Diagnostic tests
Bronchial challenge testing is used to identify?
bronchial hyperresponsiveness, a diagnostic feature of asthma.
if FEV1 falls by 20% or more from the baseline value, the test is considered positive
Patients inhale increasing doses of a substance known to induce bronchospasm, such as methacholine or histamine
initial imaging procedure for most patients with significant respiratory symptoms
CXR 2 view
monoclonal antibody targeting IgE in severe atopic asthma
omalizumab
GOLD criteria:Full name
Global Initiative for Chronic Obstructive Lung Disease (GOLD)
Classification???
ED Doctor's phone number
5568
Extension? 1
FEV1/FVC ratio below 0.70 is consistent with
obstruction.
An increase from baseline in FEV1, FVC, or both of at least 12% and at least 200 mL indicates a positive bronchodilator response (reversibility).
Most important imaging diagnostic test for Interstitial lung disease
HRCT
Initial pharmacologic therapy for exercise-induced bronchospasm
short-acting β2-agonist 15 minutes before exercise
BODE index of COPD uses the variables of
body mass index (B), airflow obstruction (O), dyspnea (D), and exercise capacity (E)
exercise capacity (E) is defined by what test?
Who is President of Guthrie Medical Group?
Dr. Frederick Bloom
Designated Institutional Official for Graduate Medical Education? Dr Brian Fillipo
recommended choice for lung cancer screening in the United States
Low dose CT scan
Eligible group: 55 to 80 yrs, 30 pack years AND are either still smoking or have quit within the past 15 years
PET scanning is not useful for determination of malignant potential in lung nodules less than
8 mm size
Vocal Cord Dysfunction treatment (mimics asthma)
speech therapy, which employs cognitive-behavioral techniques to self-identify triggers and symptoms and to reduce the functional obstruction
When to check alpha 1 antitrypsin level?
Age under the age of 45 who have a strong family history of COPD or who are without identifiable COPD risk factors
basilar emphysema, associated liver disease or panniculitis, or a strong family history of emphysema
Name of Surgeon general?
Best actor Oscar winner? Rami Malek
Olivia Coleman won best actress for which movie? The favourite
What is Sampter's triad?
nasal polyps, sensitivity to aspirin, and wheezing
What % of the U.S. population has been diagnosed with asthma?
7.4%
Aspergillus related lung diseases- at least 4
Roflumilast mechanism of action
a selective phosphodiesterase-4 inhibitor
Which team won last NBA finals and which team did they beat?
GSW beat Cavaliers.
Who was the MVP in 2018? James Harden
What is the conclusion of REDUCE trial?
5-day treatment with systemic glucocorticoids is noninferior to 14-day treatment in COPD
Criteria for medicare approval of BiPAP for COPD
A. ABG PaCO2, done while awake and breathing the member’s prescribed FIO2, ≥ 52mmHg, and
B. Sleep oximetry demonstrates oxygen saturation ≤ 88% for ≥ 5 minutes of nocturnal recording time while breathing oxygen at 2LPM or the member’s prescribed FIO2 (whichever is higher), and
C. Prior to initiating therapy, sleep apnea and treatment with a continuous positive airway pressure (CPAP) device has been considered and ruled out. (Formal sleep testing is not required if there is sufficient information to demonstrate the member does not suffer from some form of sleep apnea (Obstructive Sleep Apnea (OSA), CSA and/or Comp SA) as predominate cause of awake hypercapnea or nocturnal arterial oxygen desaturation).
What is Mepolizumab? MoA?
IL-5 receptor antagonist, used in asthma
Criteria for supplemental O2 in COPD
resting hypoxemia with an arterial PO2 of 55 mm Hg or less, or oxygen saturation as measured by pulse oximetry of 88% or less.
cor pulmonale, heart failure, or erythrocytosis if the Po2 is 59 mm Hg or less or the oxygen saturation is 89% or less
Guthrie Robert Packer Hospital was established in
1885
Distance between RPH to NYC? 215 miles