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- Med School Review 🔥 > Pulmonology > Flashcards

Pulmonology Flashcards

(101 cards)

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1
Q

Mixed aerobic/anaerobic sputum Cx

A

Aspiration PNA

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2
Q

PNA in alcoholic

A

aspiration PNA

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3
Q

Foul-smelling sputum + periodontal dz

A

Aspiration PNA

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4
Q

2nd most common cause of death in AAT

A

Cirrhosis!

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5
Q

COPD w/o risk factors

A

AAT

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6
Q

ASA + Asthma

A

AERD

(Aspirin-exacerbated respiratory disease);

pseudoallergic rxn to NSAIDs in asthmatics,

chronic rhinositis w/ nasal polyposis.

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7
Q

Splinter hemorrhage

A

think septic emboli 2/2 subacute infective endocarditis (SIE).

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8
Q

Decreased PaCO2

A

Hyperventilation (e.g. PE)

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9
Q

Increased PaCO2

A

Respiratory failure

(e.g. botulism)

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10
Q

Right Axis Deviation on EKG

A

RV strain —> PE vs. pHTN

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11
Q

Enlarged pulmonary arteries on CXR

A

pHTN

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12
Q

Enlarged RV on CXR

A

pHTN

(RV failure is late manifestation)

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13
Q

Wedge-shaped density on CT

A

PE

(vascular distribution)

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14
Q

Diffuse interstitial lung pattern on CT

A

PJP

(CD<200/mm3)

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15
Q

Cavitary lesion on CT

A

TB

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16
Q

Leukocytes in methylprednisolone treatment

A

Leukocytosis w/ neutrophilic predominance

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17
Q

Eosinophilia

A

Drug/Allergic reaction vs. Parasitic infection vs. Malignancy

  • Hypersensitivity reaction
  • TEN
  • DRESS
  • Leukemia or Lymphoma
  • Churg-Strauss (eosinophilic granulomatosis w/ polyangiitis)
  • Helminths/schistosomes (NOT protozoans!)
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18
Q

Dopamine agonists treat

A

PD, prolactinomas, RLS

(restless leg syndrome).

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19
Q

Alpha 2-adrenergic agonists treat:

A
  • HTN (clonidine, methyldopa)
  • Anesthesia (dexmedetomidine)
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20
Q

Alpha-adrenergic blockers (vasodilators) treat

A

BPH & HTN

(prazosin, terazosin, doxazosin).

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21
Q

Renal + pulmonary findings

A

Goodpasture disease

(anti-basement membrane antibodies)

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22
Q

PTX in COPD pt

A

Rupture of alveolar blebs

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23
Q

PTX Auscultation

A

Decreased breath sounds,

decreased tactile fremitus,

hyperresonant percussion

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24
Q

Atalectasis Auscultation

A

Decreased BS,

decreased tactile fremitus,

dullness to percussion

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25
Pleural effusion auscultation
Decreased BS, decreased tactile fremitus, dullness to percussion
26
Consolidation
Increased BS (+crackles, + egophony), Increased tactile fremitus, dullness to percussion
27
Emphysema | (same as PTX)
Decreased BS, Decreased tactile fremitus, hyperresonant to percussion
28
Mediastinal shift
* Away from = PTX, Pleural effusion (if large) * Toward = Atalectasis (if large)
29
COPD pt + seizures
2/2 hypercapnia (CO2 retention) from chronic disease or O2 supplementation (\>92%)
30
Noncaseating granulomas + BL hilar adenopathy
Sarcoidosis
31
Noncaseating granulomas
Hypersensitivity pneumonitis or sarcoidosis
32
Elevation of L main bronchus on CXR
Enlarged LA from long-standing mitral stenosis from RHD (think immigrants)
33
GERD can worsen asthma via
microaspiration
34
Urine osmolality in hypovolemia
ncreased | (dark urine; to conserve water)
35
Urine sodium in hypovolemia
decreased (most sensitive indicator of hypovolemia)
36
Plasma renin activity in hypovolemia
increased
37
Urine urea nitrogen in hypovolemia
Decreased | (increased BUN reabsorption)
38
Aldosterone stimulates sodium exchange for \_\_\_\_\_
**potassium** | (in collecting tubules)
39
Serum potassium in hypovolemia
decreased (due to aldosterone’s effects on collecting tubules)
40
Panacinar emphysema
Alpha-1 Antitrypsin Deficiency | (AAT)
41
**Centriacin**ar emphysema
**COPD** | (smoking-induced)
42
Lung cancer + hypercalcemia
SQUAMOUS CELL CARCINOMA of the lung (“sCa++mous” cell carcinoma of the Lung)
43
Lung cancer + SIADH
SCLC | (Small-cell carcinoma of the lung)
44
Lung cancer + ACTH production
SCLC | (Small cell carcinoma of the lung)
45
Chest mass + Hypercalcemia
SCC of the lung vs. Sarcoidosis * Sarcoid = +Erythema nodosum, BL hilar adenopathy * SCC of the lung = +smoking hx, older
46
Productive cough COPD
**Chronic Bronchitis**
47
Dyspnea COPD
**Emphysema**
48
PNA has _increased/decreased_ lung sounds
**increased**
49
Increased lung sounds
consolidation
50
New-onset RBBB
Right heart strain | (think PE vs pHTN/cor pulmonale)
51
**cANCA**+ —\>
GPA | (Granulomatosis w/ Polyangiitis)
52
**pANCA**+ —\>
* Microscopic polyangiitis * Eosinophilic granulomatosis w/ polyangiitis * PSC (Primary sclerosing cholangitis)
53
Auditory canal ulcers
**GPA** * Granulomatosis with Polyangiitis (Wegener's granulomatosis) * +triad of sinusitis, hemoptysis, hematuria
54
Most common cause of hemoptysis in adults
**Chronic bronchitis** | (productive COPD)
55
COPD Exacerbations are most commonly triggered by
**URIs** Thus, may present with fever
56
Pleural plaques on CXR
Asbestosis
57
Navy shipyard work
Asbestosis
58
Drug-induced pulmonary fibrosis
Amiodarone, Bleomycin, Busulfan, MTX, Nitrofurantoin
59
Restrictive PFTs w/ normal DLCO
OHS, MG, ALS | (not ILD; extrinsic)
60
Most common adverse effect of low-dose inhaled corticosteroids
**Thrush** Normal A-a gradient (oral candidiasis)
61
Normal A-a gradient
\<15 and increases with age
62
Elevated A-a gradient regardless of age
\>30
63
Normal A-a gradient hypoxemia causes
* Altitude (reduced inspired O2 tension) * Hypoventilation * Increased A-a gradient hypoxemia causes: * V/Q * R-L Shunt * Diffusion Limitation
64
Anaerobic PNA is higher risk in
Alcoholics, Dysphagia | (foul-smelling sputum)
65
Low bicarbonate
metabolic acidosis
66
AAT presentation age
40s in nonsmokers, 30s in smokers
67
Rhinosinusitis + Hemoptysis + Hematuria
GPA | (Wegener)
68
Asthma Tx:
Asthma Tx * SABA * +ICS low-dose * +LABA or ICS med-dose * ICS med-dose + LABA * ICS high-dose + LABA * +oral corticosteroid * Consider omalizumab for pts w/ allergies
69
Markedly decreased L breath sounds immediately after intubation
Malpositioned ETT | (R main bronchus)
70
Positive bronchodilator response (\>12%) in FEV1
Asthma, always, 100% of the time.
71
Ring sign or tram-track sign on CXR
Bronchiectasis
72
How to confirm diagnosis of bronchiectasis
HRCT | (High-res CT)
73
Diffuse BL interstitial infiltrates in imcx
PJP **(PCP**)
74
Fever, chest pain, hemoptysis triad + halo sign on CXR in imcx
**Invasive aspergillosis**
75
+galactomannan in serum
**Invasive aspergillosis**
76
CXR: Nodules w/ surrounding ground-glass opacities
**Invasive aspergillosis** | (“Halo” sign)
77
Peripheral lung cancer
**Adenocarcinoma** vs. **Large cell carcinoma**
78
Infusion of NS may worsen hyponatremia in patients with \_\_\_
SIADH
79
Elevated AFP only
Hepatoblastoma/HCC
80
Elevated AFP + B-hCG
Non-seminomatous germ cell tumor
81
Elevated B-hCG only
Seminomatous tumor
82
**Anterior Mediastinal Mass**
“4 T’s” * **T**hymoma * **T**hyroid neoplasm * **T**eratoma (+ other germ cell tumors) * _Seminomatous_ - **Elevated B-hCG (30%)**, Normal AFP * _Non-seminomatous_ - **E****levated B-hCG, Elevated AFP** (yolk sac, choriocarcinoma, embryonal carcinoma, mixed germ cell) - * “**T**errible” Lymphoma
83
Lung disease superimposed on cavitary TB
CPA Chronic Pulmonary Aspergillosis
84
Localized airway obstruction (e.g. recurrent PNA in same anatomic location)
**CT Scan** | (for malignancy)
85
\_\_\_\_ improves mortality in patients with ARDS
LTVV
86
Most common cancer in pts w/ asbestos exposure
**Bronchogenic carcinoma** (pleural mesothelioma is actually much more rare)
87
Honeycombing
* Asbestosis * Eosinophilic granuloma * Bronchiectasis
88
Normal/High FEV1/FVC
**Restrictive** * +Decreased DLCO = ILD * +Normal DLCO = Chest wall weakness
89
Low FEV1/FVC
**Obstructive** * +Decreased DLCO = COPD
90
Central lung cancer
**SCC** or **SCLC**
91
Lung cancer + hypercalcemia
**SCC of lung**
92
Lung cancer + clubbing + HPOA
**Adenocarcinoma**
93
Lung cancer + Cushing syndrome
**SCLC**
94
Lung cancer + SIADH
**SCLC**
95
Lung cancer + Lambert-Eaton syndrome (LE)
**SCLC**
96
Lung cancer + Gynecomastia/Galactorrhea
**Large Cell Carcinoma of the lung**
97
Lung cancer + e/o necrosis/cavitation
**SCC**
98
Most common primary lung cancer in smokers and non-smokers
**Adenocarcinoma**
99
Most common complications of near drowning
* ARDS * Brain damage (increased ICP or cerebral edema) * Arrhythmias * Acidosis (metabolic or respiratory) * ATN (2/2 prolonged hypoxemia/shock)
100
Tx for Hypersensitivity Pneumonitis or Sarcoidosis
Steroids | (Glucocorticoids)
101
Rule out TB before initiating these treatments:
* Glucocorticoids (e.g. for hypersensitivity pneumonitis or sarcoidosis) * MTX

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