Test #3

Question 0

What are the signs of COPD?

Answer 0

Wheezing
Decreased breath sounds
Cyanosis in the absence of polycythemia (late sign)
Signs of lung hyperinflation
Decreased measurements of airflow on spirometry

Question 1

A disease state characterized by airflow limitation that’s not fully reversible

Answer 1

COPD

Question 2

What is the single most important risk factor for COPD?

Answer 2

Cigarette smoking

Question 3

What is the ddx for COPD?

Answer 3

Asthma
Bronchiectasis
Pulmonary Tuberculosis

Question 4

How do you test for COPD?

Answer 4

Spirometry

Question 5

What imaging method should you use for COPD?

Answer 5

Chest x-rays - may show features of COPD & may rule out alternative diagnoses

Question 6

This measure indicates the presence of hypoxia or hypercapnia (in COPD)

Answer 6

Arterial blood gas

Question 7

What stage of COPD shows forced expiratory volume/forced vital capacity is decreased; usually but not always, chronic cough & sputum production; pt may not be aware that lung function is abnormal

Answer 7

Stage 2 - moderate

Question 8

What are the management goals for COPD?

Answer 8

Educate pt about disease
Prevent progression
Work to improve ADLs by decreasing symptoms
Reduce the number of exacerbations & superimposed infections
Support smoking cessation
Reduce mortality
Reverse hypoxia & maintain adequate oxygenation

Question 9

What are the xray findings assoc w/ chronic bronchitis?

Answer 9

Pulmonary overinflation
Flattened diaphragm
Increased retrosternal airspace
Increased bronchial marking

Question 10

What is the main cause of emphysema?

Answer 10

Smoking

Question 11

What are the cardinal features of asthma?

Answer 11

Episodic or chronic wheezing
Dyspnea
Cough
Feeling of tightness in chest

Question 12

What are precipitants for asthma?

Answer 12

Exercise
Cold weather
Infection
Drugs
Allergens

Question 13

What is the ddx for asthma?

Answer 13

COPD
Congestive heart disease
Pneumothorax
Pulmonary Embolism
Large airway obstruction
Vocal cord dysfunction

Question 14

How is moderate, persistent asthma treated?

Answer 14

Daily medication is recommended

Low to medium dose inhaled steroid

Question 15

This is abnormal & permanent dilation of cartilage bearing pulmonary bronchi w/ copious sputum production

Answer 15

Bronchiectasis

Question 16

What are the tx’s for bronchiectasis?

Answer 16

Antibiotics
PT
Surgery for localized disease
Lifestyle modifications

Question 17

The most characteristic physical finding is “velcro” quality bibasilar crackles that don’t clear w/ cough & are heard over posterolateral chest in mid to late inspiration

Answer 17

Occupational Lung Disease

Question 18

Refers to parenchymal lung disease resulting from inhalant of silicon dioxide or silica, in crystalline form

Answer 18

Silicosis

Question 19

Type of silicosis that occurs rarely but is usually fatal

Answer 19

Acute silicosis

Question 20

This refers to an infection of the parenchyma of lung & may occur in tandem w/ distal bronchial infection

Answer 20

Pneumonia

Question 21

Type of pneumonia that is more mild in healthy population?

Answer 21

Viral pneumonia

Question 22

What is the ddx for viral pneumonia?

Answer 22

Bronchitis
Bronchiolitis (on test)
Leukocytosis
COPD
Asthma
ARDS

Question 23

This can be a pulmonary disease or extrapulmonary disease or both that is spread from person to person via inhalant droplets.

Answer 23

TB

Question 24

What are 2 ways TB is diagnosed?

Answer 24

Isolating the organism from a clinical specimen or biopsy | Infection (not disease) is diagnosed by (+) skin test to tuberculin antigen

Question 25

How are pts w/ TB treated?

Answer 25

Active TB - Isoniazid w/ rifampin

Question 26

This disease can effect multiple organs but has a propensity to involve the respiratory tract initially. Cause is unknown

Answer 26

Sarcoidosis

Question 27

What is the tx for sarcoidosis?

Answer 27

Spontaneous regression of the pulmonary process is frequent

Question 28

What are some causes of pleural disease?

Answer 28

Transudates Exudates Empyema Cirrhosis

Question 29

What is the ddx for pleural disease?

Answer 29

CHF

Question 30

What is the primary etiologic agent that promotes the development of lung cancer?

Answer 30

Tobacco

Question 31

Smoking contributes to the development of what % of all lung cancers?

Answer 31

90%

Question 32

What are characteristics of solitary pulmonary nodules that are generally benign?

Answer 32

Present in the past | Haven't changed size for more than 2 years

Question 33

What size of pulmonary nodules are almost always malignant?

Answer 33

3cm

Question 34

The presence of what in a pulmonary nodule has a high predictive value for malignancy?

Answer 34

Corona radiata sign (fine linear strands extending outward from the nodule)

Question 35

What are characteristics of low risk nodules?

Answer 35

``` Stable in size (>2 yrs) Benign type calcifications Younger pt (<35yrs) w/ no history of exposures ```

Question 36

What are characteristics of high risk nodules?

Answer 36

Nodules larger than 3 cm Abnormal calcification patterns (corona radiata, eccentric/stippled) Older pts who are smokers

Question 37

What category of nodules do most pts have?

Answer 37

Indeterminate risk nodules