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Pulmonology Flashcards

6 cards from real ABIM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 6 Pulmonology flashcards as text

  1. A 65-year-old man with a 50-pack-year smoking history has FEV1/FVC ratio of 0.60 (post-bronchodilator). FEV1 is 55% predicted. What GOLD stage of COPD does he have?

    Answer: GOLD 2 (moderate)

    GOLD stage 2 (moderate COPD) is defined by FEV1 50–79% predicted with FEV1/FVC <0.70 post-bronchodilator.

  2. A 70-year-old woman presents with acute dyspnea, pleuritic chest pain, and tachycardia after hip replacement surgery. CT pulmonary angiography shows filling defects in the right pulmonary artery. What is the immediate treatment?

    Answer: Anticoagulation with unfractionated heparin or LMWH

    Anticoagulation with heparin (unfractionated or LMWH) is the immediate treatment for hemodynamically stable pulmonary embolism to prevent clot propagation.

  3. A patient with asthma requires daily short-acting beta-agonist use and has nighttime symptoms 3–4 times per month. FEV1 is 78% predicted. What step of asthma therapy does this represent?

    Answer: Step 2: Mild persistent asthma

    Mild persistent asthma (Step 2) is defined by symptoms >2 days/week but not daily, nighttime symptoms 3–4 times/month, and FEV1 ≥80% predicted.

  4. A 55-year-old woman with idiopathic pulmonary fibrosis (IPF) has progressive dyspnea with a UIP pattern on HRCT. FVC is 68% predicted. Which medication is approved to slow disease progression?

    Answer: Nintedanib or pirfenidone

    Nintedanib and pirfenidone are the only FDA-approved antifibrotic agents for IPF and have been shown to slow the rate of FVC decline.

  5. A 40-year-old African American woman presents with bilateral hilar lymphadenopathy, erythema nodosum, and polyarthritis. Serum ACE is elevated. What is the most likely diagnosis?

    Answer: Sarcoidosis

    Löfgren syndrome (bilateral hilar lymphadenopathy, erythema nodosum, and periarthritis/arthritis) is an acute presentation of sarcoidosis with a favorable prognosis.

  6. A patient with COPD exacerbation is on 2L/min O2 and has arterial blood gas: pH 7.29, PaCO2 62 mmHg, PaO2 58 mmHg. He is drowsy but cooperative. What is the next intervention?

    Answer: Non-invasive positive pressure ventilation (BiPAP)

    Non-invasive positive pressure ventilation (BiPAP) is the preferred initial intervention for acute hypercapnic respiratory failure in COPD before resorting to intubation.