Internal Medicine Shelf (A+ Graded)

Bilateral Hilar Adenopathy correct answers think Sarcoidosis!! (non caseasting granulomas, interstitial lung disease, hypercalcemia and erythema nodosum) Asbestosis: 1) location in lung 2) type of cancer risk 3) gross physical findings 4) histo findings 5) at risk population correct answers *LOWER lobes *mesothelioma & bronchogenic carcinoma *pleural calcifications (plaques) *asbestosis fiber=dumb bell *shipyard workers, insulation, brake lining Patient is a sand blaster/miner/glass or pottery worker...at risk for what lung disease? correct answers SILICOSIS-Fibrosis of UPPER lobes of lungs What are patients with Silicosis at risk for? correct answers Pulmonary TB (b/c of egg shell calcifications of upper lung fields provide "nest" for TB) COAL Miner's Disease correct answers *IgA and IgG increased with decreased C3 * positive ANA *small round nodular densities *"CAPLAN SYNDROME"if with RA of lung PULMONARY HYPERTENSION IS DEFINED AS: correct answers PULMONARY ARTERY PRESSURE >25MMHG OR >35MMHG DURING EXCERCISE (nml: 10-14mmHg) What are results of Pulmonary Hypertension? correct answers Atherosclerosis, intimal fibrosis of pulmonary arteries Treatment for Pulmonary Hypertension? correct answers 1st: IV prostacyclins or other VASODILATORS (adenosine, NO) 2nd: Calcium Channel Blocker 3rd: for Thromboprophylaxis: Warfarin 2ndary causes of Pulmonary Hypertension correct answers 1) COPD 2) Mitral Stenosis 3) Systemic Sclerosis (Scleroderma) 4) L-->R shunt (ASD/VSD) 5) Sleep Apnea or High altitude 6) Recurrent Thromboembolism First step in Diagnosing Pulmonary Hypertension correct answers Echo and Swan Ganz Catheter (shows RVH and high PAP) Besides ECHO and Swan Ganz Cath- Other diagnostic findings in Pulmonary Hypertension correct answers EKG-Rt axis deviation, evidence of RVH and RA enalrgement