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					MEDICINE 2 st 1 Shifting Exam (Pulmo & GI) Dr. Diza / Dr. Lucero / Dr. Salamat 1. Most frequent viral infection after lung transplant – CMV 2. Main sources of perioperative mortality – technical complications of operation, primary graft failure, infections 3. Leading cause of early death on lung transplant – graft failure 4. Bilateral lung transplant – Cystic fibrosis 5. Absolute exclusion in lung transplant – HIV infection 6. Chest exam findings in Atelectasis w/ patent airway & Pneumonia Atelectasis: dull, Inc. fremitus, broncho.,pectoriquy, crackels, egophony Pneumonia: dull, Inc. fremitus, normal BS, crackels 7. The vol. of gas contained in the lungs after maximal inspiration – TLC 8. Formula for determining total lung vol. - ? 9. Most common cause of hypoxemia clinically – V/Q mismatch 10. Collection of sputum – spot specimen collected @ the time of consult + early morning specimen + spot specimen collected when px comes back 11. Single largest risk factor for dev’t of asthma – Atopy 12. True of stimuli that incite asthma except: a. Allergic asthma is dependent on IgE response controlled by T & B lymphocytes b. In 30 to 50% of px a second wave of bronchoconstriction develops 6 to 10 hrs later c. Stimuli should be present in significant amount of time and number to incite asthma attacks d. Resp.infxn is the most common stimuli that evoke acute exacerbations of asthma 13. Sine quanon of asthma – wheezing 14. Glucocorticoids are the most potent and most effective anti-inflammatory meds. In asthma– TRUE 15. Most frequent inorganic dust-related chronic pulmo dse. – Asbetosis 16. Exposure to asbestos is not limited to persons who directly handle the mat’l – TRUE 17. Asbestosis – groundglass Silicosis – eggshell 18. Criteria for hosp.admission w/ CAP in adult – RR >28 /min 19. Aspiration pneumonitis – peperacillin / tazobactam IV

20. Radiographic finding in Pulmo HPN / Thromboembolisim – Ring Shadow 21. Most impt. Risk factors for HAP due to resistant micro-organisms – Late onset of infxn & recent antibiotic therapy 22. Earliest sign of HAP – dyspnea 23. Findings on Pulmo. Embolism a. Westermarks sign – fetal oligemia b. Hampton’s hump – wedge-shaped density above diaphragm c. Palla’s sign – enlarged right descending pulmo. Artery d. McConnell’s sign – RV free wall hypokinesis w/ normal RV apical motion ** letters a-c : findings on chest xray d: echocardiography 24. Positive pleural pressure all thru out resp.cycle – Tension pneumothorax 25. Hamman’s sign – crunching or clicking noise synchronous w/ the heartbeat & best heard in the left lat.decub. position 26. Effects are restrictive lung dse. & ventilation-perfusion imbalances – Kyphoscoliosis 27. > 90* angle causing marked ventilatory abnormality 28. Hallmark of all alveolar hypoventilation syndromes -  in alveolar PCO2 (PACO2) 29. Most common lung CA in non-smokers – Adenocarcinoma 30. Present as central mass w/ endobronchial growth – Squamous cell CA

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