Pulmonology 1

  1. a virtual space between individual alveoli
  2. from inhalation of silica
  3. The chest film will reveal diffuse rounded opacities, Contraction of the lungs may occur, Upper lung zones are primarily affected
    coal miner's lung
  4. black lung
    coal miner's lung
  5. occupational lung disease caused by the inhalation of dust
  6. Most commonly associated with mining, insulation, shipbuilding, cement mixing and sandblasting related occupations
  7. Higher rate of pulmonary tuberculosis in ____ patients
  8. Hilar lymph nodes calcify forming “eggshell” calcifications on chest films
  9. may lead to pleural disease characterized by plaques, effusion and fibrosis
  10. Mesothelioma, Bronchogenic Carcinoma are malignancies caused by
  11. “Pleural Plaques” are seen on chest films
  12. diagnosis is based largely on the history of exposure and latency period. 20-30 year exposure history
  13. Allergic pulmonary condition caused by inhalation of organic materials
    Hypersensitivity Pneumonitis
  14. Known causative agents include bacteria, molds, human and animal proteins and resins
    Hypersensitivity Pneumonitis
  15. Abrupt onset of fever, cough & dyspnea within 4-8 hours of exposure Infiltrates in the mid-to-lower lung distribution Resolution within 24 hours, after removal from exposure Often mistaken for community-acquired pneumonia, treated with antibiotics
    Hypersensitivity Pneumonitis
  16. Characterized as lung injury caused by the inhalation of nitrogen dioxide gas
    Silo-Filler’s Disease
  17. Carbon monoxide and cyanide poisoning impairs oxygenation causing tissue hypoxia
    smoke inhalation
  18. Ensuing airway edema and mucosal sloughing occurs
    smoke inhalation
  19. Routine use of corticosteroids and antibiotics has not been proven to be effective in treatment of
    smoke inhalation
  20. Topical administration of epinephrine may be used to reduce airway edema
    smoke inhalation
  21. _____ cannot differentiate carboxyhemoglobin from oxyhemoglobin.
    pulse oximetry
  22. CO has a ____ higher affinity for hemoglobin than does oxygen
    250 X
  23. ____ deposits in the alveoli and the interstitium results in irreversible fibrosis
  24. Loss of functional alveolar-capillary units, Impaired gas exchange that leads to hypoxemia and hypercapnia, Impaired lung compliance (stiff lungs)Progresses into Restrictive Lung Disease: smaller lung volumes and capacities (TLC, Tidal Volumes)
    interstitial lung disease
  25. Patchy “Ground Glass” appearance, Reticular (network) pattern, Honeycombing (thick-walled cystic spaces) in the lung periphery
    interstitial lung disease
  26. A nodular inflammatory lesion that may contain epithelial cells, phagocytes or macrophages
  27. A form of coagulation necrosis
  28. A systemic disease of unknown origin characterized by granulomatous inflammation of the lung
  29. Systemic disorder involving multiple organ systems, Highest incidence in black women, Onset in the 3rd decade of life
  30. Elevated ESR, Leukopenia, Elevated ACE levels (40-80% prevalence)
  31. Requires tissue biopsy of a lymph node showing non-caseating granulomas
  32. Long-term corticosteroid therapy, ACE levels will tend to drop
    treatment for sarcoidosis
  33. A condition characterized by the presence of vasculitis and granulomatous lesions affecting the respiratory tract and kidneys
    Wegener’s Granulomatosis
  34. Small vessel vasculitis, Granuloma formation inflammation, Necrosis
    triad of symptoms for Wegener’s Granulomatosis
  35. Nasal septum perforation, crusting and ulceration may present, Deep vein thrombosis and pulmonary emboli are common, “Saddle Nose” deformity is a late stage finding
    Wegener’s Granulomatosis
  36. Idiopathic condition involving alveolar (lung) hemorrhage and rapidly progressive glomerulonephritis
    Goodpasture's syndrome
  37. Most prevalent in men within the 3rd and 4th decade of life, Pathology is linked to glomerular antibodies
    Goodpasture's syndrome
  38. Immunosuppressive Therapy is treatment for
    Goodpasture's syndrome
  39. Most common acute cause of cough in non-smoker
    Viral infections
  40. Cough due to acute respiratory tract infections resolves within _______ weeks in the vast majority of patients.
  41. Persistent cough accompanied by excessive mucus secretions increases the likelihood of _____
  42. what is suspected when acute cough is accompanied by vital sign abnormalities (tachycardia, tachypnea, fever)
  43. Rales, decreased breath sounds, fremitus, and egophony are findings suggestive of what
    air space consolidation
  44. Rales, decreased breath sounds, fremitus, and egophony are findings suggestive of what
    Community acquired pneumonia
  45. Wheezing and rhonchi are suggestive of what in the absence of asthma
    acute bronchitis
  46. normal jugular venous pressure and negative hepatojugular reflux decrease the likelihood of what
    biventricular CHF
  47. Get a chest radiograph if you suspect what
  48. The most likely causes of cough with a clear chest x-ray and the absence of ACEI's
    postnasal drip, asthma, GERD
  49. The perception of uncomfortable breathing
  50. Rapid onset, severe dyspnea in the absence of other clinical features should raise the suspicion for
    pneumothorax, pulmonary embolism, or increased left ventricular end-diastolic pressure
  51. Is accompanied by chest pain and occurs mainly in young, thin adult males
    Spontaneous pneumothorax
  52. Most patients with pleuritic chest pain in the outpatient clinic have pleurisy due to
    acute viral respiratory tract infection
  53. Most cases of dyspnea with wheezing are due to
    Acute bronchitis
  54. pursed lip breathing, use of extra respiratory muscles and barrel shaped chest are indicative of
    obstructive airway disease
  55. asymmetric excursion
  56. metabolic acidosis
    Kussmaul respirations
  57. breathing is first rapid and shallow but as acidosis worsens, breathing gradually becomes deep, slow, labored and gasping
    Kussmaul respirations
  58. Focal wheezing raises suspicion of
    foreign body or other bronchial obstruction
  59. Testing of ______ can help distinguish cardiac from non-cardiac causes of dyspnea in the ED.
  60. Pulse ox values below ____% almost always represents clinically important hypoxemia.
  61. Urgent and emergent conditions causing acute dyspnea include
    pneumonia, COPD, asthma, pneumothorax, pulmonary embolism, cardiac disease, metabolic acidosis, cyanide toxicity, methemoglobinemia, CO poisoning
  62. The expectoration of blood that originates from below the vocal chords
  63. Most cases of hemoptysis in the outpatient setting are due to
    infection (bronchitis, pneumonia, tuberculosis)
  64. Flexible bronchoscopy is indicated for which patients
    smokers, over the age of 40, greater than 1 week history of hemoptysis
  65. Characteristic findings in a patient with chronic obstruction of the upper airway
    Inspiratory stridor, intercostal retractions on inspiration, palpable thrill over larynx, wheezing localized to the neck.
  66. Local parenchymal collapse
  67. the trachea bifurcates into the mainstem bronchi at which levels anteriorly and posteriorly
    Sternal angle, T4 process
  68. the lower border of the lung lies at T __ level posteriorly
  69. the lower border of the lung lies at __th rib level in the midclavicular line.
  70. the lower border of the lung lies at __th rib level in the midaxillary line.
  71. sensation of tingling or "pins and needles" around lips or in the extremities sometimes brought on by shortness of breath
  72. Musical respiratory sounds that may be audible to the patient or others
  73. A reflex response to stimuli that irritate receptors in the larynx, trachea, or large bronchi.
  74. hemoptysis is seen most often in those with
    cystic fibrosis
  75. Audible stridor is a sign of
    airway obstruction in the larynx or trachea
  76. decreased fremitus can be caused by
    obstructed bronchus, COPD, pleural effusion/fibrosis, pneumothorax, infiltrating tumor, very thick chest wall, soft voice.
  77. When it comes to percussion normal lungs are
  78. Dullness replaces resonance when
    air is displaced by fluid or solid tissue
  79. These breath sounds are soft and low pitched. They are heard throughout inspiration and continue without pause through expiration, and fade away 1/3 of the way through expiration
  80. These lung sounds are about equal in length in regards to inspiration and expiration. There may be a silent interval in-between
  81. These breath sounds are loud and higher in pitch, with a short silence between inspiration and expiration. Expiratory lasts longer than inspiratory
  82. these sounds suggest secretions in large airways
  83. Relatively low pitched with a snoring quality
  84. relatively high pitched with a hissing or shrill quality
  85. increased transmission of voice through chest wall suggests
    air-filled lung has become airless
  86. Pain that is described as sharp or knife like is usually
    pleural pain
  87. pectus carinatum
    pigeon chest
  88. pectus excavatum
    funnel chest
  89. dyspnea that occurs in the supine position
  90. Paroxysmal nocturnal dyspnea is associated with which condition
  91. wheezing is generally associated with which condition
  92. According to Cecil's the three most common causes of persistent cough are
    postnasal drip, asthma, GERD
  93. Massive hemoptysis is defined as more than ___ ml of blood in 24 hours
  94. this pain is usually reproducible with movement or palpation over the affected area
    musculoskeletal chest pain
  95. fremitus is increased in areas of
    underlying lung consolidation
  96. fremitus is decreased in areas of
    pleural effusion
  97. What may cause hyporesonance to percussion
    pnemothorax or hyperinflation
  98. a course rattle or fine Velcro like sound
  99. Heard in pulmonary edema, and interstitial fibrosis
  100. A crunching sound timed with the cardiac cycle
    Hamman's sign
  101. Heard in patients with pneumomediastinum
    Hamman's sign
  102. Elasticity is usually measured as its inverse function ___________
  103. The change in lung volume produced by a given chang in transpulmonary pressure
  104. This is decreased in diseases such as pulmonary fibrosis, and pulmonary edema because of they restrict lung volume expansion
  105. This is increased in emphysema because of the loss of elastic recoil
  106. How does the body control the narrow range of normal pH
    elimination or retention of carbon dioxide
  107. The PaCo2 in blood is inversely proportional to the ______
    minute ventilation
  108. What is the strongest factor controlling ventilation
    maintaining normal blood pH
  109. The neuronal control of autonomic respiration resides in the _____
    medullary reticular formation
  110. The PaO2 versus ventilation curve is a mirror image of the ______ for hemoglobin
    oxygen dissociation curve
  111. the volume of air which can be inhaled or exhaled from a person's lungs in one minute
    minute ventilation
  112. defined as ventilation inadequate to keep PaCO2 from rising above normal
  113. the portion of blood that goes from the right side of the heart to the left without an opportunity for exchange of oxygen and carbon dioxide
  114. When pulmonary capillary blood traverses unventilated lung units
    physiologic shunt
  115. the maximal amount of air that can be exhaled after maximum inhalation
    forced vital capacity
  116. "ee" sounds like "ay"
  117. "99" sounds louder and clearer
  118. Whispered sounds are clearer
    whispered pectoriloquy
  119. usually clears with coughing
  120. does not clear with coughing
  121. cough lasting <3 weeks
    acute cough
  122. cough lasting >3 weeks
    persistent cough
  123. most common cause of cough in smokers
    low-grade chronic bronchitis
  124. according to Pat the most common cause of acute cough in non-smokers
  125. Which ribs may be fractured due to cough
  126. most common cause of hemoptysis in the US
    airways disease
  127. most common cause of hemoptysis in developing countries
  128. Enlargement and dilatation of the bronchioles
  129. what does Amy Winehouse have
    crack lung
  130. FEV1
    Forced Expiratory Volume in 1 second
  131. Normal lungs can expire ____% of their vital capacity in 1 second
  132. Patients with _______ have a low vital capacity but a normal FEV1
  133. patients with _______ may have a normal vital capacity but a decreased FEV1
  134. ________ is defined as a low FEV1/VC ratio
  135. ________ is defined as a low vital capacity a low FEV1 but a normal FEV1/VC ratio
  136. Hyperreactive airway state
  137. episodic wheezing and shortness of breath
  138. blue bloater
  139. pink puffer
  140. decreased respiratory drive
  141. a change in structure and function of the right ventricle of the heart as a result of a respiratory disorder
    cor pulmonale
  142. low respiratory drive
  143. exercise limiting organ of the body
  144. #1 cause of COPD in developed countries
    tobacco smoke
  145. steroids are added early in the treatment of this disease
  146. steroids are added late in the treatment of this disease
  147. removes overdistended regions to allow more normal regions to re-expand
    Lung volume reduction surgery
  148. progressive worsening over 1-3 days can lead to
    potentially fatal asthma
  149. lower respiratory tract starts below what anatomic structure
    vocal chords
  150. diagnosed by new infiltrate on exam or x-ray
  151. #1 cause of death from infectious disease in the US is from
  152. hospital acquired pneumonia is defined as symptom onset >___ hours after hospital admission
  153. most common bacterium associated with pneumonia world wide
    Streptococcus pneumoniae
  154. pneumococcus colonizes ____% of healthy adults
  155. May have associated non-respiratory syndromes (CNS, immune hemolytic anemia)
    Mycoplasma pneumoniae
  156. the original atypical pneumonia organism, although it is present in up to 1/3 of cases
    Mycoplasma pneumoniae
  157. ‘Discovered’ in 1976 during an outbreak of pneumonia. Found in aquatic environments
    Legionella pneumophila
  158. 50% of 20 year olds have serologic evidence of past infection. Organism is associated with chronic inflammatory diseases (atherosclerosis)
    Chlamydia pneumonia
  159. may cause necrotizing infiltrates or pneumatoceles
    Staphylococcal pneumonia
  160. may cause necrotizing infiltrates or pneumatoceles
    gram negative
  161. Inhalation of oropharyngeal or gastric contents (volume-dependent)
    aspiration pneumonia
  162. may cause necrotizing infiltrates or pneumatoceles
    aspiration pneumonia
  163. what is a factor that increases risk of infection with a drug resistant-pneumococci
    recent beta lactam therapy (within the past 3 months)
  164. what is a factor that increases risk of infection with a drug resistant-pneumococci
    >65 years of age
  165. factor that increases the risk for gram negative infection
    residence in a nursing home
  166. factor that increases the risk for enteric gram negative infection
    underlying cardiopulmonary disease
  167. factor that increases the risk for infection with pseudomonas aeruginosa
    Corticosteroid therapy (> 10 mg/d of prednisone)
  168. factor that increases the risk for infection with pseudomonas aeruginosa
    Structural lung disease (bronchiectasis)
  169. factor that increases the risk for infection with pseudomonas aeruginosa
    Broad-spectrum antibiotics (> 7 d in past month)
  170. Advanced generation macrolide
    azithromycin or clarithromycin
  171. Respiratory quinolone
    Moxifloxacin, gatifloxacin, levofloxacin, or gemifloxacin
  172. Outpatient therapy for pneumonia in otherwise healthy patients
    Advanced generation macrolide
  173. Outpatient therapy for pneumonia in otherwise healthy patients
    azithromycin or clarithromycin
  174. Outpatient therapy for pneumonia in otherwise healthy patients if patient is allergic to macrolides
  175. Outpatient therapy for pneumonia in patients with cardiopulmonary disease and/or other modifying factors
    Anti-pneumococcal fluoroquinolone
  176. Outpatient therapy for pneumonia in patients with cardiopulmonary disease and/or other modifying factors
    macrolide PLUS b-Lactam (oral cefpodoxime, cefuroxime, high-dose amoxicillin, amox/clavulanate; or parenteral ceftriaxone followed by oral cefpodoxime
  177. rates of influenza has _____ compared to previous decade, possibly due to aging population and/or change in predominating viral strains (H3N2)
  178. influenza has an incubation period of ___ days
  179. Fever, myalgia, headache, malaise, nonproductive cough, sore throat, rhinitis are all symptoms of
  180. Resolution in ___ days, though cough and malaise can persist for over 2 weeks
  181. Children with influenza may present with
    otitis media, nausea, vomiting
  182. Viral cultures are optimal from ______ specimens and require specific viral culture media
  183. Only _______ effective against both Influenza A and B
    ostelmavir and zanamivir
  184. Who needs annual influenza vaccinations
    Long term aspirin therapy
  185. Who needs annual influenza vaccinations
  186. Who needs annual influenza vaccinations
    Chronic medical conditions (pulmonary, cardiac, metabolic, renal, neurologic, immunodeficiency, hemoglobinopathy)
  187. Who needs annual influenza vaccinations
    nursing home residents
  188. Who needs annual influenza vaccinations
    Age 6 months-18 years or >50 yr
Card Set
Pulmonology 1
Pulmonology flashcards made by previous students.