Show:
Radiation Oncology
Dyspnea
Alpha 1 antitrypsin
HACPNA Antibiotics
Pulmonary HTN
100
These breast cancer treatment guidelines are utilized by the radiologists oncologists and can be helpful to primary care docs advising patients
What are the NCCN guidelines
100
These are the three major etiologies of dyspnea
What are COPD Asthma Interstitial lung disease
100
What percent of patients with COPD have alpha-1 antitrypsin deficiency?
2-5%
100
This is the second most common nosocomial infection
What is hospital acquired pneumonia
100
Name the three early symptoms of pulmonary hypertension. Name the four late symptoms of pulmonary hypertension.
What are Early: exertional dyspnea (cannot incr CO with exertion) Fatigue Lethargy Late: Angina (endocardial hypoperfusion) peripheral edema hepatic congestion Syncope
200
According to the breast cancer guidelines, this is the primary treatment for DCIS
What is a lumpectomy with whole breast irradiation (cat I) vs total mastectomy with or without lymph node biopsy vs lympectomy without node bx and without radiation (cat 2b)
200
List as many of the 7 primary labs/tests you would do on a patient with dyspnea
What are: bnp cbc cmp cxr tsh PFT EKG
200
This country screens all patients for alpha-1 antitrypsin disorder.
What is Sweden
200
Patient's meeting these ten categories qualify for a "health care associated" pneumonia (excludes hospital acquired and late ventilator associated pneumonia).
What is Hospitalized 2d or more in preceding 90d Nursing home resident On Chronic dialysis Home infusion therapy Home wound care Recently received systemic antibiotics Family member infected with multidrug-resistant organism Immunosuppressive disease Immunosuppression therapy Lives in community with high prevalence of antibiotic resistance
200
These are the the reasons to refer to a pulmonologist when a patient has pulmonary hypertension (I have 5)
What are: 1. "significant" phtn 2. patient is symptomatic 3. No obvious cause--especially in a young patient 4. syncope/presyncope 5. R heart failure
300
A patient of yours has invasive stage II and IIIA cancer, and you completed these three imaging studies.
What are: chest ct CT or MRI of the abdomen and pelvis Bone scan (PET)
300
These conditions are the top 4 causes of chronic dyspnea
What are CHF, COPD, Asthma, Obesity/Deconditioning
300
The findings on a CXR or CT in a patient with COPD, and this age of patient with COPD makes you more concerned about alpha 1 antitrypsin deficiency.
What are bullous lesions at the bases of the lungs Age less than or equal to 45 years old Also consider in patient who is non or mild-smoker w/ emphysema, a patient w/ unknown cause of chronic liver disease, and a patient with panniculitis
300
The IDSA and ATS recommend these medications as first line treatments for HAPNA (more points for the OTHER options than those we traditionally use)
What are: 1. Double pseudomonal coverage Antipseudomonal cephalosporin, carbapenin, OR Beta lactam and B latamase inhibitor AND Aminoglycoside or antipseudomonal fluoroquinolone AND 2. MRSA coverage: Vancomycin or linezolid
300
PHTN can be grouped into groups by general causes *(think pathophysiology).
What is 1. Arterial problem: arterial occlusive disease (L heart normal on swan ganz), chronic thrombo-emboli 2. Venous problem (L heart backflow) 3. Lung problem (chronic hypoxia) 4. Connective tissue related (esp. lupus, scleroderma)
400
There is an "ASTRO" consensus statement that helps clinicians understand the benefits of this new type of breast cancer radiation treatment---you heard about this for hours two thursday's ago but probably don't remember.
What is accelerated partial breast irradiation and current studies and recommendations.
400
These are the secondary tests for dyspnea (3) Bonus: what are the two tertiary tests?
What are CT scan, full pft's w/ diffusion capacity, echocardiogram stress test, holter monitor
400
These are three different tests for alpha-1 antitrypsin deficiency.
What are: Immunoassay: tests Alpha antitrypsin serum level, and <11mm/L is diagnostic (aka the Alpha kit) then phenotype and/or Genotype
400
Based on the findings of the pulmonary journal club study (study on guideline compliant vs non-compliant outcomes for pt's with HCAPNA), what do they recommend regarding treatment of patient's with HCAPNA? And why did they suggest this?
What is that . . . Two drug treatment may not be necessary for psuedomonal coverage: And use your antibiograms for your local hospital/area.
400
1. What 2 scales can be used to assess PHTN severity? 2. These are the treatments for PHTN (that pcp's would use) 3. Patient's with SIGNIFICANT pulmonary HTN should avoid constipation--why? They should avoid surgery too--why?
1. NYHA heart failure score; or WHO groups 2. diuretics, O2, salt restrict, anticoagulation 3. vagal stimulation (constipation, pain); surgery--hypoxemia and volume shifts (also don't diurese too fast).