Pulmonology Flashcards
(124 cards)
1
Q
Asthma if FEV1 increases by?
A
12%
2
Q
Given methacoline with increased concentration, stopped when X drops by Y?
A
FEV1
Drops by 20%
3
Q
Positive methacholine challenge
A
> 16 = normal
4- 16 = borderline
1 -4 : mild (+)
<1 : moderate-severe
4
Q
Admission for asthma:
A
PEFR <50% predicted, ER visit within 3 days, status asthmaticus, post-treatment failure, AMS
5
Q
Intermittent asthma: symptoms
A
2 or less d/wk
6
Q
Intermittent asthma: night time awakenings
A
<2 x / month
7
Q
Intermittent asthma: SABA
A
2 or less d/wk
8
Q
Intermittent asthma: interfernece
A
none
9
Q
Intermittent asthma: lungs
A
FEV1 >80%
10
Q
Intermittent asthma: exacerbations
A
0-2 year
11
Q
Mild asthma: symptoms
A
> 2 d/wk
12
Q
Mild asthma: night time awakeneings
A
3-4 x month
13
Q
Mild asthma: SABA
A
> 2 d/ wk
14
Q
Mild asthma: Interference
A
minor
15
Q
Mild asthma: lungs
A
> 80%
16
Q
Mild asthma: exacerbations
A
> 2 yr
17
Q
moderate asthma: symptoms
A
daily
18
Q
moderate asthma: night time awakenings
A
> 1 x weekly
19
Q
moderate asthma: SABA
A
daily
20
Q
moderate asthma: interference
A
some
21
Q
moderate asthma: lungs
A
60-80%
22
Q
moderate asthma: exacerbations
A
> 2 years
23
Q
severe asthma: symptoms
A
throughout day
24
Q
severe asthma: nighttime awakenings
A
7x-week
25
severe asthma: SABA
several x day
26
severe asthma: interference
extreme
27
severe asthma: lungs
<60%
28
severe asthma: exacerbation
>2 year
29
Asthma treatment progression:
SABA --> ICS --> LABA or LD ICS OR MD ICS --> MD ICS + LABA --> HD ICS + LABA
30
What should not be used as a monotherapy in asthma?
LABA
31
Procalcitonin of X should encourage abx use?
>0.25
32
What arrythmia is associated with COPD?
MAT
33
MC type of emphysema?
Proximal acinar (centrilobular)
34
What type of emphysema is more common in upper lobes?
proximal acinar (centrilobular)
35
What type of emphysema is described as "moth-eaten"?
proximal acinar (centrilobular)
36
What type of emphysema is associated with alpha 1?
panacinar
37
What emphysema is more peripheral?
paraseptal
38
What type of emphysema is described as saw-toothed?
paraseptal
39
MC symptom of emphysema?
dyspnea
40
MC symptom of chronic bronchitis?
cough
41
FEV1/FVC < x = COPD
<0.70
42
FEV1 is used to categorize severity of COPD: GOLD 1
>80%
43
FEV1 is used to categorize severity of COPD: GOLD 2
<80%
44
FEV1 is used to categorize severity of COPD: GOLD 3
<50%
45
FEV1 is used to categorize severity of COPD: GOLD 4
<30%
46
What type of COPD is assoc with decreased vascular markings?
emphysema
47
What type of COPD is assoc with increased vascular markings?
chronic bronchitis
48
Gold guideline tx: A
SABA or short-acting anti-C
49
Gold guideline tx: B
LABA or long acting anti-C
50
Gold guideline tx: C
inhaled ICS + LABA or long-acting anti-c
51
Gold guideline tx: D
inhaled ICS + LABA or long-acting anti C
52
COPD treatment progression
SABA --> SABA + antic C or LABA --> SABA + anti C + LABA --> SABA + anti C + LABA + ICS
53
What should not be used as a monotherapy in COPD?
ICS
54
What treatment prolongs life in COPD?
02 if administered 15 hours a day
55
lung nodule if
3 cm
56
lung mass if >
3 cm
57
Location of lung nodule more likely to be malignant
upper lobe
58
MCC of malignant lung nodule
primary lung CA
59
MC primary lung CA
adenocarcinoma
60
MC benign cause of of SPN?
infectious granuloma
61
Nodule tx: <6 mm
annual CT every two years
62
nodule tx: 6-8 mm
LDCT in 3 months; if no increase repeat in 3 months.
- No increase: annual LDCT
- Increase: resect
63
Nodule tx: >8 mm
PET/CT
- -> low suspicion: LDCT 3 months, resect if increases
- -> high supsion, biopsy
64
MC site of bronchial carcinoid tumor?
GI
65
2nd MC site of bronchial carcinoid tumor?
lungs
66
Tx for NSCLC?
sx
67
Tx for SCLC?
chemo
68
MC type of bronchogenic carcinoma?
non-small cell
69
MC type of non-small cell lung cancer?
adenocarcinoma
70
Types of non-small cell cancer?
adenocarcinoma; squamous
71
Type of lung cancer assoc with pancoast tumor?
squamous
72
Lung cancer that has early mets?
small cell
73
Pancoast syndrome mneumonic?
CCCP: central, cavitary, hyper C, pancoast
74
SVC syndrome is MC with?
SCLC
75
Lambert-Eaton?
like MG, but weakness improves with use; associated with lung cancer
76
Pancoast has shoulder pain down what distribution of arm?
ulnar
77
Aspiration is MC in which lobe?
Right
78
Pneumonia CM quad?
cough + fever + dyspnea + pleuritic CP
79
MCC of bacterial pneumonia
Strep pneumo
80
Gram + cocci in pairs
strep pneumo
81
MCC of CAP
strep pneumo
82
yellow, green, blood tinged sputum
strep pneumo
83
gram + cocci in clusters
staph aureus
84
gram - bacilli (3)
klebsiella, h. flu, legionella
85
Pneumonia associated with cavitary lesions in upper lobes
klebsiella
86
currant jelly sputum
klebsiella
87
MCC of atypical "walking" pneumonia
mycoplasma
88
Pneumonia bug that's hard to stain
Legionella
89
Pneumonia assoc. with GI symptoms
legionella
90
Pneumonia assoc. with contaminated water
legionella
91
MCC HAP
pseudomonas
92
MCC of viral pneumonia in infants?
RSV, parainfluenza
93
MCC viral pneumonia in adults?
influenza
94
HAP criteria?
>48 hours after admission
95
VAP criteria?
48-72 hours after intubation
96
gold standard for diagnosis of pneumonia?
CXR
97
Urinary testing is available for what pneumonia bugs?
strep pneumo and legionella
98
CAP tx:
macrolide or doxy
99
CURB-65:
```
confusion
Urea (BUN) >19
respiratory 30+
BP <90/<60
Age: 65+
```
100
CURB-65: 0-1
outpatient
101
CURB-65: 2
inpatient vs. outpatient
102
CURB- 3+
inpatient
103
Reactivation TB is found in what aspect of lungs?
apical
104
Primary TB is found in what aspect of lungs?
middle/lower
105
If your two-step TB comes back positive, what do you have?
latent TB
106
If you have a positive TB, what is the next step?
get CXR --> 3 acid fast smears
107
Gold standard for TB
acid fast bacilli cultures
108
CXR TB
hillar adenopathy
109
Active TB tx:
- Phase 1: Rifampin + Isoniazid + Pyrazinamide + Ethambutol x 2 months
- Phase 2: INH + RIF x 4 months
110
TB: HIV
5+ mm
111
TB: organ transplant
5+ mm
112
TB: IC
5+ mm
113
TB: contact with TB
5+ mm
114
TB: fibrotic changes on CXR consistent with TB
5+
115
TB: Recent immigration (<5 years) from high prevalence country
10+
116
TB: IVDA
10+
117
TB: residence and employees of high risk congregate settings
10+
118
TB: Mycobacteriology lab
10+
119
TB: children <4 y/o
10+
120
TB: infants, children, adolescents exposed to adults in high-risk categories
10+
121
TB: those without RF
15+ mm
122
SE of INH?
increased LFTS, hepatitis
123
Purpose of latent TB tx?
helps decrease reactivation
124
Latent TB tx?
INH x 9 months; Rifampin x 4 months
| -Isoniazide + Rifapentine under DOT
