Pulmonary Disease Essentials 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 Essentials flashcards as text
A 65-year-old smoker presents with chronic productive cough and FEV1/FVC ratio of 0.62 post-bronchodilator. Which GOLD stage classification applies if FEV1 is 45% predicted?
Answer: GOLD 3 (Severe)
GOLD Stage 3 (Severe) is defined by FEV1 30-49% predicted with FEV1/FVC < 0.70 post-bronchodilator.
Which finding on CT chest is most characteristic of hypersensitivity pneumonitis in the subacute phase?
Answer: Centrilobular nodules with ground-glass opacity and air trapping
Subacute hypersensitivity pneumonitis classically shows centrilobular nodules, ground-glass opacity, and mosaic attenuation with air trapping on expiratory CT.
A patient with newly diagnosed pulmonary arterial hypertension has a mean PAP of 28 mmHg, PAWP of 10 mmHg, and PVR of 3.5 WU. What is the correct hemodynamic classification?
Answer: Pre-capillary pulmonary hypertension
Pre-capillary PH is defined by mean PAP ≥ 20 mmHg, PAWP ≤ 15 mmHg, and PVR ≥ 2 WU.
A 35-year-old nonsmoker presents with spontaneous pneumothorax. Chest X-ray shows a 2.5 cm rim of air. What is the most appropriate next step?
Answer: Needle aspiration and discharge if successful
For a primary spontaneous pneumothorax > 2 cm in a stable patient, needle aspiration is first-line per BTS guidelines, with discharge if successful.
Which medication used for COPD management acts by inhibiting phosphodiesterase-4 to reduce exacerbations?
Answer: Roflumilast
Roflumilast is a selective PDE-4 inhibitor that reduces inflammation and decreases exacerbation frequency in severe COPD with chronic bronchitis.
A 50-year-old woman with RA presents with progressive dyspnea. HRCT shows basal-predominant reticulation and honeycombing. Surgical lung biopsy shows temporal heterogeneity with fibroblastic foci. What pattern is this?
Answer: Usual interstitial pneumonia (UIP)
UIP pattern is characterized by temporal and spatial heterogeneity, fibroblastic foci, and honeycombing with basal and subpleural predominance.
What is the most common cause of a transudative pleural effusion in the United States?
Answer: Congestive heart failure
Congestive heart failure accounts for approximately 500,000 cases annually and is the leading cause of transudative pleural effusion in the US.