Allergic Disorders + Beyond
Two symptoms of allergic rhinitis common in children are _________ and ___________
allergic shiners and transverse nasal crease
Asthma affects ________ and _______ in the respiratory tract, NOT _______
What medication should be used for prophylaxis against PJP?
anti-arrhythmias, anti-inflammatories, antibiotics, antineoplastics (chemo)
List the 5 clinical classes of pulmonary hypertension
Group 3- PH due to lung disease/hypoxia
Group 4- PH due to PA obstructions
Group 5- idiopathic or multifactorial
The three primary types of non-small cell lung cancer are:
Which is the most common?
adenocarcinoma, squamous cell carcinoma, large cell carcinoma
Adenocarcinoma
Your patient just returned from a rafting trip in sub-Saharan Africa. They report having a rash for several days, and now have shortness of breath. You suspect they have pulmonary complications of __________ and can be treated with _______ and ___________ therapy
schistosomiasis; steroids and antihelmintic therapy
The allergic triad includes
eczema, asthma, allergic rhinitis
While ______ air is worse for asthma, _______ and ______ air is worse for COPD
cold; hot and humid
Which idiopathic ILD is most associated with connective tissue disease?
What is the most significant risk factor for post-COVID ILD?
severity of acute infection
The diagnostic indexes for diagnosing ASA are called the ____________ index and the ____________ index
apnea-hypopnea index
respiratory disturbance index
What type of lung cancer is most likely to be associated with paraneoplastic syndromes?
small cell lung cancer
COPD
Irritant contact dermatitis is often seen on which three sites on the body? What is the treatment?
dorsum of hands, fingertips, finger webs
Topical corticosteroids
In early COPD, sputum production will be noticeable primarily in the ________
morning/AM
Describe laboratory findings in a patient with AIP
negative viral and bacterial cultures
The number one treatment for hypersensitivity pneumonitis is __________. Other treatments include ________ and _________
antigen avoidance
glucocorticoids and immunosuppressants
Chronic Thromboembolic Disease is part of Group ____ pulmonary hypertension and is treated with ______
4; anticoagulants
80% of benign pulmonology nodules are _______ ________. They are commonly caused by _______ and ________
infectious granulomas; fungi and mycobacterium
A healthy 42 year old female non-smoker presents with ARDS. Family reports she has had approximately 1 week of fever and cough and HRCT reveals bilateral symmetric ground glass opacities. Based on the clinical picture, you suspect she has ________. What other information do you need to prove this diagnosis?
Acute interstitial pneumonia; temporally uniform diffuse alveolar damage on pathology
In atopic dermatitis, infants and toddlers usually have lesions on the ______ surfaces and children/adolescents are affected on ________ surfaces. Adults have predominant _________ (skin finding)
extensor; flexor; lichenification
Why do patients "outgrow" asthma? Do they still need treatment?
bronchioles enlarge with age so have fewer symptoms. patient should always have rescue inhaler!
Which idiopathic ILD should NOT be treated with steroids? Name two characteristic findings on CT
idiopathic pulmonary fibrosis
UIP, honeycombing
What causes lymphangioleiomyomatosis? In what patient population is it most commonly seen?
genetic mutation; young 30s women
On TTE, which measurement helps determine the probability of PH and is used to estimate pulmonary artery systolic pressure?
tricuspid regurgitant jet velocity
Which NSCLC is most closely associated with smoking? Where in the lung is it more likely to be found?
squamous cell carcinoma; centrally
A 75 year old man who previously worked restoring old buildings presents with worsening dyspnea and non-productive cough. HRCT shows thick calcified pleural plaques. What is the most likely diagnosis? What is the treatment?
Asbestosis (pneumoconiosis); supportive care
Allergic contact dermatitis and atopic dermatitis can be treated with a class of meds called _________, which include tacrolimus and pimecrolimus
topical calcineurin inhibitors
What did the SYGMA trial show about SABAs?
regular use of inhaled SABAs is associated with increased airway hyperresponsiveness
Describe the typical patient who gets desquamative interstitial pneumonia. What will be found on pathology to confirm diagnosis?
Mononuclear cells filling distal airspaces
Coal miner's lung is an example of what ILD? What is the treatment?
pneumoconioses; supportive care including oxygen and pulmonary rehab
In which PH groups should lung transplantation be considered?
1 and 3
Popcorn calcification is pathognomonic for __________, but _____ __________ is more commonly seen
hamartoma; fat attenuation
A 64 year old female with a history of rheumatoid arthritis presents with several weeks of cough and dyspnea and one week of fever. Bibasilar crackles on auscultation. Based on presentation and history you suspect
nonspecific idiopathic pneumonia
food impaction; crepe paper
COPD diagnosis requires ALL of the following (3)
pulmonary symptoms (dyspnea, cough, sputum production)
appropriate clinical context (often smoking)
evidence of airflow limitation
If you are treating a patient for pneumonia, what findings on follow-up would make you suspect COP? What changes would you make to the treatment regiment?
- lack of improvement despite antibiotics
- migration of opacity on repeat CXR
- long-term macrolide antibiotics
- 4-6 week of oral glucocorticoids for severe cases
Describe the components of Lofgren's Syndrome. It is seen in _________, which is characterized by ____________ __________ on pathology
Hilar adenopathy, erythema nodosum, and periarticular arthritis
Sarcoidosis, non-caseating granulomas
What finding on PFTs can indicate pulmonary hypertension?
isolated decreased DLCO
What are the common metastasis sites of lung cancer? (6)
Lymph nodes, liver, adrenal glands, bone, brain, pleura
Nick has been wearing a belt that contains nickel. He has a disgusting rash on his stomach now. What do you suspect?
Allergic contact dermatitis