Pulm

Question 1

CXR demonstrates bilateral hilar adenopathy

Bx reveals noncaseating granulomas

What is the dx?

Answer 1

sarcoidosis

Question 2

What is the difference between transudate and exudate pleural effusions?

Answer 2

Question 3

What is Cor Pulmonale?

Answer 3

impaired RV function or structure due to pulmonary hypertension from hypoexemia or lung dz

think COPD

Question 4

What is a Westermark sign of CXR? What dx?

Answer 4

radiographic finding on chest X-ray characterized by a focal area of oligemia (decreased pulmonary vascularity) distal to a pulmonary arterial occlusion.

This sign appears as a region of increased lucency (relative radiolucency) in the lung field, reflecting reduced blood flow secondary to obstruction of a pulmonary artery or its branches

PE

Question 5

_______ is associated with meconium aspiration syndrome in the newborn

Answer 5

persistent pulmonary hypertension

Question 6

What CXR findings are associated as the classic pattern of Pneumocystic jirovecii PNA?

Answer 6

diffuse interstitial infiltrates

Question 7

Where is the consolidation associated with TB typically found in the lungs?

Answer 7

usually in the UPPER lobes

Question 8

What dx?

Answer 8

parapneumonic effusion

Question 9

What types of cells produce surfactant?

Answer 9

type II pneumocytes

Question 10

What is the drug class and brand name for montelukast?

Answer 10

leukotriene receptor antagonist

singulair

Question 11

What dx is consistent with these thoracentesis results?

Answer 11

empyema

Question 12

This CXR and scenario of a women who did not finish abx due to recent PNA. What dx?

Answer 12

empyema

Question 13

______ is associated with catamenial pneumothorax?

Answer 13

endometriosis

Question 14

Which of the following tuberculosis medications is known to cause peripheral neuropathy and should be supplemented with pyridoxine (vitamin B6)?

Answer 14

isoniazid

Question 15

What kind of precautions are needed if you suspect TB?

Answer 15

airborne precautions

Question 16

Where are most aspirated foreign bodies located?

Answer 16

right main bronchus

Question 17

PE is suspected but pt has an elevated creatinine, what is the best diagnostic test?

Answer 17

V/Q scan

Question 18

What are the 3 causes of a transudative pleural effusions?

Answer 18

CHF
hepatic hydrothorax (pleural effusion that is caused by liver dz)
nephrotic syndrome

Question 19

What is the MC pulm side effect of amiodarone?

Answer 19

chronic interstitial pneumonitis

need annual CXR

Question 20

aspiration PNA due to alcohol, what pathogens?

Answer 20

anaerobic bacteria

Peptostreptococcus
Fusobacterium nucleatum
Bacteroides

Question 21

What will TB look like on CXR?

Answer 21

TB can look like a variety of things on CXR with varied abnormalities

Question 22

Which TB drug is likely to cause optic neuritis?

Answer 22

ethambutol

Question 23

What pathogen is commonly associated with recurrent pulm infections in pts with CF?

Answer 23

pseudomonas

Question 24

_______ is classically associated with causing postinfluenza bacterial PNA. What stain and shape?

Answer 24

staph aureus

gram + cocci in clusters

Question 25

What is the criteria for "no further follow-up" is needed for a single solitary pulm nodule?

Answer 25

low risk of a solitary pulm nodule less than 6 mm

Question 26

What is the pathologic mechanism behind emphysema?

Answer 26

alveolar destruction due to inhibition of normal protease activity

Question 27

What is the pathologic mechanism behind chronic bronchitis?

Answer 27

bronchial constriction due to smooth muscle hypertrophy in combo with mucus hypersecretion due to gland hyperplasia

Question 28

Define pulmonary hypertension

Answer 28

Pulmonary hypertension is defined as an elevation of the mean pulmonary artery pressure > 20 mm Hg at rest.

Question 29

What is the MC cause of cor pulmonale?

Answer 29

COPD

Question 30

small cystic spaces enveloped by thick, fibrotic, well-defined walls, mainly occurring in the periphery and bases. Name that finding. Associated with what dx?

Answer 30

honeycombing idiopathic pulmonary fibrosis

Question 31

_______ is a paraneoplastic syndrome associated with small cell lung cancer

Answer 31

lambert-eaton myasthenic syndrome

Question 32

______ is the best objective test to determine the severity of asthma exacerbations and can be used by patients at home with respective protocols for values lower than baseline

Answer 32

Peak expiratory flow rate

Question 33

What are 2 medications used to determine asthma as the dx?

Answer 33

albuterol -> an improvement of at least 12% in FEV1 or methacholine -> an also produce an expected response, with decreased FEV1 of 20% or more

Question 34

What is the dx? What is the route of spreading?

Answer 34

miliary tuberculosis hematogenous route

Question 35

What 2 pathogens that cause PNA can be identified by urine antigen test?

Answer 35

strep pneu and legionella

Question 36

What type of cardiomyopathy is sarcoidosis associated it?

Answer 36

restrictive cardiomyopathy due to fibrosis

Question 37

Pt's vitals are stable. What dx?

Answer 37

Question 38

Describe the Hamman sign

Answer 38

finding of the Hamman sign (crunching sound heard on auscultation of the mediastinum with each heartbeat) is suggestive of pneumomediastinum but has a low sensitivity

Question 39

What is the gold standard diagnostic test for spontaneous pneumomediastinum?

Answer 39

CT scan

Question 40

What is the usual cause of spontaneous pneumomediastinum?

Answer 40

Spontaneous pneumomediastinum usually results from rupture of alveoli, particularly after a strenuous Valsalva maneuver, leading to air dissecting along peribronchovascular sheaths and spreading into the mediastinum. The air then moves through mediastinal fascial planes and spreads to subcutaneous tissues of the thorax, upper limbs, and cervical region. Patients commonly report transient stabbing chest pain that may radiate to the shoulders, arms, or back.

Question 41

Dyspnea on exertion, papular eruptions and xray shown. What dx? What will you expect to appear on his lymph. node biopsy report?

Answer 41

sarcoidosis noncaseating granulomas