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Pulmonology Flashcards

(143 cards)

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1
Q

Pneumovax indications

A

PCV13: 6wks-15mo

PPV23: 2-5 y/o, >65 y/o, chronic illness with increased CAP risk (sickle cell, splenectomy, liver dz, transplant, lung, heart)

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2
Q

COPD CAP organism

A

H. pneumo/flu

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3
Q

Children

A

RSV

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4
Q

Children >1y/o PNA cause

A

Parainfluenza virus

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5
Q

COPD CAP organism

A

H. pneumo

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6
Q

HAP (Nosocomial pneumonia) Tx

A

Vanco + Ceftazidime/Cefepime/Imipenem/(Zosyn) Piperacillin-Tazobactam/Cipro

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7
Q

Young, otherwise healthy, low-grade fever, mild pulm sx, nonproductive cough, myalgia, fatigue

A

Mycoplasma pneumo (MCC atypical pneumonia)

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8
Q

CAP Tx

A
  1. outpt: macrolide, doxy
  2. inpt: beta lactam/cephalosporin + macrolide, FQ
  3. ICU: beta lactam + macrolide/FQ
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9
Q

Nosocomial pneumonia (HAP) Tx

A

anti pseudomonal beta lactam + anti pseudomonal FQ/AG

Vanco + Ceftazidime/Cefepime/Imipenem/Piperacillin-Tazobactam/Cipro

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10
Q

Pharyngitis cause

A

GAS

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11
Q

Aspiration Pneumonia Tx

A

3rd gen cephalosporin + metronidazole/clindamycin

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12
Q

Tx Mycoplasma pneumo and Legionella CAP

A

erythromycin

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13
Q

Tx Chlamydia CAP

A

tetracycline

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14
Q

Influenza Tx

A

zanamivir or oseltamivir (Neuraminidase inhibitors)

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15
Q

PCP pneumonia Tx

A

Bactrim

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16
Q

CD4

A

Bactrim

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17
Q

Ghon and Ranke complexes mean?

A

healed/calcified primary infxn

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18
Q

Definitive Dx TB

A

M. tb in cultures, DNA, RNA amplification.

Acid fast bacilli does NOT confirm

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19
Q

Active TB Tx

A

INH/RIF/PZA/EMB x 2mo, INH/RIF x 4mo

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20
Q

Isoniazid ADRs

A

hepatitis, periph neuropathy

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21
Q

Add what to INH Tx?

A

B6 (pyridoxine)

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22
Q

Acute bronchitis MCC

A

virus (rhinovirus, coronavirus, RSV)

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23
Q

Tx acute exact chronic bronchitis- suspect bacterial cause

A

2nd gen cephalosporin

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24
Q

3rd gen ceph

A

cefdinir (Omnicef), ceftriaxone, cefotaxime, cefixime

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25
2nd gen ceph
cefoxitin
26
1st gen ceph
cephalexin (Keflex), cefazolin (Ancef)
27
When to suspect bacterial bronchitis
elderly, cardiopulm dz, cough >7-10 days, immunocompromised
28
MCC Bronchiolitis
RSV (paramyxovirus) seen after viral infxn
29
Epiglottitis Tx
2nd/3rd gen ceph
30
Tx Small cell lung CA
chemo. | REMEMBER: Small cell, Center, Chemo
31
Tx non-small cell lung CA (AdenoCA, SCC, large cell CA)
surgery
32
High suspicion for lung CA (lung nodule/mass)
>45y/o, >2cm, indistinct margins, rapid growth, NO calcification
33
Monitoring lung nodule
CT Q3mo x 1yr -> Q2mo x 2yrs
34
Paraneoplastic syndromes
Cushings, SIADH, hypercalcemia, gynecomastia, periph neuropathy, Lambert-Eaton (myesthenia), anemia, DIC, eosinophilia, thrombocytosis. - Squamous cell: Hypercalcemia - Lg cell: gynecomastia - Small cell: Cushings, SIADH, Eaton-Lambert
35
Asthma: FEV1/FVC, methacholine challenge test
20%
36
ICS
Fluticasone, Flovent, Pulmicort, Budesonide
37
LABA
Formoterol, salmeterol. -ICS + LABA = Advair, Symbicort
38
Cystic fibrosis inheritance pattern
autosomal recessive
39
Light's criteria for exudates
1. fluid:serum protein >0.5 2. fluid:serum LDH >0.6 3. fluid LDH >2/3 UNL of serum LDH
40
Homan's sign
PE, DVT pain with dorsiflexion
41
PE Tx
stable: heparin in acute phase, LMWH (Lovenox) or warfarin continued x 6mo unstable: thrombolytics - anticoag CI: IVC filter, embolectomy
42
honeycomb lung
idiopathic pulmonary fibrosis / interstitial fibrosis, bronchiectasis
43
insulation, demolition, construction
asbestosis
44
mining, stone work
silicosis
45
high technology (aerospace, nuclear, manufacturing)
berryliosis
46
erythema nodosum associated with what?
sarcoidosis. (also: enlarged parotids/lymph nodes/liver/spleen, uveitis) erythema nodosum= red, tender shins
47
Sarcoidosis labs/CXR
leukopenia, eosinophilia, incr ESR, hypercalcemia/uria, incr ACE, b/l hilar adenopathy, cutaneous anergy (decr rxn)
48
Sarcoidosis Tx
NONE | PO corticosteroids: worsening
49
3 MCC of ARDS
sepsis**, trauma, aspiration gastric contents
50
frothy pink/red sputum
ARDS
51
MCC respiratory dz in preterm infant
Hyaline membrane dz
52
Ground glass appearance
PCP, Hyaline membrane dz
53
pulmonary cap wedge pressure
ARDS
54
pulmonary cap wedge pressure >15
cardiogenic
55
what to use to distinguish true transudate vs pseduoexudate?
cholesterol
56
Hampton's hump
PE
57
Squamous cell lung CA extrapulm sx
hypercalcemia
58
small cell lung CA extrapulm sx
Lambert Eaton, SIADH
59
Dx of active TB infxn (3)
1. clinical 2. CXR 3. sputum (stain AND culture)
60
timing of HAP, VAP, HCAP
HAP >48hrs VAP >48-72hrs HCAP contact extensive
61
Tx pertussis
erythromycin
62
MCC and Dx bronchiectasis
cystic fibrosis, CT
63
extrapulm complications of lung CA (6)
SVC syndr, Pancoast tumor, Horner's, endocrine, recurrent laryngeal sx, exudative effusions
64
PNA and rats
Yersinia pestis
65
indications for flu vaccine (4)
>50y/o, underlying chronic med condition, 6-59 mo, preg, HCW, NH residents
66
MC location mesothelioma
pleural lining (pleural thickening on CXR)
67
eggshell opacities
silicosis
68
splenectomy vaccines given
H. flu, seasonal flu, N. gonorrhea, Pneumovax
69
very sick, lung infiltrates spare costophrenic angles
ARDS
70
Westermark sign
PE
71
Laryngotracheitis: sx
croup stridor, barking, seal like cough, hoarse, fever steeple sign
72
barking cough? whooping cough? | Tx
barking cough: croup (laryngotracheitis) 6mo-6y/o Tx: cool humidified air, PO steroids, epi whooping cough: pertussis
73
chemoreceptors location
central: medulla periph: carotid bodies, CN IX, aortic bodies, CN X
74
gold std test to Dx asthma
PFT
75
assess asthma severity/response in ED
peak exp flow rate (PEFR)
76
Tx asthma
SABA for acute +ICS +LABA +PO steroids send all home on short course PO steroids (unless super tiny exac)
77
ICS ADR
thrush
78
asthma FEV1: >80%, 60-80%,
>80% mild, 60-80% mod,
79
Tx allergic rhinitis, ASA-induced asthma
Leukotrienes | montelukast
80
genetic dz linked with COPD,
alpha1-antitrypsin def
81
COPD, resp acidosis/alk
resp acidosis, incr CO2, hypoxic: chronic bronchitis | resp alk: emphysema
82
arrhythmia with COPD
MAT
83
COPD: FEV1/FVC
84
COPD: DLCO
decr in emphysema
85
COPD Dx gold std test
PFT/spirometry
86
Tx COPD
anticholinergics (ipratropium, atrovent) preferred O2- for cor pulmonale (>90% at rest) pneumo and flu vaccines
87
inhaled anticholinergic ADR (ipratropium)
BPH...
88
bronchiectasis MCC
``` cystic fibrosis (in US) Pseudomonas ``` H. flu (if not CF)
89
bronchiectasis test of choice
CT
90
Signet ring sign
bronchiectasis pulm A. with dilated bronchus
91
pseudomonas abx
fluoroquinolone, Zosyn (piperacillin-tazobactam), aminoglycoside (gentamicin), cephalosporin (cefepime), imipenem
92
H flu: bacteria type
gram neg, coccobacillus, facultative anaerobe
93
CF lung dz
bronchiectasis
94
young, bronchiectasis, pancreatic insuff, growth delays, infertility, vit ADEK def, DM
CF
95
meconium ileus at birth
CF
96
elev sweat chloride test
>60
97
obstructive lung dz
BRONCHIECTASIS, CF...
98
sarcoidosis: what exam in ALL pts
ophthalmic
99
lupus pernia assoc with what?
sarcoidosis. | violaceous, raised discoloration- face
100
cornerstone of COPD Tx
anticholinergics- ipratropium
101
sarcoidosis: lung findings
b/l hilar lymphadenopathy
102
Tx sarcoidosis
``` none PO corticosteroids (if worsening) ```
103
exposure: silicosis, byssinosis
silicosis: quarry, pottery, sandblasting byssinosis: cotton, textile
104
reduce asbestosis -> CA risk how?
smoking cessation
105
lung location: silicosis, CWL, asbestosis
upper: silicosis, CWL lower: asbestosis
106
benign pulm nodule
calcifications, cavitary
107
Small cell carcinoma: Tx
oat cell, SCLC central Tx chemo
108
NSCLC: Tx
Tx surgery (more cancers, cut it out) Adenocarcinoma: nonsmokers Squamous: central Large cell
109
Squamous cell: extrapulm
hypercalcemia, Pancoast, Horner's
110
Small cell: extrapulm
SIADH, Eaton-Lambert, SVC syndr
111
MCC CA deaths
lung CA
112
Tietze syndr
tenderness at costochondral/sternal junction + PALPABLE EDEMA
113
amt fluid seen on CXR
>175 mL
114
pulsus paradoxus + lung condition- tachypnea
tension PTX
115
PE initial screening test, gold std
initial: CT | gold std: pulm angiography
116
heparin antidote
protamine sulfate
117
pneumonia- hypoNa, incr LFTs
Legionella
118
pneumonia- cavitary lesions
Klebsiella
119
pneumonia- after viral illness/flu
S aureus
120
viral pneumonia in adults, kids
adults: influenza kids: RSV
121
consolidation sx
bronchial BS, incr tactile fremitus
122
INH ADR, prevention of ADR
peripheral neuropathy, hep prevent: B6 (pyridoxine)
123
Pyrazinamide ADR
hyperuricemia, photosensitivity, hep
124
ethambutol ADR
peripheral neuropathy, optic neuritis
125
RIF ADR
thrombocytopenia, orange
126
latent TB Tx
``` INH x 9mo plus pyridoxine (B6) ```
127
URI sx -> 1-2days later resp distress, wheezing | young child
bronchiolitis
128
RF bronchiolitis
cigarette exposure, no breastfeed, premature
129
Tx bronchiolitis
humidified O2
130
MCC acute bronchitis (vs bronchiolitis)
bronchitis: adenovirus bronchiolitis: RSV both after URI
131
definitive Dx epiglottitis
laryngoscopy
132
pertussis phases
catarrhal: URI paroxysmal: coughing fits, whoop after, emesis convalescent: resolving
133
MCC death in 1st mo of life
``` infant RDS (hyaline membrane dz) Tx: exogenous surfactant, steroids to fetus ```
134
severe refractory hypoxemia, not responsive to 100% O2
ARDS
135
Dx, Tx ARDS
cardiac cath of pulm artery: PCWP
136
flu vaccine CI
eggs, gelatin, thimerosal allergy
137
normal BS
bronchial: trachea, larynx bronchovesicular: primary bronchus vesicular: all areas
138
Cheyne Stokes causes
hypercapnia, decr brain blood flow
139
Biot's breathing causes
opioid use, medulla oblongata damage
140
MCC pulm HTN
idiopathic
141
pulm HTN sx
middle aged/young female cor pulmanale, R HF, RVH, RAE, RAD, RBB
142
definitive Dx pulm HTN
R sided cath (pulm artery pressure >25)
143
pulm HTN TX
CCB

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