Pulmonology: Lab/Diagnostics Flashcards

1
Q

What are the indications for a thoracentesis?

A

a NEW pleural effusion, atypical pleural effusion, or if effusion fails to resolve as expected

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2
Q

What do you see with a thoracentesis?

A

Allow for visualization for the fluid and to analyze the chemical and mircrobes found in order to ID underlying pathology

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3
Q

First line of diagnostic imaging for suspected PE

A

CT angiography; high negative predictive value; uses CT rather than xray

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4
Q

Diagnostic test for DVT

A

venous ultrasonography

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5
Q

When do you order a sodium chloride sweat test?

A

suspected cystic fibrosis

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6
Q

How do you perform a sodium chloride sweat test?

A

Two tests on different days are REQUIRED for accurate diagnosis

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7
Q

True of false: a normal chloride sweat tests excludes the diagnosis of CF

A

False! genotyping or other diagnostic studies can be performed

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8
Q

When would you order a pulmonary angiography?

A

Used to be good for PE but not CT angiography is better; XRAY based (unlike CT angiography)

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9
Q

What are the disadvantages of the ventilation/perfusion scan?

A

It can miss small clots but also isn’t great in the presence of comorbid lung disease

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10
Q

When would you order a CT chest?

A

Can be helpful in the diagnosis of cancer, PNA, TB, emphysema, diffuse interstitial lung disease and congenital abnormalities

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11
Q

What are some circumstances that can decrease the accuracy of pulse ox?

A

severe anemia, motion, hypotension or other processes inhibiting blood flow (also, cold hands)

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12
Q

What is a polysomnography?

A

A sleep study

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13
Q

When is a polysomnography indicated?

A

to diagnosis sleep apnea and treat secondary pulmonary HTN

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14
Q

Define bronchoscopy

A

a scope inserted into the bronchial tree used to visualize, collect specimens or perform procedures

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15
Q

When would you use a flexible bronchoscopy?

A

evaluation of the airway, diagnosis carcinoma, FB removal, lung biopsy. requires topical anesthesia

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16
Q

When would you use a rigid bronchoscopy?

A

Large airway obstructions: FB, blood clots, tumors. Evaluation of massive hemoptysis. requires general anesthesia

17
Q

Which requires only topical anesthesia: a flexible or rigid bronchoscopy?

A

flexible

18
Q

Is a D-dimer a sensitive or specific test?

A

Sensitive: a negative result can help rule-out a PE