Pulmonology Flashcards

A 30-year-old woman has erythema nodosum, bilateral hilar lymphadenopathy, ankle arthritis, and fever. What is the most appropriate management?

Answer: NSAIDs for symptoms; spontaneous remission is likely

Löfgren syndrome is an acute form of sarcoidosis with an excellent prognosis and usually resolves with supportive NSAID therapy.

Which therapy slows the decline in FVC in idiopathic pulmonary fibrosis?

Answer: Nintedanib

Antifibrotics (nintedanib or pirfenidone) slow FVC decline in IPF, while combined immunosuppression causes harm.

Which ventilator strategy reduces mortality in ARDS?

Answer: Tidal volume of 6 mL/kg predicted body weight with plateau pressure ≤30 cm H2O

Low-tidal-volume ventilation based on predicted body weight lowered mortality in the ARDSNet trial.

In a stable patient with COPD at rest, which finding is an indication for long-term oxygen therapy?

Answer: PaO2 ≤55 mm Hg

Long-term oxygen improves survival when resting PaO2 is ≤55 mm Hg or SpO2 is ≤88%, or when PaO2 is 56–59 mm Hg with cor pulmonale or erythrocytosis.

A patient with asthma has central bronchiectasis, total IgE >1000 IU/mL, and positive Aspergillus-specific IgE. What is the initial treatment?

Answer: Oral glucocorticoids, often with itraconazole

Allergic bronchopulmonary aspergillosis is treated with systemic glucocorticoids, and an azole such as itraconazole is often added to reduce exacerbations.

A parapneumonic effusion has pleural fluid pH 7.05 and glucose 35 mg/dL. What is the next step?

Answer: Chest tube drainage

Pleural pH <7.20 or glucose <60 mg/dL indicates a complicated parapneumonic effusion that requires drainage.

Which lung cancer is most associated with hypercalcemia caused by PTH-related peptide?

Answer: Squamous cell carcinoma

Squamous cell lung carcinoma classically secretes PTHrP, whereas small cell carcinoma is linked to SIADH and ectopic ACTH.