UPDATED QUESTIONS AND SOLUTIONS
◉ Aspiration PNA.
Answer: s/s: foul smelling sputum, reduced consciousness, breath
sounds decreased, dullness to percussion in RLL
Meds: Augmentin or Ampicillin/Sulbactum depending on severity,
need the combo abx
◉ Small Cell Lung Cancer.
Answer: most aggressive lung cancer
5 year survival rate is lowest
"SCLC"
Smoking (strong association)
Central (mass is usually located in central airway)
Lambert Eaton Syndrome (paraneoplastic syndrome common)
Chemo (extremely responsive to chemo)
◉ Mycoplasma Pneumonia.
Answer: most common cause of walking PNA
young health patients
hazy or patchy infiltrates
,extrapulmonary symptoms - cough, ear ache, pharyngitis
◉ Samter's Triad.
Answer: combo of asthma, nasal polyps and sensitivity to
aspirin/NSAIDs
◉ adenocarcinoma.
Answer: arises from bronchial mucosal glands
lung cancer most commonly seen in non-smokers
mucin or gland formation on histology
◉ Squamous cell carcinoma.
Answer: sCuamous cell carcinoma "4 C's"
Centrally located
Cigarettes
Calcium elevation
Cavitary lesions
◉ croup.
Answer: laryngotracheitis
Treatment: nebulized epinephrine and dexamethasone
Supportive treatment like humidified oxygen
,S/s: marked intercostal retractions, inspiratory stridor, cyanosis,
barking seal like cough
most common cause - parainfluenza virus type 1
"para-croupers"
◉ asbestosis.
Answer: a chronic, progressive lung disease caused by inhaling
asbestos fibers, resulting in scarring (fibrosis) of lung tissue, usually
decades after exposure
"shaggy heart sign" - ill defined cardiac border on CXR
work in attics, roofing, UP HIGH, so nodules will be DOWN LOW in
lower lobs
◉ coal worker's pneumoconiosis.
Answer: black lung disease, is a progressive, irreversible lung
disease caused by long-term inhalation of coal mine dust, leading to
inflammation and scarring (fibrosis)
work DOWN LOW so the nodules will be UP HIGH in upper lobes
◉ legionella.
Answer: diarrhea and cough
Risk factors: contaminated water sources
Labs: elevated liver enzymes, hyponatremia
, ◉ bronchiectasis.
Answer: airways get damaged and enlarged
s/s: persistent cough with hemoptysis, thick sputum, signet ring sign
(bronchioles larger than the pulmonary artery), dilated bronchi and
thickening of airway
◉ causes of bronchiectasis.
Answer: cystic fibrosis
mycobacterial infections (TB or MAC)
autoimmune or inflammatory disease
FB or tumors
Fibrosis or scarring
HIV
◉ pertussis.
Answer: whooping cough
often supportive methods are enough but sometimes abx: macrolide
(azithromycin)
s/s: paroxysmal cough, post cough vomiting, not UTD on
immunizations, inspiratory whooping sound
◉ phases of pertussis.