review questions

Question 1

Causes of airway obstruction in COPD

Answer 1

Loss of tethering, active expiration, airway inflammation, bronchiolostenosis

Question 2

Causes of airway obstruction in asthma

Answer 2

Edema, smooth muscle hypertrophy, secretions

Question 3

Why are patients with COPD dyspneic?

Answer 3

Airway obstruction, active expiration, hypoxia, hypercapnia, altered chest architecture

Question 4

Lung transplant indications

Answer 4

CF, Pulmonary HTN, IPF, COPD

Question 5

Causes of a rise in PACO2 in patients on O2 therapy (3)

Answer 5

1- loss of hypoxic drive to breathe; 2- worsening V/Q mismatch (override hypoxic vasoconstriction); 3- Haldane effect

Question 6

Benefits of lung volume reduction surgery

Answer 6

Improved diaphragmatic contour; decrease hyperinflation; expand healthy segments

Question 7

Name the infection: rusty sputum, chills, lobar infiltrate, gram+ diplococcus

Answer 7

Pneumococcal pneumonia

Question 8

Name the infection: URI, atypical pneumonia, bilateral LL infiltrate

Answer 8

Mycoplasma

Question 9

Name the infection: high fever, post-influenza, abscesses, hospitalized pt

Answer 9

Staph aureus

Question 10

What can PCP be treated with?

Answer 10

Steroids, and NOT antifungals

Question 11

Name the infection: HIV+, low CD4+, cultured from blood and sputum but may not cause disease

Answer 11

MAI

Question 12

Most common cause of unexplained, recurrent PE:

Answer 12

Factor V Leiden

Question 13

Bronchiolitis-associated conditions

Answer 13

BO, BOOP, toxic bronchiolitis, respiratory bronchiolitis

Question 14

Respiratory pacemaker is located where?

Answer 14

Pre-Botzinger Area (ventrolateral medulla)

Question 15

PPEAK-PPLAT maintained

Answer 15

Parenchymal dx, PE, pulmonary edema, PNA, PTX, anxiety/pain, Auto-PEEP

Question 16

PPEAK-PPLAT wide

Answer 16

Airway problems: ETT issue, tubing kinked, secretions, bronchospasm

Question 17

What’s the molecular basis of COPD?

Answer 17

Imbalance between proteases and antiproteases leading to destruction of collagen/elastin in lung tissue

Question 18

What causes hypercapnea in COPD?

Answer 18

Increased WOB, decreased sensitivity to CO2, V/Q mismatch

Question 19

Classification of pleural effusions, based on lab markers:

Answer 19

LDH >0.6, protein >0.5: exudate; otherwise, transudate

Question 20

Transudate effusion - CAUSES

Answer 20

CHARM: cardiac disease, hypothyroidism, (hypo)albuminemia, renal failure, malabsorption

Question 21

Exudate effusion - CAUSES

Answer 21

PINTARS: pneumonia/pancreatitis, infarct, neoplasm, trauma/TB, abscess, RA, sarcoid/SLE/scleroderma

Question 22

Massive hemoptysis - CAUSES

Answer 22

Adenocarcinoma in situ, TB, pulmonary AVM

Question 23

Sub-massive hemoptysis - CAUSES

Answer 23

Chronic bronchitis, bronchiectasis, PE, pneumonia (bacterial, in AIDS pt)

Question 24

Hemoptysis workup

Answer 24

CXR, ABG, CBC, PT, PTT, UA, gram stain, bronchoscopy, ?CT, angio, V/Q scan

Question 25

Most hemoptysis originates from which blood supply?

Answer 25

Bronchial (high P) - from submucosal bronchial plexus