung disease
71
Is FEV1 <80% suggestive of obstructive or restrictive lung disease?
Obstructive
72
pH - 7.12 PaO2 - 56 PaCO2 - 80 PaHCO3 - 34 Diagnose me!
Respiratory acidosis, partially compensated
73
Moderate hypoxia SpO2 levels and who this is most common in
86-91% Chronic lung conditions
74
pH - 7.55 PaO2 - 90 PaCO2 - 22 PaHCO3 - 24 Diagnose me!
Respiratory alkalosis, uncompensated
75
Breathing faster will increase or decrease blood pH?
Increase (more basic)

CDP (13 decks)

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