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Flashcards in Pulm Deck (119)
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1

What is increased in patients with emphysema-dominant chronic obstructive pulmonary disease?

Residual volume

2

Which tuberculosis drug is associated with hepatitis and peripheral neuropathy? This drug may also interact with tyramine-containing foods

Isoniazid

3

A 44 year old male is involved in a motor vehicle accident. On physical exam, he has distended jugular veins with decreased pulses only on inspiration. There are decreased breath sounds on the entire right side. The heart sounds are not muffled. What do you do?

Insert a large bore needle into the second intercostal pleural space followed by chest tube thoracostomy

4

Distended juglar veins and decreased breath sounds indicate a....

Tension pneumothorax

5

Which type of pneumothorax is defined as a pneumothorax in which the increasingly positive pressure displaces or kinks the great vessels, leading to a marked decrease in cardiac output and forward flow. The blood that can't go forward backs up into the jugular veins and causes JVD

Tension pneumothorax

6

Emergent management is needle decompression to restore cardiac output followed by chest tube placement

Tension pneumothorax

7

What is typical for a physical exam finding consistent with a right middle lobe pneumonia?

Dullness to percussion, Bronchial breath sounds, Egophony on the R side

8

Bronchial breath sounds and ego phony are associated with..

Lobar pneumonia

9

Hyperresonance to percussion with trachea deviation to opposite side

Tension pneumothorax

10

Resonance to percussion, vesicular breath sounds, normal fremitus

Normal exam!

11

Dullness to percussion, decreased breath sounds, decreased fremitus

Pleural effusions

12

Hyperresonance on percussion, decreased breath sounds, decreased fremitus

Pneumothorax or hyperinflation (i.e. severe emphysema)

13

Any disease that decreases the alveolar total surface area will decrease..

diffusing lung capacity for carbon monoxide (DLCO)

14

Protein in the lungs that prevents macrophage enzymes (such as elastase) from destroying the elastic tissue of the lung

Alpha-1 antitrypsin

15

Smoking can cause a relative ______ deficiency?

Alpha-1 antitrypsin

(leading to decreased elasticity)

16

55 year old male presents with a persistent cough. A CT scan of the chest shows lack of tapering of the bronchi and bronchial wall thickening. Pulmonary function tests show a decreased FEV1 and a decreased FEV1/FVC ratio of 65%. What is the dx?

Bronchiectasis


**Hallmark=lack of tapering of bronchi and bronchial wall thickening****

17

Enlargement of the larger airways
**Hallmark is lack of tapering of the enlarged bronchi and bronchial wall thickening***

Bronchiectasis

18

What kind of general disorder is associated with a FEV1/FVC ratio of

Obstructive disorder

19

Which of the following is considered a positive PPD test?
A. HIV pos female with a PPD of 4 mm induration and 8 mm erythema
B. A Physician Assistant with a PPD of 11mm induration and 5mm erythema
C. 40 yo male w no risk factors with PPD of 11mm induration and 5 mm erythema
D. 45 yo male w history of a granuloma on chest radiograph w a PPD of 4 mm induration and 10mm erythema
E. 32 yo prison inmate w PPD of 8mm induration and 10mm erythema

B, a Physician Assistant w a PPD of 11 mm induration and 5 mm erythema.

In evaluation of a PPD, the erythema is NOT part of the measurement, only the transverse induration. Because the pt is a health care worker and is at risk of occupational TB exposure, >10mm induration is considered a positive finding

20

An HIV pos pt needs what measurement to be considered pos for a PPD test

> or equal to 5mm

21

A pt with hx of granuloma on chest X ray needs ____ mm on PPD test for it to be positive

5mm or greater

22

A pt with no risk factors needs what size PPD to be positive?

15 mm or higher

23

A prison inmate needs what size PPD to be positive?

10 mm or higher

24

A 40 yo female presents w bilateral anterior shin redness that is tender to palpation. She is also complaining of eye pain and redness as well as the insidious onset of a nonproductive cough. A chest radiograph is performed, showing bilateral hilar lymphadenopathy. You notice a rash on her face consistent with lupus perinea. What is her dx and what is the pathophysiology going on?

Dx= Sarcoidosis

Pathophysiology= idiopathic, exaggerated T cell response with the formation of noncaseating granulomas

25

Why are corticosteroids used in the tx of Sarcoidosis

They blunt the immune response and decrease the granuloma formation

26

If a pt has erythema nodosum (bilateral anterior shin redness that is tender to palpation), ALWAYS consider...

Sarcoidosis

27

Uveitis (eye pain and redness) and pulmonary involvement (non productive cough w a chest radiograph showing BILATERAL HILAR LYMPHADENOPATHY), think....

Sarcoidosis

28

The production of caseating granulomas w central caseous necrosis in tissues is seen in..

TB

29

Inflammation reaction to an organic antigen describes the pathophysiology of

Hypersensitivity pneumonitis

30

What is the most common cause of a transudative pleural effusion?

Congestive Heart Failure (CHF)

(accounts for 90%)