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pulmonology Flashcards

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1
Q

PAINT in restrictive lung disease

A 
Pleural 
alveolar
intersticial lung disease
inflamatory
idiopathic
Neuromuscular
Thoracic wall
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2
Q

Pleural problem causing restrictive disease(4)

A

fibrosis
effusions
empyema
pneumothorax

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3
Q

alveolar problem causing restrictive disease(3)

A

edema
hemorrage
pus

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4
Q

intersticial lung disease causing restrictive disease

A

idiopathic pulmonary fibrosis

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5
Q

inflammatory problem causing restrictive disease(2)

A

sarcoid

bronchiolitis obliterans with organised pneumonia

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6
Q

Neuromuscular problem causing restrictive disease(3)

A

myasthenia gravis
phrenic nerve palsy
myopathy

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7
Q

thoracic wall problem involved in restrictive pulmonary disease(5)

A 
kyphoscoliosis
obesity
ascites
pregnancy
ankylosing spondilytis
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8
Q

drugs associated with intersticial lung disease(6)

A 
busulfan
nitrofurantoin
amiodarone
radiation
bleomycin
long term o2 concentration
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9
Q

features of sarcoid GRUELING

A 
granulomas
rheumatoid arthritis
uveitis
erythema  nodosum
lymphadenopathy
intersticial fibrosis
negative TB test
gammaglobulinemia
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10
Q

lab for sarcoidosis(3)

A

high ACE
hypercalcemia
high ALP

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11
Q

antigens of hypersensitivity pneumonitis associated with farmer’s lung

A

spores of actinomycetes from moldy hay

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12
Q

antigens of hypersensitivity pneumonitis associated with bird fancier’s lung(3)

A

antigens from feathers
excreta
serum

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13
Q

antigens of hypersensitivity pneumonitis associated with mushrom worker’s lung

A

spores actinomycetes from compost

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14
Q

antigens of hypersensitivity pneumonitis associated with malt worker’s lung

A

spores of aspergillus clavatus

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15
Q

antigens of hypersensitivity pneumonitis associated with grain handler’s lung

A

grain weevil dust

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16
Q

antigens of hypersensitivity pneumonitis associated with bagassosis

A

spores of actinomycetes from sugar cane

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17
Q

antigen associated with air conditioner lung

A

spores of actinomycetes from air conditionners

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18
Q

causes of obstructive pulmonary disease(4)ABCT

A

asthma
bronchiectasis
cystic fibrosis
tracheal or bronchial obstruction

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19
Q

physiopatho in asthma symptoms(5)

A 
reversible airway obstruction
bronchial hyperactivity
airway inflammation
mucous plugging
smooth muscle hypertrophy
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20
Q

diseases in pneumoconiosis(4)

A

asbestosis
coal mine disease
silicosis
beryliosis

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21
Q

biopsy in asbestosis

A

asbestos bodies

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22
Q

occupation link with coal mine disease

A

work in undergroung coal mine

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23
Q

CXR in coal mine disease

A

small nodular opacities < 1 cm in upper lung zones

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24
Q

complication of coal mine disease

A

progressive massive fibrosis

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25
CXR in silicosis
small < 1 cm nodular opacities in upper lung | eggshell calcification
26
complication of silicosis(2)
high risk of TB | progressive massive fibrosis
27
what to do in silicosis
need annual tb skin test
28
CXR of beryliosis(2)
diffuse infiltrates | hilar adenopathy
29
rx for beryliosis
chronic steroid rx
30
asthma triggers(5)
``` allergens URI cold air exercice stress ```
31
when to suspect asthma in children(2)
children with multiples episodes of croup | and URI associated with dyspnea
32
definitive Dx of asthma
methacholine test
33
rationale of methacholine test
test bronchial hyperresponsiveness
34
when to perform methacholine test
should be performed >/ 3 months following an acute episode
35
B2 agonist medication action
relaxes bronchial smooth muscle
36
long acting B2 agonist
salmeterol
37
class of drug for theophyline
methylxanthines
38
action of theophyline
cause bronchodilation by inhibiting phosdiesterase
39
consequence in inhibition of phosphodiesterase in the setting of theophyline use
Decrease C AMP hydrolysis
40
limitation in use of theophyline
narrow therapeutic index
41
side effect of theophyline(2
cardiotoxicity | neurotoxicity
42
action of ipratopium
muscarinic antagonist
43
action of muscarinic antagonist
block of muscarinic receptors preventing bronchoconstriction
44
action of cromolyn
prevents release of mediators from mast cells
45
importance of cromolyn
important in asthma prophylaxis
46
indication of corticosteroids in asthma
first line rx in chronic asthma
47
drug ,antileukotriens(2)
zileuton | zafirlukast
48
action of zileuton(2)
5 lipoxygenase pathway inhibitor | blocks conversion of arachidonic acid acid leukotriens
49
action of zafirlukast
blocks leukotriens receptors
50
quid of bronchiectasis
dialtion of bronchi due to cycles of infection and inflammation
51
CT for bronchiectasis(2)
dilated airways | ballooned cysts at the end of the bronchus
52
xray in bronchiectasis(2)
tram lines | honeycombing area
53
tram lines
parallele lines outlining dilated bronchi
54
physio patho of tram lines in bronchiectasis
peribronchial inflammation and fibrosis
55
dx differantiel de bronchiectasis BRONCHIECTASIS
``` Bronchial cyst repeated gastric acid or due to foreign bodies necrotizing pneumonia chemical corrosicve substance hypogammaglobulinemia immotile cilia syndrome eosinophilia cystic fibrosis TB ATOPIC BRONCHIAL ASTHMA strep pnuemonia in young syndrome staph pneumonia ```
56
CAUSE OF EMPHYSEMA
terminal airway destruction
57
Cause of panlobular emphysema
alpha 1 antitrypsin deficiency
58
Cause of centrilobular emphysema
smoking
59
COPD(2)
emphysema | chronic bronchitis
60
Pink puffer appearance
emphysema
61
symptoms in pink puffer(2)
dyspnea | pursed lips
62
blue bloater appearance
chronic bronchitis
63
symptoms of blue bloater
productive cough
64
CXR of emphysema(2)
hyperinflated lungs | parenchymal bullae or subpleural blebs
65
pathognomonic chest xray in emphysema
bleb subpleural or parenchymal bullae
66
swanz ganz wedge pressure in ARDS
< 18 mm de hg
67
main pulmonary vasculature disorder
pulmonary hypertension
68
pulmonary hT
> 25 mm de hg
69
cause of pulmonary hypertension(3)
left heart failure mitral valve disease increase resistance in the pulmonary veins
70
dyspnea tachycardia normal XCR in a hospitalised and or bedridden patient what to think
pulmonary embolism
71
rx of sleep apnea(3)
weight loss continuous positive airway pressure (CPAP) avoid alcohol and sedatives
72
main location for lung cancer metastasis(4)
bone liver adrenals brain
73
lung cancer associated with gynecomastia
large cell
74
lung cancer associated with hypertrophic pulmonary osteoarthropathy
non small cell
75
small cell carcinoma and neuromuscular syndrome
peripheral neuropathy subacute cerebellar degeneration Myasthenia (eaton lambert syndrome)
76
lung cancer associated with dermatomyositis
All
77
lung cancer associated with anemia
all
78
lung cancer associated with DIC
all
79
lung cancer associated with eosinophilia
all
80
lung cancer associated with thrombocytosis
all
81
lung cancer associated with acanthosis nigricans
all
82
lung cancer associated with erythema gyratum repens
all
83
lung cancer assoiciated with thrombophlebitis
adenocarcinoma
84
lung cancer assoiciated with nonbacterial verrucous endocarditis
adenocarcinoma
85
quid of horner syndrome(3)
miosis ptosis anhidrosis
86
presentation of Pneumothorax Pthorax
``` Pleuritic chest pain tracheal deviation hyperresonnance onset sudden reduced breath sounds absent fremitus xrays shows collapse ```
87
the most common lung cancer
adenocarcinoma
88
localisation of adenocarcinoma
peripheral
89
localisation of SCC
centrally located
90
3 types of pneumothorax
spontaneous secondary tension
91
spontaneous pneumothorax why
rupture of subpleural apical blebs
92
presentation of spontaneous pneumothorax (3)
young males thin tall
93
cause of secondary pneumothorax(4)
infection Trauma COPD iatrogenic
94
iatrogenic cause of secondary pneumothorax(4)
thorococentesis subclavian line placement Positive pressure mechanical ventilation bronchoscopy
95
first rx in tension pneumothorax(2)
needle decompression | followed by chest tube
96
dx of wegener (graulomatosi with polyangitis)
serum antineutrophilic cytoplasmic antibody(C anca)
97
rx of wegener
cytotoxic agent plus corticosteroids
98
c8 t2 involvement
weakness and atrophy of intrinsic hand muscles
99
initial management if you suspect pancoast tumor
chest xray
100
spirometry in obstructive disease
low fev1/fvc
101
next step in front of low FEV1/FVC
brochodilator challenge
102
increase of FEV 1 in bronchodilator challenge dx
asthma
103
no change in FEV 1 inbronchodilator challenge
COPD
104
spirometry in restrictive disease
normal or high FEV1/FVC
105
next step in normal or high FEV1/fvc in restrictive disease
DLCO test
106
quid of peak airway
sum of airway resistance plus plateau pressure
107
quid of plateau pressure
sum of the elastic pressure and PEEP
108
how to calculate plateau pressure
during end inspiratory hold maneuver
109
how to calculate PEEP
during end expiratory hold maneuver
110
high peak pressure and high plateau pressure
decreased lung compliance
111
procees causing decreased pulmonary compliance(5)
``` pneumothorax pulmonary edema pneumonia atelectasis right mainstem intubation ```
112
high peak pressure with normal plateau pressure(3)
bronchospasm mucus plug biting ET tube
113
normal plateau pressure
< 30
114
fev1 in obstructive lung disease
< 80%
115
FEV 1 in restrictive lung diseasae
< 80%
116
indication of long term o2 therapy in COPD(3)
PAo2 < 55 and SAO2 < 88 % cor pulmonale with pulmonary hypertension or Hmt > 55% patient with resting awake PA)2 > 60 mm de hg with sao2 90% if they become hypoxic during exercice or sleep
117
rule to put patient with cor pulmonale on home o2 if copd
evidence of pulmonary HTA or hmt> 55% should be started on Home oxygen even if PAo2 is 56-59 mm de hg with SAO2 > 89%
118
causes of exsudate(7)
``` infections malignancy connective tissue disease inflammatory disorders movement of fluid from abdomen to pleural space coronary artery bypass surgery pulmonary embolism ```
119
co2 narcosis risk and worsening hypercapnia in patient with high flow o2 supplemental in the setting of acute on chronic respiratory failure(3)
reduced alveolar ventilation increased dead space ventilation causing ventilation perfusion mismatch decreased hb affinity for co2
120
postpartum omen with pulmonary symptoms and multiple nodules on chest xray
choriocarcinoma
121
cardiac cause of hemoptysis
mitral stenosis with acute pulmonary edema
122
infectious disease causing hemoptysis(2)
TB | Lung abcess
123
vasculopathy causing hemoptysis
arterioveinous malformations
124
hematologic disease causing hemoptysis
coagulopathy
125
systemic disease causing hemoptysis(4)
wegener goodpasture SLE vasculitis
126
gold standard test for cor pulmonale
right heart catheterisation
127
finding in right catetherisation on cor pulmonale(3)
right ventricular dysfunction pulmonary HT no left heart disease
128
right ventricular failure symptoms(6)
``` Jugular venous distension increased intensity of P2 right ventricular heave hepatomegaly pitting edema ascites possible ```
129
complication of severe atrial enlargement in mitral stenosis
elevated left main bronchus
130
conditions associated with digital clubbing(4)
intrathoracic neoplasms intrathoracic suppurative disease lung disease cardiovascular disease
131
intrathoracic neoplasms associated with digital clubbing(4)
bronchogenic carcinoma metastatics cancer malignnat mesothelioma lymphoma
132
intrathoraci suppurative disease associated with digital clubbing(5)
``` lung abcess empyema bronchiectasis cystic fibrosis chronic cavitary infections ```
133
lung disease associated with digital clubbing(3)
idiopathic pulmoanry fibrosis asbestosis pulmonaary arterio veinous malformation
134
cardiovascular disease associated with digital clubbing
cyanotic congenital heart disease
135
dx of digital clubbing
angle between nail fold and nail plate >180 o
136
lovibond 's angle
angle between nail fold and nail plate >180 o
137
symptoms superior vena cava syndrome(3)
dyspnea swelling of the head swelling of arms adn neck
138
most common cause of SVC
malignancy
139
malignancy involved in SVC(2)
``` lung cancer (small cell lung cancer) Non hogkin lymphoma ```
140
other causes of SVC syndrome(2)
fibrosisng mediastinitis | thrombosis secondary to indwelling central venous devices
141
best test to in SVC
chest x ray
142
most common pulmonary complications in patients with systemic sclerosis
intersticial fibrosis
143
restrictive pattern with low DLCO(4)
intersticial lung diseases sarcoidosis asbestosis heart failure
144
restrictive pattern with normal DLCO(2)
musculoskeletal deformity | neuromuscular disease
145
restrictive pattern with increased DLCO
morbid obesity
146
two ways to decrease mortality in COPD(2)
smoking cessation | home oxygen therapy
147
external manif of wegener(2)
nasal cartilage destruction | vasculitic cutaneous lesions
148
low grade fever dyspnea and chest pain after hemothorax
empyema
149
patient with urticaria and respiratory distress dx
upper airway obstruction
150
complication of chemo or radiation in Hodgkin lymphoma
secondary malignancy
151
sites of secondary malignancy in post radiation and chemo (5)
``` lung breast thyroid bone GI ```
152
most common malignancy in asbestos
bronchogenic carcinoma
153
test helping differentiate asthma from chronic OPD
spirometry before and after bronchodilator

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