Adenocarcinoma - ANSWER adenocarcinoma, like other lung cancer types, is more likely
to appear in smokers;
It is the most common lung cancer seen in nonsmokers, particularly women and younger
patients.
It generally originates in the periphery of the lung.
Squamous cell carcinoma - ANSWER Squamous cell carcinoma is associated with
hypercalcemia due to secretion of parathyroid hormone-related peptide (pthrp) as well as
bone destruction.
Lymphangio-leiomyomatosis - ANSWER This is a cancer of the smooth muscle of the lung
that occurs most commonly in menstruating females.
It causes obstruction of bronchioles, blood and lymph vessels due to cysts.
They most commonly present with a pneumothorax.
Overnight polysomnography - ANSWER Overnight polysomnography This is the test of
choice for diagnosing sleep apnea.
Coccidioidomycosis - ANSWER The first line drug of choice for Valley Fever is fluconazole.
Patient may remain on therapy up to 6 months to prevent relapse while recovery is
monitored via serum complement fixation titers
Small cell carcinoma - ANSWER Small cell lung cancer is the most aggressive
bronchogenic cancer.
It is centrally located and metastasizes early.
History of smoking is common in this type of cancer.
1
,Asbestosis - ANSWER Pleural plaques and reticular patterns at the lung bases on x-ray are
associated with asbestosis.
Occupational and industrial exposure to asbestos predisposes to development of asbestosis:
pipefitters, insulation workers, laborers, shipbuilding/repair, railway/trucking, plastic/rubber
manufacturer.
Epiglottitis - ANSWER Intravenous cephalosporins (e.g. Ceftriaxone) is indicated in the
treatment of epiglottitis.
Pseudomonas aeruginosa - ANSWER Pseudomonas is the most common organism
causing hospital acquired pneumonia.
Influenza - ANSWER Viral culture: This is the definitive test for influenza
Pulmonary embolism - ANSWER Pulmonary angiography is the definitive test for
pulmonary embolism
Superior vena cava syndrome - ANSWER Lung cancer, particularly adenocarcinoma, is the
most common cause of superior vena cava syndrome (SVCS)
Up to 10% of right-sided intrathoracic malignancies lead to SVCS, secondary to direct
invasion leading to vascular thrombosis, or direct tumor compression of the SVC.
Obstructive sleep apnea - ANSWER Obstructive sleep apnea (OSA) is more common in
middle-aged, and overweight males.
A history of poorly controlled hypertension may also be present.
OSA occurs secondary to small airways and loss of muscular tone which allows the pharynx
to collapse during inspiration.
2
,These patients complain of daytime drowsiness, persistent fatigue, and cognitive difficulties.
Use of sedatives may worsen their symptoms.
Cor Pulmonale - ANSWER Right ventricular hypertrophy RVH is the most common ECG
finding seen in Cor Pulmonale.
Inhaled fluticasone - ANSWER Inhaled corticosteroids are the most important
maintenance medication in moderate-persistent asthma.
Heart failure - ANSWER Heart failure is the most common cause of pulmonary edema.
Asbestosis - ANSWER Lung biopsy is the definitive diagnostic test in asbestosis as well as
the other idiopathic pulmonary disorders
Diagnostic test of choice for bronchiectasis - ANSWER High resolution chest CT showing
dilated tortuous airways is diagnostic of bronchiectasis
Mycoplasma pneumoniae - ANSWER Erythromycin is the drug of choice for treating
Mycoplasma pneumoniae
Indications for thoracentesis - ANSWER Diagnose new effusion in toxic-appearing patient
Suspected parapneumonic effusions (including patients with previously diagnosed effusions)
Symptomatic dyspnea caused by large effusions
10-mm layer of fluid is visible on a radiograph,
Pulmonary Hypertension test workup - ANSWER Generally chest radiographs are
performed first, and may reveal enlarged pulmonary arteries.
3
, Trans-thoracic echocardiogram (TTE) would be the next step in the workup of this patient,
since it is non-invasive,
TEE may be used if TTE isn't conclusive.
Right heart catheterization is the diagnostic test of choice, but is usually performed after
echocardiography due to it's invasive nature.
Side effects of the treatment for active tuberculosis - ANSWER Rifampin: Orange colored
secretions
Isoniazid: Peripheral neuropathies and hepatotoxicity I N nerves H hepatocytes
Pyrazinamide: Hyperuricemia is the most common side effect
Ethambutol: may cause optic neuritis
RIPE
Cystic fibrosis - ANSWER Cystic fibrosis, inherited in an autosomal recessive manner, is a
disorder of the exocrine glands that can predispose patients to conditions such as lung
infections or pancreatitis.
The pilocarpine iontophoresis sweat test revealing elevated sodium and chloride levels in
the sweat of the patient on two separate days is required for the most accurate diagnosis of
cystic fibrosis.
Pneumocystis jirovecci - ANSWER Pneumocystis jirovecci, formerly known as
Pneumocystis carinii, infection occurs most commonly in HIV positive patients with a low
CD4 cell count (<200).
The preferred agent for treatment of Pneumocystis jiroveci infections is oral trimethoprim-
sulfamethoxazole.
Fungal infection, - ANSWER Steroids are contraindicated in cases of fungal infection, due
to the possibility that they could exacerbate the condition
4
to appear in smokers;
It is the most common lung cancer seen in nonsmokers, particularly women and younger
patients.
It generally originates in the periphery of the lung.
Squamous cell carcinoma - ANSWER Squamous cell carcinoma is associated with
hypercalcemia due to secretion of parathyroid hormone-related peptide (pthrp) as well as
bone destruction.
Lymphangio-leiomyomatosis - ANSWER This is a cancer of the smooth muscle of the lung
that occurs most commonly in menstruating females.
It causes obstruction of bronchioles, blood and lymph vessels due to cysts.
They most commonly present with a pneumothorax.
Overnight polysomnography - ANSWER Overnight polysomnography This is the test of
choice for diagnosing sleep apnea.
Coccidioidomycosis - ANSWER The first line drug of choice for Valley Fever is fluconazole.
Patient may remain on therapy up to 6 months to prevent relapse while recovery is
monitored via serum complement fixation titers
Small cell carcinoma - ANSWER Small cell lung cancer is the most aggressive
bronchogenic cancer.
It is centrally located and metastasizes early.
History of smoking is common in this type of cancer.
1
,Asbestosis - ANSWER Pleural plaques and reticular patterns at the lung bases on x-ray are
associated with asbestosis.
Occupational and industrial exposure to asbestos predisposes to development of asbestosis:
pipefitters, insulation workers, laborers, shipbuilding/repair, railway/trucking, plastic/rubber
manufacturer.
Epiglottitis - ANSWER Intravenous cephalosporins (e.g. Ceftriaxone) is indicated in the
treatment of epiglottitis.
Pseudomonas aeruginosa - ANSWER Pseudomonas is the most common organism
causing hospital acquired pneumonia.
Influenza - ANSWER Viral culture: This is the definitive test for influenza
Pulmonary embolism - ANSWER Pulmonary angiography is the definitive test for
pulmonary embolism
Superior vena cava syndrome - ANSWER Lung cancer, particularly adenocarcinoma, is the
most common cause of superior vena cava syndrome (SVCS)
Up to 10% of right-sided intrathoracic malignancies lead to SVCS, secondary to direct
invasion leading to vascular thrombosis, or direct tumor compression of the SVC.
Obstructive sleep apnea - ANSWER Obstructive sleep apnea (OSA) is more common in
middle-aged, and overweight males.
A history of poorly controlled hypertension may also be present.
OSA occurs secondary to small airways and loss of muscular tone which allows the pharynx
to collapse during inspiration.
2
,These patients complain of daytime drowsiness, persistent fatigue, and cognitive difficulties.
Use of sedatives may worsen their symptoms.
Cor Pulmonale - ANSWER Right ventricular hypertrophy RVH is the most common ECG
finding seen in Cor Pulmonale.
Inhaled fluticasone - ANSWER Inhaled corticosteroids are the most important
maintenance medication in moderate-persistent asthma.
Heart failure - ANSWER Heart failure is the most common cause of pulmonary edema.
Asbestosis - ANSWER Lung biopsy is the definitive diagnostic test in asbestosis as well as
the other idiopathic pulmonary disorders
Diagnostic test of choice for bronchiectasis - ANSWER High resolution chest CT showing
dilated tortuous airways is diagnostic of bronchiectasis
Mycoplasma pneumoniae - ANSWER Erythromycin is the drug of choice for treating
Mycoplasma pneumoniae
Indications for thoracentesis - ANSWER Diagnose new effusion in toxic-appearing patient
Suspected parapneumonic effusions (including patients with previously diagnosed effusions)
Symptomatic dyspnea caused by large effusions
10-mm layer of fluid is visible on a radiograph,
Pulmonary Hypertension test workup - ANSWER Generally chest radiographs are
performed first, and may reveal enlarged pulmonary arteries.
3
, Trans-thoracic echocardiogram (TTE) would be the next step in the workup of this patient,
since it is non-invasive,
TEE may be used if TTE isn't conclusive.
Right heart catheterization is the diagnostic test of choice, but is usually performed after
echocardiography due to it's invasive nature.
Side effects of the treatment for active tuberculosis - ANSWER Rifampin: Orange colored
secretions
Isoniazid: Peripheral neuropathies and hepatotoxicity I N nerves H hepatocytes
Pyrazinamide: Hyperuricemia is the most common side effect
Ethambutol: may cause optic neuritis
RIPE
Cystic fibrosis - ANSWER Cystic fibrosis, inherited in an autosomal recessive manner, is a
disorder of the exocrine glands that can predispose patients to conditions such as lung
infections or pancreatitis.
The pilocarpine iontophoresis sweat test revealing elevated sodium and chloride levels in
the sweat of the patient on two separate days is required for the most accurate diagnosis of
cystic fibrosis.
Pneumocystis jirovecci - ANSWER Pneumocystis jirovecci, formerly known as
Pneumocystis carinii, infection occurs most commonly in HIV positive patients with a low
CD4 cell count (<200).
The preferred agent for treatment of Pneumocystis jiroveci infections is oral trimethoprim-
sulfamethoxazole.
Fungal infection, - ANSWER Steroids are contraindicated in cases of fungal infection, due
to the possibility that they could exacerbate the condition
4
