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106 Cards in this Set
- Front
- Back
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Name some viral causes to acute bronchitis.
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1. rhinovirus
2. respiratory synctial virus 3. influenza A and B 4. coronavirus |
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Name some bacterial causes to acute bronchitis.
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1. Haemophilus influenzae
2. Mycoplasma pneumoniae 3. Moraxella catarrhalis 4. Chlamydia pneumoniae 5. Streptococcus pneumoniae |
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What is the most common organism to cause acute bronchiolitis?
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Respiratory synctial virus (RSV)
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What is the treament of bronchiolitis caused by RSV?
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Ribavirin
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"sniffing" or "tripod" position
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Acute epiglottitis
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Treatment in a patient that has a "thumbprint" sign on lateral xray.
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Humidified Oxygen and IV fluids.
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Most common bug for epiglotittis.
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H. influenzae
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Age group affected by epiglotittis.
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3-7 years old
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IV Abx for epiglotittis.
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Ceftriaxone or cefuroxime
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Most common bug for croup
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Parainfluenzae
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"Steeple sign", "barking cough"
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Laryngotracheobronchitis (croup).
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What is the tx for croup (severe).
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1. Glucocorticoids
2. Oxygen 3. Racemic epinephrine |
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Which two drugs can be used in the treatment to shorten the course of Influenza A?
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Rimantadine and amantadine
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Which two drugs are neuramindase inhibitors?
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Zanamivir and Oseltamivir
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Side effects of oseltamivir.
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nausea and vomiting
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When is it safe to give a pregnant patient the flu vaccine?
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second or third trimester.
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Child presenting with a "whooping" cough, what is the bug?
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Bordetella pertussis
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Mucous plug that is expelled followed by vomiting, which stage of pertussis is this child in?
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paroxysmal
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How do you culture pertussis?
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nasal swab
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Drug of choice in Bordetella.
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erythromycin
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When is the fourth dose given for DTaP?
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15 to 18 months
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A patient that presents with productive cough, dyspnea, pleuritic chest pain, and fever that has a job of tour guiding through caves that are filled with bats. What is the most likely etiology of his pneumonia?
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Histoplasma capsulatum
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Pneumonia in a cystic fibrotic patient
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Pseudomonas aeruginosa
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Which bug is most likely involved in pneumonia in an IV drug user?
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Staphylococcus aureus
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Which bug is most likely to cause pneumonia in a smoker with a hx of COPD?
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Streptococcus pneumoniae
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What are the two sub-types of bronchogenic carcinoma.
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1. non-small cell
2. small cell |
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Which type of cancer originates in the central airways and patient usually suffers from hypercalcemia?
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squamous cell
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Besides cigarette smoking what are other rish factors for lung cancer?
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1. Asbestos exposure
2. Ionizing radiation 3. Radon 4. COPD |
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What size of skin induration would be TB positive in a patient that is an IV drug user.
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>=10 mm
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Patient that presents with facial swelling with known bronchogenic carcinoma, what is the possible cause.
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Superior vena cava syndrome
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Patient presents with anhidrosis, ptosis, and miosis. What is the condition and what caused it?
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Horner's syndrome and possible Pancoast tumor.
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At what size is a nodule no longer a nodule but a mass?
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>=5cm
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Besides absence of symptoms what size is a nodule if it is favorable to be benign?
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<2cm
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Mucus casts from the small airways seen in asthma
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Curschman's spirals
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Laboratory tests show elevated white blood cell count with eosinophilia. Arterial blood gas reveal respiratory alkalosis and hypoxia
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Asthma
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Classification of Asthma in a patient with symptoms >2 times per week and/or nocturnal symptoms > 2 times per month
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Mild persistent
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Classification of Asthma in a patient with symptoms daily and/or nocturnal symptoms > 6 times per month
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Moderate persistent
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What two mechanisms in respiratory failure are seen in patients with Status asthmaticus.
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1. Respiratory muscle fatigue
2. bronchial obstruction leading to V/Q mismatch |
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A normal TLC and decreased FEV1 on PFTs. Obstructive or restrictive?
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Obstructive
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Txt in status asthmaticus
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1. Oxygen
2. Bronchodialator 3. Corticosteroids 4. Mechanical ventilator |
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Anticholinergic that is useful in COPD that helps dry secretions.
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Ipratropium bromide
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Long acting agent that is not useful in acute asthma attacks.
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Salmeterol
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To put a patient on theophylline what side effects are expected?
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1. anorexia
2. nausea 3. abdominal pain 4. seizures 5. arrythmias |
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Side effects of anti-inflammatories like flunisolide.
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1. Osteoporosis
2. edema 3. increased appetite 4. increased risk of oral candidiasis |
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Congenital cause of bronchiectasis besides cystic fibrosis.
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Alpha-1- antitrypsin deficiency
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What class of medication is cromolyn sodium?
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Mast cell stabilizer
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Leukotriene inhibitors need what eveluated regularly?
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LFTs
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Leukotriene inhibitor known to interfere with warfarin.
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Zafirlukast
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Used in conjunction with a beta agonist for a chronic bronchitis.
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Theophylline (weak bronchodilator)
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Which chromosome is involved in cystic fibrosis?
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7
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A patient with + peripheral edema, elevated hemoglobin, PO2 reduced, PCO2 elevated, ronchi present. What is the most likely diagnosis?
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Chronic bronchitis (blue bloater)
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Most common lethal disease in white americans.
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Cystic fibrosis
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5 year old white child with cystic fibrosis and airway infection. Which organism is most common.
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Staph Aureus
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25 year old cystic fibrotic with airway infection. Which organism is most common.
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Pseudomonas aerginosa
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What is the lab value of the sweat chloride test in a child with cystic fibrosis.
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> 60 mEq/L
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Newborns with supected cystic fibrosis have what type of GI pathologies?
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1. Intestinal obstruction
2. Meconium Ileus |
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What is suspected in a patient that develops emphysema at 37 years old?
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Alpha-1antitrypsin deficiency
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ABG shows severe hypoxemia and hypercapnia. CXR shows overinflation, flat diaphragm.
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Emphysema
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Test used to determine a transudate vs. exudate ( pleural fluid protein to serum protein greater than 0.5)
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Lights criteria
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The most common lung cancer; peripheral location.
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Adenocarcinoma
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Lung cancer associated with cushing's syndrome (ACTH)
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Small cell
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Lung cancer associated with gynecomastia
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Large cell
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Hypercoagulability and thrombophlebitis associated cancer
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Adenocarcinoma
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Oligemia in the affected lung zone is known as what sign?
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westermark's sign
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Wedge shaped infarct found on CXR.
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Hampton's hump
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Least common lung cancer associated with a poor prognosis
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Large cell
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Vitamin K-dependent factors for Coumadin
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2,7,9,10, protein C and S
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Coumadin overdose. What is the treatment?
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Vitamin K or fresh frozen plasma
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Pain in calf with dorsiflexion, with knee bent. Sign?
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Deep venous thrombosis. Homans sign
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A patient has presented with a PAO2/FiO2 < 200mmHg. What is the probable dx?
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Acute respiratory distress syndrom (ARDS)
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What is the mean pulmonary arterial pressure?
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15mmHg
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What are the main locations for lung cancer metastisis? (hint BLAB)
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Bone
Liver Adrenals Brain |
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Dyspnea, lateral hilar lymphadenopathy on CXR, noncaseating granulomas, increased ACE and hypercalcemia
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Sarcoidosis
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PFTs showing decreased FEV1/FVC
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Obstructive pulmonary dz
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PFTs showing increased FEV1/FVC
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restrictive pulmonary dz
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Honeycomb pattern on CXR. Dx? Tx?
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Interstitial pulmonary fibrosis. Supportive care and steroids
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Tx for SVC?
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Radiation
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Tx for mild persistent asthma
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Inhaled B-agonists and inhaled cortcosteroids
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Acid-base disorder in Pulmonary embolism
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hypoxia and hypocarbia (respiratory alkalosis)
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Non-small cell lung cancer associated with hypercalcemia
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Squamous cell carcinoma
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Lung cancer associated with SIADH
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Small-cell lung cancer
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Lung cancer highly related to cigarette exposure
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small-cell lung cancer
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A tall white male presents with shortness of breath. Dx? Tx?
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Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful.
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Treament of tension pneumothorax
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Immediate needle thoracostomy.
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Hypoxia and pulmonary edema with normal pulmonary wedge pressure.
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ARDS
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What bug is at an increased risk in a patient with silicosis?
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Mycobacterium tuberculosis
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Cardiomegaly, prominent pulmonary vessels, Kerley B lines, "bat's-wings" apperance of hilar shadows, and perivascular and peribronchial cuffing.
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CXR findings for pulmonary edema
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Sign that refers to inward movement of the lower rib cage during inspiration, implying a flat, but functioning, diaphragm, often associated with COPD
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Hoover's sign
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Which medication that is used for usual interstitial pneumonia causes leukopenia, thrombocytopenia, hemorrhagic cystitis, and nausea/ vomiting?
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Cyclophosphamide
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What disease is seen with hilar node calcifications (eggshell pattern)?
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Silicosis
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What kind of complications could present in an Asbestiosis patient? What would be their CXR pattern?
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Mesotheliomas. Pleural plaques
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What food is the single most common cause of death from food aspiration?
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Hot dogs
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Three predisposing factors of hyaline membrane disease?
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1.Diabetic mother
2. Premature birth 3. + family history |
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Pulmonary capillary wedge pressure less than 12 mmHg
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ARDS
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Pulmonary capillary wedge pressure greater than 15mmHg
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cardiogenic
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An alcoholic with "currant Jelly" Sputum. Which bug and what tx?
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1. Klebsiella
2. Rocephin or Levoquin |
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A rabbit hunter that has developed possible pneumonia which organism is most likely?
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Francisella tularensis
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AIDS patient presents with fever, night sweats, eosinophilia. Sputum culture reveals acid-fast aerobe that mimics TB, which bug is suspected?
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Nocardia asteroides
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Name the "RIPE" drugs of TB tx.
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1. Rifampin
2. Isoniazid 3. Pyrizinamide 4. Ethambutol |
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Neutropenic patient with a "fungus ball" on CXR, Which bug and tx.
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1. Aspergillus
2. Amphotericin B |
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A child from Pheonix that presents with possible pneumonia, prodromal fever, and myalgias that has a hampster as a pet. Which organism is likely?
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Hantavirus
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What are sx of carcinoid syndrome?
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flushing, diarrhea, and hypotension
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"Ground-glass appearance"
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Pneumocystic jirovecii (PCP)
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A patient that has had a splenectomy, what organisms are they susceptable to?
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Encapsilated organisms ( Strep pneumoniae, H. influenae)
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A patient that has leukemia is suseptible to which organisms?
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Aspergillus
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What two organisms are the most common of lethal pneumonia?
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1. Strep pneumoniae
2. Legionella pneumophilia |
