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 48-year-old obese man reports excessive daytime sleepiness, loud snoring, and witnessed apneas. Polysomnography shows an AHI of 32. What is the first-line treatment?
Answer: Continuous positive airway pressure (CPAP)
CPAP is the first-line treatment for moderate-to-severe obstructive sleep apnea (AHI ≥15), as it maintains airway patency during sleep.
A 30-year-old African American woman presents with dyspnea, bilateral hilar lymphadenopathy on CXR, and elevated serum ACE. Transbronchial biopsy shows noncaseating granulomas. What is the diagnosis?
Answer: Sarcoidosis
Sarcoidosis classically presents with bilateral hilar adenopathy, elevated ACE, and noncaseating granulomas on biopsy, most commonly in young Black women.
Which type of lung cancer is most strongly associated with hypercalcemia without bone metastases?
Answer: Squamous cell carcinoma
Squamous cell carcinoma secretes PTHrP, causing hypercalcemia of malignancy independent of bone metastases.
A 25-year-old tall, thin male develops sudden onset right-sided chest pain and dyspnea. CXR shows a 25% right pneumothorax. He has no prior lung disease. What is the most appropriate management?
Answer: Tube thoracostomy with chest tube drainage
A primary spontaneous pneumothorax >20% in a symptomatic patient warrants tube thoracostomy for lung re-expansion.
A patient on isoniazid for latent TB develops peripheral neuropathy. Which vitamin deficiency is responsible?
Answer: Vitamin B6 (pyridoxine)
Isoniazid inhibits pyridoxine (B6) metabolism, causing peripheral neuropathy; B6 supplementation is given prophylactically.
Which of the following is the most common cause of massive hemoptysis (>300 mL/24h) in the United States?
Answer: Bronchiectasis
Bronchiectasis, particularly from cystic fibrosis or prior infections, is the most common cause of massive hemoptysis due to erosion of hypertrophied bronchial arteries.
A 65-year-old woman with rheumatoid arthritis develops bilateral interstitial infiltrates and restrictive pulmonary physiology. Biopsy shows usual interstitial pneumonia (UIP) pattern. Which medication is most appropriate?
Answer: Nintedanib or pirfenidone
Antifibrotic agents (nintedanib, pirfenidone) slow progression in UIP-pattern fibrosis; steroids alone do not reverse established fibrosis and may cause harm.