Pulmonology

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Author:
pszurnicki
ID:
202370
Filename:
Pulmonology
Updated:
2013-02-24 13:14:51
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Pulmonology
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Pulmonology
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  1. Frequency of symptoms, FEV1 and rx in asthma
    mild intermittent
    mild persistent
    moderate persistent
    severe
    <2 days/week <2nights/week- >80% albuterol

    >2 days/week >2 nights/week-  >80%alb + low dose ICS

    daily symptoms and >1 night/week- 60-80% alb +mod dose ICS + salmeterol

    continual daily symptoms and frequent nighttime episodes-<60% alb + high dose ICS +salmeterol + po prednisone
  2. Indications for home oxygen in copd?
    • paO2 <55% or sao2 <88
    • and signs of right sided heart failure
    • pulmonary htn
    • peripheral edema
    • polycythemia
  3. What are the stages of copd and what FEV1 values correspond to them and rx
    • stage 1 >80%- albuterol or ipratropium
    • stage 2 50-80%- alb +salmeterol
    • stage 3 30-50%- alb + salm + ICS
    • stage 4 <30%-Alb + salm + ICS + theophylline + O2
  4. how to tell chronic bronchitis from emphysema?
    do DLCO
  5. what decreaes mortality in copd?
    oxygen
  6. what increases risk of lung cnacer?
    • smoking
    • radon
  7. rx for idiopathic pulmonary fibrosis?
    steroid + azathioprine
  8. what pneumoconiosis increases risk for tb infection?
    silicosis
  9. rx for good pastures?
    • plasmapharesis
    • immunosuppresion
  10. Most accurate test of IPF?
    biopsy
  11. what 2 pneumoconiosis increase ca risk?
    • asbestosis
    • berryliosis
  12. patient presenting with acanthosis nigricans, next best step?
    check blood glucose level
  13. most common cause of acute glomerulonephritis ?
    berger dz post URI
  14. presentation of wiskot aldrich syndrome?
    • Thrombocytopenia
    • Infection
    • Eczema
  15. what tells you the severity of schock?
    • hypotension
    • mental status
  16. rx for pulmonary htn?
    • endothelin antagonist--bosentan
    • prostaglandin agonists
    • phosphodiesterase inhibitors--sildenafil
  17. next step when suspecting pulmonary hypertension?
    most accurate step?
    • echo
    • catherer--swan-ganz
  18. pharmocology in rapid intubation?
    • lidocaine
    • fentanyl
    • atropine
    • induction of anastesia--midazolam
    • paralytic--succinylcholine, recoronium
  19. placement of a chest tube in pneumothorax?
    • midclavicular line--2 ics
    • midaxillary line---6 ics
  20. rx for croup?
    • aerosolized epinephrine
    • po prednisone
  21. rx for epiglottitis
    antibiotics
  22. rx for bronchiolitis
    epi
  23. rx for cf?
    • b2 agonist
    • dnase or n acetycystein-
    • antibiotics
    • hypertonic saline
  24. what are the 3 drugs for pseudomonas?
    • penicillins---ticeracillin or cephalosporing
    • meropenems
    • aminoglycoside
  25. drug given in increased icp before you intubate?
    lidocaine
  26. what meds shud asthmatics avoid?
    • aspiring, nsaid
    • bb
  27. what are the 2 variants of asthma?
    • nocturnal cough
    • exercise
  28. do u discontinue theophylline in acute exacerbtion?
    no, you leave it
  29. what decreases levels of theophylline/?
    smoking
  30. what decreses mortality in copd?
    • stop smoking
    • oxygen
    • vaccine
    • pneumoccocal
    • hib
    • influenza
  31. most accurate test for pneumoconiosis?
    biopsy
  32. caplan syndrome?
    rheumatoid arthritis nodules in the lung + coal workers pneumoconiosis
  33. from what veins of the lower extremity due dvt arise?
    deep veins including superficial femoral vein
  34. /3 acquired thrombophilia
    • lupus anticoagulatn
    • nephrotic
    • oral contraceptives
  35. a normal vq scan means what chance of pe?
    0%
  36. when suspecting a pe, and a doppler of leg shows a dvt, this means?
    pe
  37. rx of pe with hemodynamic instability and antigoagulation contraindication?
    embolectomy and IVC filter
  38. rx of post thrombotic syndrome?
    compression stockings
  39. HIT causes bleeding or clotting?
    clotting
  40. dx of HIT?
    platelets decrease by 50%
  41. what is the only thrombocytopenia that cuases thrombosis?
    HIT
  42. the only hypercoagulability that causes arterial thrombosis?
    APL--elevated ptt and hypercoagulable
  43. presentation of fat embolism?
    • petechiae around neck and axila
    • confusion
  44. rx for sleep apnea?
    • weightloss
    • cpap
    • uvuloplasty
  45. rx for  central sleep apnea
    acetazolamide
  46. pancoast tumor?
    cnacer affecting the brachial plexus
  47. Rx of svc syndrome?
    radiation of the tumor
  48. lung cancer + hoarsness means?
    metastasis and non resectable
  49. what stage of lung cancer is unresectable?
    stage 3b
  50. lung mass and an effusion, next best step?
    thoracocentesis and analysis
  51. the fev1 has to be at least what to be resectable?
    fev1>50%
  52. when is lung cancer non resectable?
    4 conditions
    • metastasis to outside of the lung anywhere
    • metastasis to pleura--producing effusion
    • close to the carina/main stem bronchus
    • metastasis to the other lung

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