Topic list

Question 1

Chronic bronchitis patients are often called ___ due to ______

Answer 1

Blue bloaters

/mucus plugs –> Hypoxia and hypercapnia

Question 2

Emphysema patients are often called ___ due to ______

Answer 2

Pink puffers

CO2 retention but no change in O2

Question 3

Why will we hear crackles at the beginning of inspiration in patient with chronic bronchitis?

Answer 3

Due to opening of small collapsed airways

Question 4

Hypoxia will cause vaso__

Answer 4

constriction

Question 5

Hypoxic vasoconc. in lungs will lead to

Answer 5

Increase pulmonary vascular resistance and pulmonary HTN

Question 6

Types of emphysema

Answer 6

Centriacinar- Smoking
Panacinar- a1-AT deficiency
Paraseptal

Question 7

Chronic bronchitis definition

Answer 7

Productive cough on most days of the week for at least 3 months with total duration of 2 years

Question 8

mMRC measures

Answer 8

Breathless scale 0-4

Question 9

3 steps of combined COPD asessment

Answer 9

Spirometry to confirm diagnosis
Assessment of airflow limitation
Assessment of symp./risk of exacerbations

Question 10

COPD non-pharmacological treatment

Answer 10

Smokin cessation
Smoke prevention
Regular exercise
Rehabilitation
Oxygen therapy
NIV (CPAP)
Lung Volume Reduction Therapy
LuTx

Question 11

Oxygent therapy- How long per day and what is the indication?

Answer 11

minimum 15h/d

PaO2 < 60 mmHg and <88% O2 saturation

Question 12

COPD pharmacological treatment other than LABA LAMA ICS..

Answer 12

Influenza vaccine
Mucolytics
AB

Question 13

Define COPD exacerbation

Answer 13

Acute worsening of respiratory symp. that result in need of additional therapy

Question 14

How to assess the severity of an exacerbation?

Answer 14

Arterial blood gass
CXR (for alternative diagnosis)
ECG
WBC count

Question 15

Systemic corticosteroids- What will we give, how much and for how long?

Answer 15

Prednisone
40 mg
5 days

Question 16

Asthma severity classification

Answer 16

Mild intermittent
Mild persistent
Moderate persistent
Severe persistent

Question 17

Special feature of PEF?

Answer 17

Daily variability > 20%

Question 18

Anti IgE drug

Answer 18

Omalizumab

Question 19

Clinical features of asthma exacerbation

Answer 19

Too breathless
Respiratory rate > 25/min
HR > 110 BPM
PEF < 50% of predicted normal or best

Question 20

PEF value in life threatening situations

Answer 20

< 33%

Question 21

Immediate management of asthma exacerbation

Answer 21

Oxygen
High dose Albuterol+Ipratropium
High dose systemic steroids

Question 22

asthma exacerbation respiratory medicine lecture notes what to add

Answer 22

Nebulized ipratropium
IV MgSO4
IV bronchodilators

Question 23

Classification of pneumonia (pathology)

Answer 23

Bronchopneumonia
Lobar
Interstitial

Question 24

Stages of pneumonia (4)

Answer 24

1. Congestion
2. Red hepatization
3. Grey hepatization
4. Resolution

Question 25

Grey hepatization is due to

Answer 25

Break down of RBC

Question 26

Auscultation of pneumonia

Answer 26

Bronchial breathing sounds

Question 27

Tectile fermitus is pneumonia

Answer 27

Increased due to lungs being filled with fluids

Question 28

Bronchopneumonia on CXR

Answer 28

Patchy areas spread throughout the lung

Question 29

Interstitial pneumonia on CXR

Answer 29

Spread pattern throughout, especially concentrated in the perihilar regions

Question 30

Pneumonia specific pathogen - How can we recogniza?

Answer 30

``` Sputum culture Blood culture Pleural fluid Antigen detection Serological test ```

Question 31

Which AB can we start if we suspect interstitial pneumonia?

Answer 31

Macrolides - Clarythromicine

Question 32

Hospital Aquired Pneumonia definition

Answer 32

Pneumonia that developes 48h post hospital admission

Question 33

Lung abscess are caused mainly by which bacterias?

Answer 33

``` Fusobacterium Prevotella Strep Staph Klebsiella ```

Question 34

When can we say that a patient is free of TB infection?

Answer 34

3 sputum samples are negative

Question 35

Treatment for TB lasts

Answer 35

6-24 months

Question 36

ILD of known etiology caused by exposure is devided into 2

Answer 36

Organic- Hypersensitivity pneumonitis | Inorganic- Silicosis, Asbestosis

Question 37

Inorganic substances

Answer 37

Silicosis Asbestosis Berylliosis Coal worker's lung

Question 38

IIP is devided into

Answer 38

Idiopathic Pulmonary Fibrosis Usual Interstitial Pneumonia Acute Interstitial Pneumonia

Question 39

CXR in ILD

Answer 39

Reticular Diffuse / Nodular bronchovascular Reticulonodular or infiltrative pattern

Question 40

In IIP which is the most common?

Answer 40

IPF

Question 41

IPF drug

Answer 41

Nintedanib

Question 42

Sarcoidosis is most common in which populatons?

Answer 42

African american | Scandinevian

Question 43

Sarcoisosis symptoms

Answer 43

Hypoxemia Heart blocks Bells palsy Erythema nodosum

Question 44

Sarcoidosis on HRCT

Answer 44

Ground glass appearance

Question 45

OSA definition

Answer 45

Total cessation of airflow > 10 sec

Question 46

Hypopnea=

Answer 46

shallow breathing or an abnormally low respiratory rate

Question 47

Apnea-Hypopnea Index is used to

Answer 47

Indicate the severity of sleep apnea

Question 48

AHI values

Answer 48

Normal: AHI<5 Mild sleep apnea: 5≤AHI<15 Moderate sleep apnea: 15≤AHI<30 Severe sleep apnea: AHI≥30

Question 49

Causes for OSA

Answer 49

``` Obesity Short neck Alcohol Diabetes Tonsillitis Macroglossia Large uvula Chronic URI ```

Question 50

Name of an intra-oral device that is given to OSA patients

Answer 50

Mandibular Advancement Device

Question 51

Why give CPAP/BPAP in OSA?

Answer 51

Airflow can prevent pharyngeal collapse