Respiratory Disorders Flashcards
(112 cards)
1
Q
common cause of pneumonia in immunocompromised patients
A
PCP
2
Q
most common cause of atypical/walking pneumonia
A
mycoplasma pneumoniae
3
Q
common causative agent for pneumonia in alcoholics
A
klebsiella
4
Q
can cause an interstitial pnuemonia in bird handlers
A
chlamidya psitacci
5
Q
often the cause of pnuemonia in a patient with a history of exposure to bats
A
histoplasma
6
Q
cause of pneumonia in a patient who has recently visited california, new mexico, or west texas
A
coccidiomycoses
7
Q
pnuemonia associated with “current jelly” sputum
A
klebsiella
8
Q
pneumonia associated with Q fever
A
coxiella burnetti (interstitial pneumonia)
9
Q
pneumonia acquired from air conditioners
A
legionella
10
Q
most common cause of pnuemonia in children 1 year old or younger
A
RSV
11
Q
most common cause of pnuemonia in neonate
A
GBS and E coli
12
Q
most common cause of pneumonia in children and young adults
A
mycoplasma pneumonia
13
Q
common cause of pneumonia in patients hospitalized or with other health probelms
A
klebsiella pneumoniae
14
Q
most common cause of viral pneumonia
A
RSV
15
Q
life-threatening pneumonia causes wool-sorter’s disease
A
bacillus anthracis
16
Q
common bacterial cause of COPD exacerbation
A
haemophilus influenzae
17
Q
common pneumonia in ventilator patients and those with cystic fibrosis
A
pseudomonas
18
Q
pontiac fever
A
legionella
19
Q
pneumonia gram + cocci in clusters
A
staph aureus
20
Q
pneumonia gram + cocci in pairs
A
strep pneumoniae
21
Q
pneumonia gram - rods in 80 year old
A
e. coli
22
Q
pneumonia gram + cocci in nenonate
A
GBS
23
Q
pneumonia gram - rods in neonate
A
e. coli
24
Q
size of induration for positive reading in patient who is HIV-positive
A
5 mm
25
size of induration for positive reading in patient who had close contact with TB-infected patient
5 mm
26
size of induration for positive reading in patient who has signs of TB seen on CXR
5 mm
27
size of induration for positive reading in patient in homeless patients
10 mm
28
size of induration for positive reading in patient in immigrants from developing nations
10 mm
29
size of induration for positive reading in patient with IV drug abuse
10 mm
30
size of induration for positive reading in patient in chronically ill patients
10 mm
31
size of induration for positive reading in patient in health care workers
10 mm
32
size of induration for positive reading in patient with recent incarceration
10 mm
33
size of induration for positive reading in patient that does not fit into other category
15 mm
34
how is diagnosis of active TB made
sputum acid fast stain
sputum culture for TB
bronchoscopy with bronchoalveolar lavage or biopsy
35
how can PCWP distinguish between ARDS and cardiogenic edema
< 18 in ARDS
| > 18 in cardiogenic
36
differential diagnosis of ground-glass infiltrates on CXR
```
interstitial pneumoniae
PCP
pulmonary edema
pulmonary hemorrhage
hypersensitivity pneumonitis (from methotrexate)
heroine, cocaine
```
37
normal A-a gradient
5 - 15 mmHg
38
what causes a high A-a gradient
pulmonary embolism
pulmonary edema
ARDS
39
emperic treatment for pnuemonia in a 2 month-old
macrolide
40
empierc treatment for pnuemonia in a 2 year-old
amoxicillin or ampicillin
41
treatment for atypical pneumonia
macrolide
42
next step in work-up of patient with a solitary pulmonary nodule
compare to previous CXR
43
definition of chronic bronchitis
> 3 months of symptoms per year for at least 2 years
44
when do patients with chronic COPD qualify for home O2
pulse ox < 88%, pulmonary hypertension, peripheral edema, or polycythemia
45
type of lung cancer associated with cushing's syndrome
small cell lung cancer
46
type of lung cancer associated with hypercalcemia
squamous cell lung cancer
47
type of lung cancer associated with SIADH and hyponatremia
small cell lung cancer
48
lung cancer with antibodies to presynaptic calcium channels
small cell lung cancer
49
initial treatment for small cell lung cancer
chemotherapy
50
initial treatment for localized non-small cell lung cancer
surgical resection followed by chemotherapy
51
what factors make pulmonary nodule more likely to be malignant
```
> 2 cm
> 45
irregular margins
smoker
irregular calcifications
```
52
outpatient management for mild persistent asthma
low-dose inhaled corticosteroid
adjunct montelukast if necessary
short-acting beta agonist for exacerbations
53
radiologic findings in idiopathic pulmonary fibrosis
honeycomb lung
54
treatment for idiopathic pulmonary fibrosis
steroids, azathioprine, and n-acetylcysteine
may substitute cyclophosphamide for azathioprine but greater incidence of side effects
lung transplant
55
pnuemoconiosis with progressive fibrosis
silicosis and coal mining
56
pneumoconiosis with increased risk of TB
silicosis
57
pneumoconiosis associated with working with electronics and increased cancer risk
berylliosis
58
pneumoconiosis with malignant mesothelioma and bronchogenic carcinoma
asbestosis
59
patient w/chronic FEV1 of 40%
inhaled corticosteroid, long-acting beta-agonist, annual influenza vaccine
60
diagnosis and treatment: chronic sinusitis, hemoptysis, and hematuria
wegener's granulomatosis
| steroids + cyclophosphamide
61
diagnosis and treatment: anti-glomerular basement membrane antibodies
goodpasture's syndrome
| plasmapheresis, steroids, additional immunosuppressive agents
62
smoker with rapid onset JVD, facial swelling, and altered mental status
superior vena cava syndrome
63
pathologies with decreased DLCO (decreased diffusion capacity at alveoli-arterial interface)
ARDS (alveoli filled with fluid)
| emphysema (fibrotic destruction of alveoli)
64
diagnostic distinction between bronchitis and emphysema
bronchitis: normal DLCO
emphysema: decreased DLCO (fibrotic destruction of alveoli)
65
easier way to determine oxygen diffusion at alveolar-arterial interface instead of measuring DLCO
A-a gradient
66
vaccines for patients with COPD
influenza vaccine annually
pneumococcal vaccine every 5 years
haemophilus influenza vaccine once
67
what kind of oxygen do you give patients with COPD
low-flow via nasal cannula
| do not want to reduce hypoxic drive
68
genetic disorders associated wit bronchiectasis
cystic fibrosis, kartagener's syndrome
69
how to monitor heparin dosage after PE
titrate PTT to 1.5-2.5 times normal
70
pulmonary embolism treatment
heparin x 5 days, cross over to warfarin x 3-6 months
71
criteria for labeling pleural fluid as exudative
pleural LDH > 0.6 serum LDH
| pleural protein > 0.5 serum protein
72
drug of choice for inpatient management of pneumonia
levofloxain, moxifloxacin
for nosocomial penumonia, add vancomycin to cover MRSA
73
drug of choice for outpatient management of pneumonia
azithromycin, doxycycline
74
test to differentiate between asthma and COPD
FEV1 with and without bronchodilator
| DLCO
75
which test on pleural fluid is most helpful in determining need for chest tube placement in parapneumonic effusion
pH: low pH (< 60 also is an indication for thoracostomy
76
aspirin sensitivity syndrome
pseudo-allergic reaction caused by prostaglandin/leukotriene imbalance in susceptible individuals
treatment: avoid NSAIDs and use leukotriene receptor antagonists
77
mobile cavitary mass in lung with intermittent hemoptysis
aspergillosis
78
physical exam in lung consolidation
bronchial breath sounds (full inspiration and expiration), dullness to percusion, and increased fremitus
bronchial breath sounds have a full expiratory phase
79
physical exam in pleural effusion
decreased breath sounds, dullness to percussion, decreased fremitus and transmitted airway sounds
80
physical exam in emphysema
hyper-resonant to percussion, breath sounds are vesicular, intensity of sound is decreased, wheezing may be present
81
physical exam in pneumothorax
hyper-resonance on percussion, decreased breath sounds
82
physical exam in interstitial lung disease
lungs are resonant on percussion, vesicular breath sounds, fine crackles heard at the end of inspiration
83
normal A-a gradient
5-15 mmHg
84
how to calculate PAO2 from PaCO2
PAO2 = 150 mmHg - (1.2)PaCO2
85
most common bacterial cause of bronchitis in nonsmokers
mycoplasma pneumoniae
86
most common cause of bronchitis in smokers
streptococcus pneumonia
| haemophilus influenzae
87
bacterial pneumonia associated with abscess formation
staphylococcus aureus
88
mechanism of aspiration pneumonia
impaired gag reflex
89
pneumonia associated with young adults
mycoplasma pneumoniae
90
pneumonia associated cold-agglutinin test
mycoplasma pneumoniae
91
pneumonia in cystic fibrosis
pseudomonas
92
pneumonia associated with nausea, diarrhea, confusion, hyponatremia
legionella
93
treatment for coccidio pneumonia
amphotericin B, ketoconazole
94
treatment for legionella pneumonia
macrolides, fluoroquinolones
95
treatment for pseudomonas pneumonia
fluoroquinolones, aminoglycosides, 3rd generation cephalosporins
96
treatment for mycoplasma pneuominae
macrolides
97
treatment for klebsiella pneumonia
cephalosporins and aminoglycosides
98
lung cancer: cavitary lesions, direct extension to hilar lymph nodes
squamous cell lung cancer
99
lung cancer: wide metastases, can be caused by asebestos, pleural effusions show increased hyaluronidase
adenocarcinoma
100
lung cancer: rapidly growing, early distant metastases
small cell lung cancer
101
lung cancer: late distant metastases, early cavitation
large cell carcinoma
102
treatment for idiopathic pulmonary fibrosis
corticosteroids +/- azathioprine
n-acetylcysteine
lung transplant
103
treatment for sarcoidosis
self-resolving in most cases
| otherwise, corticosteroids, cytotoxic drugs, or lung transplant
104
gold standard for measuring pulmonary artery pressures
cardiac catheterization
105
predictors of ventilator weaning success
```
maximal inspiratory pressure < 30 cmH2O
vital capacity > 10 mL/kg
minute ventilation < 10 L/min
PaO2/FiO2 ratio > 200
frequency:tidal volume ratio < 100 breaths/min/L
```
106
treatment for croup
aerosolized epinephrine and inhaled corticosteroids
107
pathogen in croup
paraindluenzae virus
108
barking cough, inspiratory stridor
croup
109
drooling, soft stridor
epiglottitis
110
epiglottitis treatment
antibiotics 7-10 days
111
RSV bronchiolitis treatment
racemic epinephrine, corticosteroids, beta-agonists
| ribavirin in severe cases
112
what ratio is important for evaluating for respiratory distress in the newborn
lecithin:sphingemyelin ratio
