Pulmonary System Disorders Flashcards
7 cards from real Physician Assistant 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 System Disorders flashcards as text
A 48-year-old bird handler presents with fever, dry cough, and diffuse interstitial infiltrates 6 hours after cleaning the bird cage. Pulmonary function tests show a restrictive pattern. What is the most likely diagnosis?
Answer: Hypersensitivity pneumonitis (bird fancier's lung)
Bird fancier's lung is a classic hypersensitivity pneumonitis triggered by avian antigens, presenting hours after exposure with fever, dyspnea, and restrictive physiology.
A patient on amiodarone for 18 months develops new bilateral pulmonary infiltrates and decreased DLCO. Which finding on BAL most supports amiodarone pulmonary toxicity?
Answer: Foamy lipid-laden macrophages
Foamy macrophages containing phospholipid inclusions are characteristic of amiodarone pulmonary toxicity due to drug-induced phospholipidosis, though they are not specific.
A 38-year-old woman with antiphospholipid syndrome has a right lower lobe pulmonary infarction confirmed on V/Q scan. She completes 3 months of anticoagulation. What is the recommended long-term management?
Answer: Indefinite anticoagulation with a vitamin K antagonist targeting INR 2-3
Antiphospholipid syndrome with thrombosis requires indefinite anticoagulation with a VKA (warfarin) targeting INR 2-3 due to very high recurrence risk.
A 65-year-old with stage IIIA non-small cell lung cancer (N2 disease, no distant metastases) is being evaluated for treatment. He has adequate pulmonary reserve. What is the preferred approach?
Answer: Concurrent chemoradiation followed by durvalumab
Unresectable stage III NSCLC is treated with concurrent platinum-based chemoradiation followed by consolidation durvalumab (anti-PD-L1), per the PACIFIC trial.
A 55-year-old develops hemoptysis, and bronchoscopy reveals a central endobronchial mass with biopsy showing small cell lung cancer. PET/CT shows hilar lymphadenopathy only. This is classified as:
Answer: Limited-stage SCLC
Limited-stage SCLC is confined to one hemithorax and regional nodes that can be encompassed in a radiation field; this patient's disease fits within that definition.
A 42-year-old woman presents with massive hemoptysis (>300 mL in 24 hours). She has a history of bronchiectasis from childhood tuberculosis. What is the MOST important immediate intervention?
Answer: Airway protection and positioning the bleeding lung in the dependent position
The bleeding lung should be placed dependent (affected side down) to prevent aspiration of blood into the healthy lung, which is the most immediate life-threatening risk.
Which pulmonary function test finding is characteristic of a fixed upper airway obstruction (e.g., tracheal stenosis)?
Answer: Flow-volume loop shows flattening of both inspiratory and expiratory limbs
Fixed upper airway obstruction causes equal limitation of both inspiratory and expiratory flow, producing a characteristic plateau (flattening) on both limbs of the flow-volume loop.