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The Final Step > Pulmonology > Flashcards

Pulmonology Flashcards

(88 cards)

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1
Q

What is the most common patient complaint with emphysema?

A

Shortness of breath

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2
Q

What age should vaccinations for pneumococcal pneumonia begin?

A

65

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3
Q

Prolonged expiration (low FEV1) should make you think of what diagnosis?

A

Asthma or COPD

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4
Q

Hampton’s hump on CXR should make you think of what diagnosis?

A

PE

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5
Q

How long after administering a PPD should it be read?

A

48-72 hours

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6
Q

A patient without a functioning spleen is more susceptible to what type of organisms?

A

Encapsulated organisms most commonly strep pneumoniae and H. flu

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7
Q

What is the most common cause of pneumonia in children less than 1 year old?

A

RSV

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8
Q

What is the treatment for pneumocystitis jiroveci?

A

Bactrim

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9
Q

What occupations are the most associated with berylliosis?

A

Aerospace and nuclear plant workers

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10
Q

What CXR finding combined with patient history might make you think of berylliosis?

A

Diffuse infiltrates with hilar adenopathy

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11
Q

What is the gold standard diagnosis of a pleural effusion?

A

Thoracentesis

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12
Q

When performing a decompression for a tension pneumothorax where do you put the needle?

A

2nd ICS at the midclavicular line

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13
Q

Tamiflu can be given to children above what age?

A

1

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14
Q

Zanamavir (Relenza) may be given to children above what age?

A

7

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15
Q

HIV patients with ground glass appearance on CXR should make you think of what diagnosis?

A

Pneumocystitis jiroveci pneumonia (PJP used to known as PCP)

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16
Q

A noncaseating granuloma should make you think of what diagnosis?

A

Sarcoidosis

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17
Q

A pearl formation on CXR should make you think of what diagnosis?

A

Squamous lung cancer

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18
Q

Ghon or ranke complexes on CXR should make you think of what diagnosis?

A

TB

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19
Q

A Westermark sign on CXR should make you think of what diagnosis?

A

PE

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20
Q

Mesothelioma is most commonly found in what lung location?

A

80% found in pleural lining

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21
Q

What CXR finding might make you think of mesothelioma?

A

Pleural thickening, remember 80% are found in pleura lining

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22
Q

Hyperinflation on CXR as well as eosinophelia on CBC should lead you to what diagnosis?

A

Asthma

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23
Q

What organism is the most common cause of pneumonia in a patient with cystic fibrosis?

A

Pseudamonas

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24
Q

A college student presents with pneumonia. What two organisms should you be thinking of?

A

Chlamydia and mycoplasma

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25
What size induration would a PPD be positive for in an HIV patient?
5mm
26
You suspect a pneumothorax. What instructions should go along with the order for a CXR?
It should be an end expiratory view in order to look for visceral pleural air
27
List the three most commonly used treatments for COPD?
Oxygen, ipatropium, and albuterol
28
List 4 medications which may cause asthma
Beta blockers, NSAIDS, ASA, ACE inibitors
29
Nobular opacities in the upper lung fields should make you think of what diagnosis?
Silicosis
30
What is the initial treatment for active TB?
RIPE | RIF + INH + PZA + EMB for several months followed by INH + RIF once sensitivities come back
31
Caseating granulomas should make you think of what diagnosis?
TB
32
"Blue bloater" refers to the characteristic physical exam findings of what disease?
Chronic bronchitis
33
A contralateral mediastinal shift should make you think of what diagnosis?
Tension pneumothorax
34
What is the best test to diagnose bronchiectasis?
CT
35
What are the main side effects of isoniazid (TB med INH)
Hepatitis and peripheral neuropathy
36
You are treating a patient for TB. He has noticed that this body fluids have an orange tint. What drug is causing this?
RIF (Rifampin)
37
Ethambutol has what major side effects?
Optic neuritis, red green vision loss
38
If you see a question that has anything to do with rats and the patient has pneumonia, what organism should you be thinking of?
Yersinia pestis
39
What is the most common organism causing pneumonia in COPD patients?
H. influenzae
40
Where is a pan coast tumor found on chest x-ray?
At the apex of either the right or left lung
41
Will evidence of TB be seen more frequently in the upper or lower lung lobes on CXR?
Upper
42
Patient with pneumonia has rust colored sputum. What diagnosis should you be thinking of?
Strep pneumonia
43
Coal miners lung often shows nodular opacities in what lung fields?
Upper lung fields
44
When you step up the diagnosis from intermittent asthma to mild persistent asthma what medication should you add?
Inhaled steroid like fluticasone
45
Any question about rabbits and pneumonia should make you think of what diagnosis?
Tularemia
46
Dullness to percussion should make you think of what diagnosis?
Lobular pneumonia
47
Young child presents to ER and you see him waiting in the tripod position. What diagnosis should you be thinking of?
Epiglottitis
48
At what size induration would a PPD be positive for a healthcare worker?
10mm
49
List 6 extrapulmonary complications of lung cancer
``` SPHERE SVC syndrome Pancoast tumor Horner's syndrome Endocrine problems Recurrent laryngeal symptoms Effusions (Exudative) ```
50
Currant jelly sputum should make you think of what diagnosis?
Klebsiella pneumoniae
51
What happens to TLC in sarcoidosis?
Decreases
52
What will the likely findings be on a CXR of a patient with asbestosis?
Linear opacities at the bases with pleural plaques
53
What are the most common cancers to metastasize to the lungs?
Breast, liver, colon
54
A thumbprint sign on X-ray should make you think of what diagnosis?
Later c-spine = epiglottitis
55
A barrel chest should make you think of what diagnosis?
Emphysema
56
Are the lungs noisy or quiet in COPD?
Quiet
57
List four indications for the flu vaccine
Child 6-59 months Pregnant female Healthcare worker Age greater than 50
58
Post tussive rales should make you think of what diagnosis?
TB
59
Parenchymal metastasis and blebs on CXR should make you think of what diagnosis?
Emphysema
60
Rhonci or wheezes that clear after coughing suggest what diagnosis?
Bronchi or atelectasis
61
Does FEV1 go up or down with asthma?
Down
62
A very sick patient with diffuse infiltrates that spare the costophrenic angles should make you think of what diagnosis?
ARDS
63
What is the most common cause for bronchiectasis?
CF
64
What is the gold standard for the diagnosis of CF?
Sweat chloride test
65
An exudative pleural effusion should make you think of what diagnosis?
TB, lung cancer
66
What is the treatment for epiglottitis?
2nd or 3rd generation cephalosporins (ceftriaxone) Erythromycin or clindamycin are other options
67
Transudative pleural effusions should make you think of what diagnosis?
CHF
68
What two lung cancers are typically found centrally on x-ray?
Small cell cancer and squamous cell cancer
69
What two lung cancers are typically found peripherally on x-ray?
Adenocarcinoma and large cell
70
Pertussis is most commonly treated with what antibiotic?
Erythromycin
71
List for most common places for metastasis from lung cancer?
Bone, brain, liver, adrenal glands
72
If you come across a question where the patient has erythema nodosum and an enlarged parotid gland what diagnosis should you be thinking of?
Sarcoidosis
73
What is erythema nodosum?
Tender red nodules found on the shins
74
A thin looking and flattened diaphragm on CXR should make you think of what diagnosis?
Emphysema
75
If you see a question with an alcoholic who has been diagnosed with pneumonia what is the most likely organism?
Klebsiella pneumoniae
76
Honeycombing and tram tracks on CXR should make you think of what diagnosis?
Bronchiectasis and idiopathic pulmonary fibrosis
77
Paradoxical pulses may be found in which pulmonary disorder?
Asthma
78
An older patient presents with pneumonia and diarrhea. What diagnosis are you thinking of?
Legionella pneumonia
79
Eggshell opacities on the CXR should make you think of what diagnosis?
Silicosis
80
List three causes of decreased tactile fremitus
COPD, asthma, pleural effuison, pneumothorax
81
Hyperresonance to percussion should make you think of what diagnosis?
Emphysema, pneumothorax, asthma
82
Tympany to percussion should make you think of what diagnosis?
Large pneumothorax
83
If you hear crackles in the lung fields list three pulmonary issues that should be in your differential
PNA, fibrosis, CHF, bronchitis
84
Does TLC go up or down in COPD
Up
85
List three differential diagnoses if you hear wheezes on lung exam?
Asthma, COPD, bronchitis
86
What is it called when a patient says "eeee" but on auscultation you hear "ay"
Egophony
87
A physical exam finding of egophany should make you think of what diagnosis?
Lobar pneumonia
88
CXR shows vascular redistribution and blurred vascular outlines. What diagnosis should you be thinking of?
CHF

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