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99 Cards in this Set
- Front
- Back
side effects of oseltamivir (tamiflu)
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nausea and vomiting
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side effects of zanamivir (relenza)
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bronchospasms
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sudden onset fever, malaise, non-productive cough and nasal discharge usually in winter months
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influenza
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pts who should get flu vaccine
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nursing home residents
copd pts pregnants in 2nd and 3rd trimester |
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fever, productive cough, pleurisy and sob
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pneumonia
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bacteria associated with pneumonia secondary to alcoholism
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klebsiella pneumonia
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organism causing pneumonia associated with exposure to bats
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histoplasma capsulatum
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bacteria associated with pneumonia due to cystic fibrosis
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pseudomonas
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bacteria associated to pneumonia due to birds contact
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clamydia psittaci
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Diffuse, granular infiltrates on xray
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interstitial pneumonia (pcp and cmv)
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what organisms can more commonly cause nodular lesions in the lungs?
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fungi: histoplasma, cryptococcus and coccidiomyces
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tx for community acquired pneumonia in outpt setting
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MACROLIDE (Z-PACK)
DOXYCYCLINE 100 MG PO BID X 7-10 DAYS LEVOFLOXACIN 500 MG PO QD X 7-14 DAYS |
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tx for capn in inpt setting
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1- THRID GENERATION CEPHALOSPORIN (CEFTRIAXONE, CEFOTAXIME) AND A MACROLIDE
2- LEVOFLOXACIN 3- UNASYN |
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tx for aspiration pneumonia outpt setting
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clindamycin
pen G |
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tx for aspiration pneumonia in a hospitalized pt
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quinolones, ceftriaxone + clindamycin or
pipercillin-tazobactam (zosyn) or ticarcillin-clauvanate (timentin) |
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tx for atypical pneumonias
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tetracyclines and macrolides
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mine worker from southern/ midwestern USA with pneumonia. what's the culprit?
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histoplasma
(ohio, misissipi) |
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culprit for pneumonia in the west (california, arizona, new mexico,texas)
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coccidiomyces
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xrays show patchy infiltrates with mediastinal lymphadenopathy
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histoplasmosis
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sputum cx reveals spherules and eosinophilia
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coccidiomycosis
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diagnostic findings in pcp (4)
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1.butterfly pattern on xray
2.cx neg for bacteria 3.elevated ldh 4.high gallium uptake in infected areas |
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calcified focus of infection involving lymph nodes in tb
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ghon's complex
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extrapulmonary tb affecting the spine
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pott's dz
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extrapulmonary tb affecting the cervical nodes
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scrofula or tuberculous cervical lymphadenitis
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pts in which a 5mm induration gives a positive ppd
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active infection
immunocompromised |
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pts in which a 10mm induration gives a + ppd
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children < 4 yo
confined iv drug abusers |
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fever, cough productive or not, with a normal cxr
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bronchitis
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physical finding associated with aspiration pulmonary abscess
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foul smell breath secondary to anaerobic infexn
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use of abx for anaerobic infection
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clindamycin if above the diaphragm
metronidazole if below the diaphragm |
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dx test for aspiration abscess
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aspiration bx (cant cx sputum bc mouth anaerobes)
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pt more likely to have h. flu pneumonia
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smoker
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test of choice for atypical pneumonias
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serology
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lung ca in which tumor cells contain mucins
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adenocarcinoma
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name the non-small cell ca of the lung
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adenoca
squamous ca large cell ca |
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syndromes associated with lung ca (3)
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superior vena cava synd
horner's synd pancoast's synd |
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unilateral facial anhydrosis, miosis and ptosis
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horner's syndrome
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horner's syndrome with shoulder and arm pain
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pancoast's syndrome
due to tumor invasion to the apex and sympathetic nerves |
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areas where lung ca commonly mets
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brain
bone adrenals liver |
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chemo and xrt combined with surgery are indicated for which type of lung ca?
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non-small cell ca
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dx test to localize carcinoid tumor
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ocreotide scintigraphy
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tx for carcinoid tumors
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surgery only
chemo and xrt are not helpful |
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when a nodule become a mass?
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> 3 cm in diameter
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indication for resection of a solitary nodule
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pts > 35 yo
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mucus casts of small airways found in sputum of asthmatics
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Curschmann's spirals
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crystals indicative of eosinophilic involvement due to asthma or parasitic infections
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charcot-leyden crystals
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first line for asthma exacerbation
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inhaled beta-agonist
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tx for excercise induced asthma
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beta-agonist or cromolyn sodium 15 min pre exercise
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two mechanisms for respiratory failure
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obstruction
resp muscle fatigue |
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pulsus paradoxus, no wheezing, intercostal retractions
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status asthmaticus
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ct finding due to thickening of bronchial walls in bronchiectasis
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signet ring sign
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standard test to dx bronchiectasis
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ct
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emphysema by late 30s, suspect...
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alpha-1-antitrypsin deficiency
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first line tx for emphysema
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anticholinergics
ie. ipratropium (atrovent), tiotropium (spiriva) |
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cromolyn and nedocromil sodium are...
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mast cell stabilizers
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sob, pleuritic pain and absent breath sounds
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ptx
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findings on ekg and abg with pe
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rbbb and resp alkalosis
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sign on cxr seen in 2% of pe pts due to distal vasoconstriction of vessels distal to the embolus
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westermark's sign
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sign on cxr indicating pulmonary infarction and atelectasis in a pe
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hamptom's hump
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gold standard test for pe dx
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pulm. angiography
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gold standard tx for pe
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heparin
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exertional dyspnea, syncope but no orthopnea
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primary pulmonary htn
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3 types of pulmonary htn
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pre-capillary: anything that increases pressure in arteries (pe, vsd...)
passive: anthing that raises pulmonary venous return ( lv failure, htn...) reactive: mitral stenosis |
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dyspnea but no orthopnea, pnd or pulm. edema
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pre-capilary htn
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dyspnea, orthopnea, pnd and evident underlying condition
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passive pulmonary htn
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dyspnea and marked decreased exercise tolerance
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reactive htn
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cxr reveals prominent central pulmonary arteries
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reactive p. htn
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prominent upper lobe pulm. veins and kerley b lines
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passive p. htn
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mcc of cor pulmonale
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copd
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Pt presents w/ RUQ pain, SOB and weakness. PE shows wheezing, elevated JVP and pedal edema.Ekg shows right axis deviation plus prominent p waves as well as Q waves in leads 2, 3 and avf. MLDx?
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cor pulmonale
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half life of warfarin
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36 hr
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idiopathic interstitial pneumonia which shows excellent response to steroids
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cryptogenic organizing pneumonia AKA BOOP (broncholitis obliterans w/ organizing pneumonia)
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idiopathic interstitial pneumonia where complete recovery its unlikely
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usual interstitial pneumonia
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gold standard test to dx interstitial pneumonia
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lung bx
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mainstay of tx for interstitial pneumonia
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steroids
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ra and pneumoconiosis
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caplan's syndrome
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pneumoconiosis associated with nuclear weapons construction
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berylliosis
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Calcium oxalate and protein inclusions in a granuloma associated with sarcoidosis
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schaumann's bodies
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multisystem disorder presents with alveolitis and epitheloid granulomas
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sarcoidosis
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enzyme elevated in sarcoidosis
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ace
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side effects include hemorrhagic cystitis, leukopenia and n/v
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cyclophosphamide
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side effects include hyperglycemia, osteoporosis and edema
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corticosteroids
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side effects include anemia, leukemia and n/v
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azathioprine (imuran) immunosuppresant
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criteria for ards
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pa02 to fi02 ratio</= 200
infiltrates on cxr pwp</= 18 |
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egg-shell pattern on x ray of a glass factory worker
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silicosis
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Most common benign tumor of the lung
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Hamartoma
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Accumulation of coal pigment in the lung parenchma w/o cellular reaction
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ANTHRACOSIS
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Pulmonary fibrosis and rheumatoid arthritis
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CAPLAN'S SYNDROME
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Describe Well's criteria for PE
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- TACHYCARDIA
- HEMOPTYSIS - HX OF PE/DVT - SX/SI OF DVT - IMMOBILE - MALIGNANCY |
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Criteria for home oxygen tx (2)
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1. PO2 < 55 AT REST
2. PO2 BETWEEN 55 AND 60 WITH EVIDENCE OF ERYTHROCYTOSIS OR COR PULMONALE |
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Pt presents w/ sx of pneumonia. Sputum production is scant, CXR reveals patchy infiltrates and consolidation and stain shows PMNs but no organisms. Dx?
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LEGIONNAIRE'S DISEASE
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Histologic analysis of lung parenchyma reveals cells w/ scant or no cytoplasm and a "salt and pepper" appearance of nuclei. Which malignancy is most likely?
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SMALL CELL CA
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Factors that make the oxyhemoglobin dissociation curve shift to the right...
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- low ph
- high CO2 - high temperature - high 2,3 diphosphoglycerate |
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Why should a pt using steroid inhaler rinse his/her mouth after use?
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TO AVOID THE DEVELOPMENT OF ORAL CANDIDIASIS
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Drug of choice for persistent asthma
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INHALED CORTICOSTEROIDS
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Most common causing mechanism of lung abscess?
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ASPIRATION
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Standard therapy for lung abscess?
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CLINDAMYCIN
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Most common cause of chronic lung disease in children and young adults?
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CYSTIC FIBROSIS
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A child presents w/ recurrent bacterial pneumonias, productive cough and diarrhea for a year. PE shows clubbing, nasal polyps and apical crackles. X-ray reveals increased AP diameter and hyperinflated lungs. Diarrhea analysis shows increased fat content. MLDx?
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CYSTIC FIBROSIS
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A pt diagnosed w/ Mycoplasma Pna is at risk of which blood complication and why?
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AUTO-IMMUNE HEMOLYSIS 2/2 IGM HEMAGGLUTININ ANTIBODIES AGAINST RBC's
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