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Pulmonary (23-32) Flashcards | StudBud
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Pulmonary (23-32)
Pulmonary (23-32)
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1
Pulmonary hypertension due to chronic lung disease/hypoxia would be classified into what group of PH?
2
4
3
1
2
This pt had a recent long bone fracture, what is the most likely diagnosis based on this CXR?
pulmonary edema
pneumonia
NSIP
bronchiectasis
3
Which of the following are part of Virchow's triad of risk factors for developing a PE?
HR > 100
trauma
hypercoagulability
immobility
4
A pt with a high clinical suspicion of PE presents but is hemodynamically stable would be treated with:
thrombolytics
thrombin inhibitors
heparin
IVC filter
5
Which of the following are physiological consequences of PE?
increased CO
RBBB
increased dead space ventilation
decrease in minute ventilation
6
A CHF patient presents with nocturnal desaturations during a recent hospitalization. What's the diagnosis?
sleep related hypoventilation
AHI below 5
cheyne-stokes ventilations
obstructive sleep apnea
7
What would the initial vent settings be for a pt w/ emphysema who "got tired of breathing" & has ABG 7.3/60/58 & 70 kg
AC 500/4/50/7.5
AC 450/8/100/5
AC 1000/12/100/5
AC 500/4/100/5
8
What is a consequence of PEEP?
increases work of breathing
increase PaO2/FiO2 ratio
increases intra-alveolar shunts
increased lung compliance
9
Pulmonary hypertension due to left sided heart disease would be classified into what group of PH?
2
1
4
3
10
What requirements should be met with respect to FIO2 in vent settings?
PaO2 > 60 mmHg
PaO2 > 80 mmHg
FIO2 < 40%
FIO2 < 60%
11
How would you describe this CXR?
bat-wing
hazy
reticular
diffuse
12
The most likely cause for this pattern is
bacterial pneumonia
CHF
emphysema
CF
13
What is the most common vent setting used in the hospital?
synchronized intermittent mandatory ventilation (SIMV)
pressure-controlled
negative pressure
assist control (AC)
14
A pt presents w/ dyspnea and hemoptysis. What is their PE risk level
low (<2pts)
none (0pts)
moderate (2-6)
high (>6 pts)
15
How would you treat this patient
negative pressure ventilation
positive pressure ventilation
adaptive servo-ventilation
pressure-controlled ventilation
16
This pt presented with beads on a string pattern on their CT. What do you suspect?
IPF
pulmonary embolism
bronchiectasis
pulmonary hypertension
17
Which of the following would be on your differential for this patient?
NSIP
pneumoconiosis
IPF
sarcoidosis
18
You suspect PH in a patient with symptoms at rest. What WHO functional class are they in?
2
3
4
1
19
A pt gets off a long flight with dyspnea, chest pain, leg swelling and tachycardia. What's the gold standard to diagnose
pulmonary angiography
D-dimer
lower extremity US
echocardiogram
20
What is the potential side effect of leaving your patient on high levels of O2 for an extended amount of time?
pneumothorax
pulmonary fibrosis
pulmonary edema
ARDS
21
Which of the following would you expect to see in the majority of patients with a PE?
normal A-a gradient
elevated D-dimer
sinus tachycardia
thrombus seen on echo
22
What is the potential issue that can occur during mechanical ventilation if the tidal volume is too high?
pulmonary fibrosis
pleural effusion
pulmonary edema
pneumothorax
23
In a pt with moderate risk of PE, what prophylaxis would you consider?
low dose SC heparin
keep pt moving
warfarin
LMW heparin
24
A pt presents w/ leg swelling/pain, HR 124, hemoptysis and hx of DVT. What is their PE risk level
high (>6 pts)
low (<2pts)
none (0pts)
moderate (2-6)
25
Reversible/idiopathic PE should be treated for what length of time?
0-3 months
3-6 months
6-12
indefinitely
26
A pt presents w/ dyspnea, they had surgery within the last 3 months and had a DVT last year. What is their PE risk level
moderate (2-6)
high (>6 pts)
none (0pts)
low (<2pts)
27
You see this and an x-ray with lots of tiny dots... you diagnose:
bronchiectasis
miliary TB
IPF
pneumonia
28
The majority of pulmonary emboli come from which veins?
iliac-pelvic
calf
femoral
upper extremity
29
Current settings: TV 500, RR 12, FIO2 100%, PEEP 5, ABG 7.32/67/255, PIP 30. Choose the appropriate changes:
increase TV to 600 cc if the pt is 70 kg
decrease TV to 450 cc
increase PEEP to 7.5
increase RR to 14 and decrease FIO2 to 60%
30
Which of the following are considered risk factors for developing obstructive sleep apnea?
prone sleep position
neck circumference > 12 inches
male
age > 60
31
Which of the following may cause hypercapnic respiratory failure
drug OD
asthma exacerbation
pneumonia
PE
32
In a patient with severe bronchospasm, the respiratory rate should be set at:
<10
16-18
>18
10-12
33
Pulmonary hypertension due to unclear/multifactorial mechanisms would be classified into what group of PH?
5
2
3
4
34
What should you set the tidal volume at for a patient on a ventilator?
6-8 cc/kg
8-10 cc/kg
10-12 cc/kg
4-6 cc/kg
35
What would be high on your index of suspicion if you saw this pulmonary infarction?
pneumonia
pleural effusion
pulmonary embolism
ILD
36
What is the gold standard in diagnosing pulmonary hypertension?
right heart catheterization
echocardiogram
based on clinical symptoms alone
left heart catheterization
37
Moderate sleep apnea is defined as having how many apneic events a night?
0-5
30+
5-15
15-30
38
How would you describe this CXR?
interstitial abnormalities
bronchiole abnormalities
nodule
normal
39
Pulmonary hypertension is defined as:
mean pulmonary venous pressure > 20 mmHg at rest
mean pulmonary venous pressure >10 mmHg at rest
mean bronchial artery pressures >20 mmHg at rest
mean pulmonary artery pressure >20 mmHg at rest
40
Your pt presents with worsening dyspnea, fatigue, exertional chest pain, elevated JVP and lower leg edema. You suspect:
PH
Lung cancer
PE
IPF
41
Your PH patient has mild limitations in activity, but can still walk 2 blocks. What WHO functional class are they in?
2
4
3
1
42
ARDS is defined as a PAO2/FiO2 ratio of
below 400
below 100
below 300
below 200
43
Which of the following is true about AC but not SIMV?
positive-pressure breathing
every breath is supported with a fixed set volume
volume-controlled breathing
allows the patient to initiate breaths
44
A goal of mechanical ventilation is to keep PIP ______ and plateau pressure ______
below 35 ; below 30
below 50 ; below 30
above 35 ; above 30
above 50 ; above 35
45
Which of the following would be on your differential for this patient?
IPF
cancer
sarcoidosis
TB
46
What are some potential health implications of untreated OSA?
pulmonary fibrosis
hypertension
increased risk of MI
increased risk of trauma related death
47
The majority of patients with PAH (group I) are treated with:
pulmonary rehab
heart transplant
o2 and diuretics
high dose ca2+ channel blockers
