Are you pneum here?
low pitched sounds that can be heard most commonly on expiration when air moves through larger airways with excess amounts of mucus secretions
Rhonchi
What is virchow’s triad and what is it used to identify?
venous stasis (Immobility)
vessel injury
hypercoagulability (ex. Factor 5 leiden def)
to diagnosis PE!!
What is the mechanism of action of cromolyn?
mast cell stabilizer that prevents degranulation of mast cell membranes
A chronic productive cough x 3 months over 2 successive years with chronic inflammation leading to goblet cell mucous production and mucous gland hyperplasia.
COPD - blue bloater pres, cyanosis from hypoxia d/t chronic bronchitis
What is the FDA indicated outpatient tx for COVID?
Nirmatrelvir/Ritonivir (paxlovid)
What is the most common pathogen of community acquired pneumonia?
strep pneumonia - “rusty colored sputum"
__ pleural effusions are low in protein & cell count.
__ pleural effusions are high in protein & cell count.
transudative is low in protein and cell count
exudative is high in protein and cell count
What is the MCC and subsequent tx of pediatric sleep apnea?
Adenotonsillar hypertrophy tx with adenotonsillectomy being curative in most cases (CPAP 1st line in adults)
Hypoxemic respiratory failure is defined as a paO2 under __. Hypercapnia respiratory failure is defined as a paCO2 over ___.
Hypoxic resp failure is a paO2 <60mmHg
Hypercapnic resp failure is a paCO2 >50mmHg
A 32-year-old man with HIV (CD4 count 80) presents with progressive dyspnea, nonproductive cough, and fever. Chest X-ray shows diffuse bilateral interstitial infiltrates. Which of the following is the treatment of choice?
Bactrim
what is the first line diagnosis tool used for aspiration pneumonia?
modified barium swallow study
what is the most common cause of bronchiolitis?
RSV
A 30 yr old came back from a trip to Mississippi a wk ago and has since developed a cough, fever, & chest pain. He reports purulent sputum and on PE you see raised verrucous skin lesions and ulcerations. What is the appropriate tx for the suspected dx?
itraconazole - this is blastomycosis
What PDE4 inhibitor medication prevents frequency of exacerbations in COPD?
roflumilast
A 29-year-old immigrant presents with chronic cough, night sweats, and weight loss. CXR shows cavitary lesions in the upper lobes. What is considered the gold standard for dx?
Acid-fast bacilli culture on Lowenstein-Jensen medium - this is mycobacterium tuberculosis, likely in reactivation stage d/t to progression of symptoms.
A 65-year-old male with a 30 yr pack history pesents to the emergency department with a 5-day history of high fever, dry cough and headache. He reports also experiencing nausea, vomiting, and watery diarrhea for the past 2 days. He recently returned from a cruise. Lab work is notable for hyponatremia and chest X-ray shows a patchy infiltrate in the right lower lobe. What is the likely dx?
legionella pneumoniae
What is heard on lung auscultation of pericarditis?
pleural friction rub - loud grating sounds on pleuras rubbing together
A retired rock miner comes into the office reporting new onset dyspnea. On CXR diffuse hilar nodular opacities are seen that are more prominent in the upper lung. What is the most likely diagnoses
silicosis
what spirometry result(s) supports the dx of asthma?
spirometry result of FEV1/FVC ratio <80% (or equal to) after bronchdilator - increase of >10% after 10-15 min (or equal to)
what condition presents with a slow growing, serotonin secreting tumor that requires surgical excision for definitive tx?
Bronchial carcinoid tumor
What is the treatment of community acquired pneumonia in a 45 yr old pt with a history of heart failure?
Combo of 1. macrolide or doxycycline + 2. augmentin or 3rd gen ceph
2nd line - levo or moxifloxacin
A 20 yr old male presents in the ER with tachycardia, hypotension, and JVP. You notice that the pts systolic blood pressure drops on inspiration and on Xray you see a contralateral shift of the mediastinum. What is the most appropriate first step in management?
ASAP needle decompression - This is tension Pneumothorax!
A 40 yr old african american woman presents to the office complaining of gradually increasing difficulty breathing over the last 2 years. She presents with diffuse red patches on her lower extremities and violaceous papules on her cheeks and nose. She will likely have enlargement of what gland?
parotid! This is sarcoidosis
enlarged lungs, flattened diaphragm, increase in AP diameter are, decreased lung markings and large bullae in upper lobes are xray findings that would support what diagnosis?
Emphysema COPD - pink puffers
What is the chest xray presentation of SCC of the lung? What is the MC associated paraneoplastic syndrome?
centrally located mass, widened mediastinum, cavitary lesions
hypercalcemia