Cough
Obstructive
Lung Cancer/Nodules
Restrictive
Miscellaneous
100
A patient presenting with new onset cough after starting this medication.
What is: ACE-inhibitor
100
Two interventions known to improve mortality in COPD
What is:
- Smoking Cessation
- Long-Term Oxygen Therapy (LTOT): severe resting hypoxemia with PaO2 < 55 or SaO2 < 88%
100
The USPSTF guidelines for lung cancer screening are:
What is annual lung cancer screening with low-dose computed tomography in people who meet all of these criteria:
- Are ages 50 to 80 years
- Have a 20 pack-year smoking history
- Currently smoke cigarettes or quit within the past 15 years
100
These criteria are necessary on PFTs for definition of restrictive lung disease
What is:
- decreased TLC
- decreased FEV1
- increased or normal FEV1/FVC ratio
100
The name of the screening tool for OSA
STOP-BANG
Snoring
Tired
Observed Apnea
Pressure
BMI >35
Age >50
Neck Circumference >40
Gender: male
200
Length of time to call a cough "chronic"
What is: 8 weeks
200
The next test to order for 40 year male with panacinar emphysema
What is: alpha-1 anti-trypsin?
200
You stop lung cancer screening when
What is
- Age >81
- If a former smoker has not smoked for 15 consecutive years
- If the patient develops a condition that makes them unable or unwilling to undergo surgery/treatment (e.g., severe lung disease, terminal illness).
200
What is asbestosis with pleural plaques & lower lobe fibrosis?
200
The possible treatments for patients with Group 4 Pulmonary Hypertension are
lifelong anticoagulation
consideration of pulmonary thromboendarterectomy
pulmonary vasodilators if recurrent or unable to tolerate procedure (Riociguat)
300
A 45-year-old nonsmoker presents with chronic cough for 3 months. She is not taking an ACE inhibitor, has no red flag symptoms, and her physical exam is normal. According to chronic cough evaluation guidelines, this is the next step
X ray
300
The underlying pathology is
What is COPD (no improvement with bronchodilator) with decreased FEV1/FVC
300
A 60 year old active smoker with 30 pack year history presents with right arm weakness, droopy eyelid, decreased sweating on the face.
What is Pancoast tumor?
Usually non-small cell lung cancer
Located in the superior sulcus (apex) of the lung
300
These are 2 (atleast) medications that you would want to obtain baseline PFTs before starting
What is
bleomycin, amiodarone, trastuzumab
300
Sleep study showing
What is Chyene Stokes Breathing
(usually associated with HF & stroke)
Tx is to optimize the above issues as opposed to CPAP
400
Most common cause of cough in non smokers with normal chest x-ray?
What is: upper airway cough syndrome (PND)
400
Samter's Triad is
What is: asthma, nasal polyps, and reactivity to NSAIDs or aspirin
400
This cancer is most common in non smokers and with EGFR mutations
What is Adenocarcinoma
400
A 56-year-old woman presents with 6 weeks of progressive cough, low-grade fevers, malaise, and shortness of breath. She was treated with multiple courses of antibiotics for presumed community-acquired pneumonia with minimal improvement.
On exam: bilateral inspiratory crackles.
Chest CT shows bilateral patchy, peripheral consolidations with some ground-glass opacities.
Pulmonary function testing reveals restrictive pattern with reduced DLCO.
Bronchoscopy with BAL and transbronchial biopsy shows intra-alveolar buds of granulation tissue.
This is the most likely diagnosis and the first-line treatment.
What is COP (previously known as BOOP)
Etiology: alveolar epithelial injury
Histopath: the excessive proliferation of fibrous tissue within the alveolar sacs and ducts, extending into the bronchioles.
400
These criteria help differentiate a simple vs complicated parapneumonic effusion
What is:
pH <7.2
glucose <60
LDH >900
Nucleated Cell Count>50,000
500
The likely diagnosis in a patient with chronic cough, normal spirometry, and normal methacholine challenge but with increased eosinophils & improves with corticosteroid use
What is: non-asthmatic eosinophilic bronchitis?
"eosinophilic inflammation of the respiratory tract, without any bronchospasm"
500
Name a biologic agent used in asthma with absolute eosinophils >150/ uL
What is Dupilumab, benralizumab, mepolizumab?
Of note omalizumab is to be used if IgE is elevated
500
In the middle of the OSH discharge summary the classic new patient hospital follow up, there's mention of a 7 mm solid nodule in the right upper lobe. Your patient has prior history of tobacco use and his father had lung cancer.
The appropriate surveillance would be this
What is repeat CT at 6-12 month mark and at 18-24 month mark
500
This anti-fibrotic medication slows disease progression of IPF but does not improve survival
What is nintedanib?
Tyrosine Kinase inhibitor
500
The combination of bilateral hilar lymphadenopathy, erythema nodosum, ankle arthritis and fever is referred to as this
What is Lofgren Syndrome
* this is a specific acute presentation of sarcoidosis
Treat with NSAIDs, colchicine, --> steroids if severe