Pulmonary Disease Flashcards
7 cards from real Internal Medicine Exam practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Pulmonary Disease flashcards as text
A patient presents with fever, productive cough, and right lower lobe consolidation on CXR. He lives in a nursing home. Which organism is the most likely causative pathogen?
Answer: Streptococcus pneumoniae
Streptococcus pneumoniae remains the most common cause of community-acquired pneumonia (CAP) in all settings including nursing homes.
A 52-year-old woman presents with exertional dyspnea, a loud P2, and right heart failure signs. Right heart catheterization shows mean PAP 38 mmHg, PCWP 10 mmHg. What is the diagnosis?
Answer: Group 1 pulmonary arterial hypertension (PAH)
PAH (Group 1) is defined by mean PAP ≥25 mmHg with PCWP ≤15 mmHg and elevated pulmonary vascular resistance without left heart disease.
Which chest X-ray finding is most suggestive of a tension pneumothorax?
Answer: Ipsilateral lung collapse with tracheal deviation away from the affected side
Tension pneumothorax causes contralateral tracheal deviation and mediastinal shift away from the affected side due to positive pressure buildup.
A 40-year-old woman with lupus presents with pleuritic chest pain and a friction rub. CXR shows a small pleural effusion. What is the expected pleural fluid finding?
Answer: Exudative fluid meeting Light's criteria
Lupus pleuritis produces an exudative pleural effusion meeting Light's criteria due to pleural inflammation from immune complex deposition.
A 70-year-old lifelong smoker with a 50 pack-year history is screened by low-dose CT and found to have a 10 mm solid pulmonary nodule. What is the recommended next step per Fleischner Society guidelines?
Answer: PET-CT scan or CT-guided biopsy
In a high-risk patient, a solid nodule ≥8 mm warrants PET-CT, CT-guided biopsy, or surgical resection for definitive characterization per Fleischner guidelines.
Which finding is most characteristic of hypersensitivity pneumonitis (extrinsic allergic alveolitis)?
Answer: Improvement of symptoms after antigen removal
Hypersensitivity pneumonitis is caused by inhaled antigens; the hallmark is symptomatic improvement upon removal of the offending antigen source.
A 45-year-old man with HIV (CD4 count 60 cells/µL) presents with fever, non-productive cough, and progressive dyspnea. CXR shows bilateral interstitial infiltrates. LDH is elevated. What is the most likely diagnosis?
Answer: Pneumocystis jirovecii pneumonia (PCP)
PCP classically presents in severely immunocompromised HIV patients (CD4 <200) with bilateral interstitial infiltrates, elevated LDH, and gradual onset dyspnea.