Pulmonary

Question 1

Risk factors for DVT

Answer 1

Stasis, endothelial injury, and hypercoagulability (Virchow triad)

Question 2

Criteria for exudative effusion

Answer 2

Pleural/serum protein >0,5; pleural serum/LDH>0,6

Question 3

Causes of exudative effusion

Answer 3

Think of leaky capillaries, Malgnancy, TB, bacgterial or viral infecrtion, pulmonary embolism (PE) with infarct, and pancreatitis

Question 4

Causes of transudative effusion

Answer 4

Think of intact capillaries, CHF, liver or kidney disease, ad protein-losing enteropathy

Question 5

Normalizing Pco2 in a patient having an asthma exacderbation may indicate ______.
Treatment for acute asthma and COPD exacerbations

Answer 5

Fatigue and impending respiratory failure

Beta2-agonists and corticosteroids (anticholinergics and antibiotics for COPD exacerbation as well)

Question 6

Sarcoidosis

Answer 6

Dyspnea, lateral hilar lymphadenopathy on chest radiograph, noncaseating granulomas, elevated angiotensin-converting enzyme, and hypercalcemia

Question 7

PFTs of obstructive pulmonary disease

Answer 7

lowered FEV1/FVC

Question 8

PFTs of restrictive pulmonary disease

Answer 8

elevated FEV1/FVC, lowered TLC

Question 9

Honeycomb pattern on chest radiograph. Treatment?

Answer 9

Diffuse interstial pulmonary fibrosis. Supportive care; antifibrotic agents may help

Question 10

Treatmet for SVC syndrome

Answer 10

Radiation

Question 11

Treatment for mild persistent asthma

Answer 11

Inhaled beta-agonists and inhaled corticosteroids

Question 12

Treatment vor COPD exacerbation

Answer 12

O2, bronchodilators, antibiotics, corticosteroids with taper, smoking cessation

Question 13

Treatment for chronic COPD

Answer 13

Smoking cessation, home O2, beta-agonists, anticholinergics, systemic or inhaled corticosteroids, flu and pneumococcal vaccines

Question 14

Acid-base disorder in PE

Answer 14

Respiratory aldalosis with hypoxia and hypocarbia

Question 15

Non-small cell lung cancer (NSCLC) associated with hypercalcemia

Answer 15

Squamous cell carcinoma

Question 16

Lung cancer associated with syndrome of inappropriate antidiuretic hormone (SIADH)

Answer 16

Small cell lung cancer (SCLC)

Question 17

Lung cancer associated with Lambert Eaton syndrome

Answer 17

SCLC

Question 18

Lung cancers with highly related to cigarett exposure

Answer 18

SCLC, SCC

Question 19

A tall Caucasian man presents with acute shortness of breath. Diagnosis? Treatment?

Answer 19

Spontaneous pneumothorax. Spontaneous regression; supplemental O2 may be helpful

Question 20

Treatment of tension pneumothorax

Answer 20

Immediate needle thoracostomy (over diagnostic)

Question 21

Characteristics favoring carcinoma in an isolated pulmonary nodule

Answer 21

Age >45-50 tobacco use; lesions new or larger in comparison to old films; absence of calcification or irregular calcification ; size > 2cm; irregular margins

Question 22

ARDS

Answer 22

Hypoxemia and pulmonary edema with normal pulmonary capillary wedge pressure (PCWP)

Question 23

Sequelae of asbestos exposure

Answer 23

Pulmonary fibrosis, pleural plaques, bronchogenic carcinoma (mass in lung field) mesotherlioma (pleural mass)

Question 24

Eleveted risk of what infection with silicoses

Answer 24

Mycobacterium tuberculosis

Question 25

Causes of hypoxemia

Answer 25

Right-to-left shunt; hypoventilation,low is O2 tension, diffusion defect, V/Q mismatch

Question 26

Classic chest radiographic finding for pulmonary edema

Answer 26

Cardiomegaly; prominent pulmonary vessels, Kerley B lines, “bat’s swing” appearance of hilar shadows, and perivascular and peribronchial cuffing

Question 27

Chest radiaograhy findings suggestive of PE

Answer 27

Westermark sign and Hampton hump