AGNP ACTUAL EXAM 2 QUESTIONS WITH ANSWERS
2025/2026 GRADED A
S/S of pleural effusion - small: asymptomatic
mod-large-SOB, chest pain, fever, cough
Diagnostics of pleural effusion - CXR
US
Chest Ct
Thoracentesis: Diagnostic vs. therapuetic
Plural Fluid Analysis - Transudate-clear
exudate-WBC, protein and blood
Plural fluids Light's criteria - PFluid protein/serum protein >0.5
PF LDH/Serum LDH >0.6
PFLDH > 2/3 of upper normal serum LDH
Chemical eval of plural fluid - protein
ldh
low glucose
tumor markers
Nucleated cells in Plural fluid - >50000-empyemia
>10000-bacterial PNA, acute pancreatis, lups
>5000- TB, Malignancy
Treatment for plural effusion - 1. underlying cause
2. thoracentesis
3. chest tube
4. pluraldesis (doxycycline)
5. Plural drain -pleurx
6. plural decortication
Noncardiac pulmonary edema cause - Barbituate or opiate overdoes, inhalation of
gases, rapid administration of IV fluids'
*Main reason: ARDs
ARDS (acute respiratory distress syndrome) - Acute diffuse, inflammatory lung injury
leading to increased pulmonary vascular permeability, increased lung weight, and loss
of aerated lung tissue
Berlins ARDS - 1. onset within 7 days of event
2. bilateral opacities
3. no need to exclude HF
4. No clear risk factors
, ARDS management - Ventilator support: Mode, TV, Fio2, PEEP
Additional ARDS Management - sedation
paralytics
nitric oxide, prostacyclin
prone position
ECMO
Non-cardiac pulmonary edema - 1. reperfusion PEdema
2. Re-expansion PEdema
3. opiod overdose
4. High altitude PEdema
Cardiogenic PEdema - 1. lt ventricular dysfunction
2. heart enzymes
3. EKG
4. CXR/CT
5. BNP (high- HF, normal- lung disease)
Treatment PEdema - 1. O2
2. Preload reducer: NTB, Diuretics, Fluid restriction
3. afterload reducer: Nitroprusside
4. Manage BP
5. Morphine
Unilateral pulmonary edema causea - 1. papillary dsyfunctio, MVR
2. dependent lung (not turned enough)
3. rapid removal fluid
4. Aspiration of gastric content
5. Unilateral infusion of fluid through misplaced catheter
6. **bronchial obstruction
TRALI (transfusion related acute lung injury) - usually within 6h of blood transfusion
SOB
Fever
Chills
low BP
low O2
infiltrates, normal EF
exudate fluid
little response to diuretics
TACO - transfusion associated circulatory overload
within 6 hours
resp. distress
2025/2026 GRADED A
S/S of pleural effusion - small: asymptomatic
mod-large-SOB, chest pain, fever, cough
Diagnostics of pleural effusion - CXR
US
Chest Ct
Thoracentesis: Diagnostic vs. therapuetic
Plural Fluid Analysis - Transudate-clear
exudate-WBC, protein and blood
Plural fluids Light's criteria - PFluid protein/serum protein >0.5
PF LDH/Serum LDH >0.6
PFLDH > 2/3 of upper normal serum LDH
Chemical eval of plural fluid - protein
ldh
low glucose
tumor markers
Nucleated cells in Plural fluid - >50000-empyemia
>10000-bacterial PNA, acute pancreatis, lups
>5000- TB, Malignancy
Treatment for plural effusion - 1. underlying cause
2. thoracentesis
3. chest tube
4. pluraldesis (doxycycline)
5. Plural drain -pleurx
6. plural decortication
Noncardiac pulmonary edema cause - Barbituate or opiate overdoes, inhalation of
gases, rapid administration of IV fluids'
*Main reason: ARDs
ARDS (acute respiratory distress syndrome) - Acute diffuse, inflammatory lung injury
leading to increased pulmonary vascular permeability, increased lung weight, and loss
of aerated lung tissue
Berlins ARDS - 1. onset within 7 days of event
2. bilateral opacities
3. no need to exclude HF
4. No clear risk factors
, ARDS management - Ventilator support: Mode, TV, Fio2, PEEP
Additional ARDS Management - sedation
paralytics
nitric oxide, prostacyclin
prone position
ECMO
Non-cardiac pulmonary edema - 1. reperfusion PEdema
2. Re-expansion PEdema
3. opiod overdose
4. High altitude PEdema
Cardiogenic PEdema - 1. lt ventricular dysfunction
2. heart enzymes
3. EKG
4. CXR/CT
5. BNP (high- HF, normal- lung disease)
Treatment PEdema - 1. O2
2. Preload reducer: NTB, Diuretics, Fluid restriction
3. afterload reducer: Nitroprusside
4. Manage BP
5. Morphine
Unilateral pulmonary edema causea - 1. papillary dsyfunctio, MVR
2. dependent lung (not turned enough)
3. rapid removal fluid
4. Aspiration of gastric content
5. Unilateral infusion of fluid through misplaced catheter
6. **bronchial obstruction
TRALI (transfusion related acute lung injury) - usually within 6h of blood transfusion
SOB
Fever
Chills
low BP
low O2
infiltrates, normal EF
exudate fluid
little response to diuretics
TACO - transfusion associated circulatory overload
within 6 hours
resp. distress
