Pulm Ck

mikenakhla's version from 2016-05-19 21:41



Question Answer
• Common bacterial pathogens in CF related pneumonia. Gram negative rod? Gram negative coccobacilli? Gram positive cocci in chains? Gram positive cocci in clusters?pseudomonas, H flu, strep pneumoniae, staph aureus
• Mississippi or ohio river valey causing noncaseating granulomas and mimics TBhistoplasmosis
• Southwest US, mimics TBcoccidodomycosis
• Neonates are vulnerable to these complications following RSV infectionapnea and respiratory failure
• Monoclonal antibody against RSV used for prophylaxis in children < 2 who are at high risk of complications (chronic lung disease, hemodynamically significant congenital heart disease, etc)palivizumab
• What lab value is consistent with pulmonary embolism?increased A-a gradient because of impaired gas exchange (V/Q mismatch)
• COPD with digital clubbing and sudden onset joint pain, what is this?Hypertrophic osteoarthropathy, associated with lung cancer so get a chest X ray .
• Pleural effusion on X ray (excess fluid in pleural space), what do you do next?thoracentesis to see if fluid is exudative or transudative.
• Pulmonary hypertension due to left ventricular dysfunction - how do you treat this?Diuretics and ACE inhibitors or ARBs.
• Most common cancer associated with asbestos exposurebronchogenic carcinoma, also causes pleural mesothelioma but not as commonly.
• Prominent bronchovascular markings, flattened diaphragm, and normal DLCO in a smokerchronic bronchitis. DLCO is decreased in emphysema and interstitial lung diseases
• Panacinar vs centriacinar emphysema?panacinar is A1AT, centriacinar is COPD
• This lung tumor can present with shoulder pain and horner's syndrome?pancoast tumor, non small cell lung cancer
• Try this for two hours in a patient with COPD exacerbation before intubating them. This decreases work of breathingNoninvasive positive pressure ventilation
• Pneumonia causes what lung finding?V/Q mismatch
• Four categories of asthmaintermittent, mild persistent, moderate persistent, and severe persistent
• Intermittent asthma "criteria"daytime symptoms 2 days a week or less, nighttime awakenings 2 times or less a moth, use of albuterol 2 times or less a week, no limitations to daily activity
• Asthma symptoms more than 2 days a week but not daily and 3-4 nighttime awakenings a month, minor limitations of activities. What severity of asthma is this and what should their treatment regimen be?mild persistent asthma, albuterol plus low dose inhaled steroid as a controller medication
• Daily asthma symptoms, frequent nighttime awakenings, limited activity, fev1 < 60% of predicted. What asthma severity is this and what should their treatment regimen be?this is moderate persistent asthma and should be taking albuterol, inhaled corticosteroids, and a long acting beta agonist
• Asthma symptoms throughout the day, frequent nighttime awakenings, very limited activity and fev1 < 60% predicted. What asthma severity is this and what is their treatment regimen?albuterol, inhaled corticosteroid, long acting beta agonist, and oral prednisone
• Progressive dyspnea on exertion and a dry non productive cough. "velcro like" crackles on auscultationidiopathic pulmonary fibrosis
• Uveitis, erythema nodosum, and dyspnea/coughsarcoidosis
• Sudden onset dyspnea, chest pain, tachycardia with hemorrhagic, exudative pleural effusion in the absence of consolidation on chest imaging suggestsPE
• Normal FEV1/FVC ratio?.75 to .8. less in obstructive diseases and normal in restrictive
• Wheezing in children younger than 2, think thisRSV
• Solitary pulmonary nodule in young person with no smoking history, think thishamartoma
• Treatment for ARDS?intubate, ventilate with high O2 percentage and PEEP and treat underlying cause
• Causative pathogen of pneumonia in college student?Mycoplasma or chlamydia
• Causative pathogen of pneumonia in COPDH flu, moraxella
• Causative pathogen of pneumonia in silicosis patienttb
• HIV, pneumonia, koilocytosisCMV
• Causative pathogen of pneumonia in exposure to bird droppingschlamydia psittaci or histoplasmosis
• Causative pathogen of pneumonia in child 2-5?croup, paninfluenza
• Neonate with excessive oral secretions, coughing/cyanosis with attempted feeding, aspiration pneumonia. Can't pass NG tubeTE fistula. Most causes have esophagus that ends with blind pouch and a fistula
• Aspiration pneumonia vs pneumonitis? How do you treat each?aspiration pneumonia is oral cavity microbes being aspirated, presenting days after aspiration event. Treat with clinda or betalactam and lactamase inhibitor. Pneumonitis presents HOURS after and is aspiration of GASTRIC contents, treatment is supportive, no abx.
• Treatment of COPD exacerbation with these 4 thingsoxygen, albuterol/anticholinergics, antibiotics and SYSTEMIC steroids
• Wedge shape on chest CTpathognomonic for PE
• These patients are "high risk" for lung cancer and their solitary nodules should just be taken out when foundolder than 60, irregular margins of nodule, and recently quit smoking.
• Exudates are caused by ____ transudates are caused by ___increased capillary permeability, transudates increased hydrostatic or decreased oncotic pressure
• How do you diagnose bronchiectasis?CT scan

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