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Pulmonology

Internal Medicine

QuestionAnswer
1. β-agonist inhaler used for acute asthma exacerbations 2. long acting β-agonist inhaler 1. albuterol 2. salmeterol
Good drug to use for asthma control in patients with heart disease. anticholinergic drugs (i.e. ipratropium bromide or tiopropium)
Chronic asthma control in: 1. adults 2. children 1. inhaled corticosteroids 2. mast cell stabilizers (cromolyn and nedocromil)
First line drugs in COPD patients anticholinergic drugs (i.e. ipratropium bromide or tiopropium)
Test to evaluate a patient with hx of cough and wheezing who has a normal PFT. 1. methacholine challenge for asthma diagnosis 2. patient may have normal PFT when there is no asthma exacerbation
Diagnosis: 1. obstructive pattern PFT 2. normal DLCO 3. bronchodilator reversibility asthma
Diagnosis: 1. obstructive pattern PFT 2. normal DLCO 3. no bronchodilator reversibility chronic bronchitis
Diagnosis: 1. obstructive pattern PFT 2. decreased DLCO emphysema
How is the A-a gradient calculated? 150 - 1.25xPaCO2 - PaO2
1. What is the normal A-a gradient? 2. What causes an increase in the gradient? 1. between 5 and 15 2. all causes of hypoxemia except hypoventilation and high altitude
To investigate an unexplained pleural effusion, what tests should be performed from the thoracentesis fluid? 1. LDH 2. protein
Thoracentesis fluid 1. LDH > 200 IU/ml 2. protein/serum ration < 0.5 1. exudative 2. transudative
Management of a pleural effusion in a pneumonia patient? 1. antibiotics 2. thoracocentesis to rule out empyema
What are common triggers of intrinsic asthma? 1. infections 2. cold 3. exercise
What are common triggers of extrinsic asthma? allergens (IgE mediated)
Prophylactic medication for exercise induced asthma. cromolyn
Most common cause of COPD exacerbation. viral lung infections
Treatment of acute COPD exacerbation 1. ipratropium + albuterol 2. systemic corticosteroids 3. antibiotics (fluroquinolone or azithromycin)
Best predictor of survival in COPD patients? FEV1
Patient develops a skin ulceration after starting warfarin. What is the deficiency? 1. Warfarin skin necrosis 2. protein C deficiency
1. ICU patient suddenly gets respiratory failure with pulmonary edema 2. Treatment 1. ARDS 2. treat underlying cause and start PEEP
Best initial test to diagnose bronchiectasis? CT scan