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20 Cards in this Set
- Front
- Back
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Key History -
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Acute vs. chronic
presence/description of sputum associated Sxs - constitutional URI postnasal drip dyspnea wheezing chest pain heartburn exacerbating and alleviating factors exposures smoking history h/o lung disease allergies meds - esp. ACEI |
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Key PE -
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VS
pulse oximetry exam of nasal mucosa oropharynx heart lungs lymph nodes extremities - clubbing cyanosis edema |
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30 y/o M
presents with SOB, cough and wheezing that worsens in the cold air. He has had several such episodes over the past 4 mos. What is Differential? |
Asthma
GERD bronchitis pneumonitis foreign body |
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30 y/o M
presents with SOB, cough and wheezing that worsens in the cold air. He has had several such episodes over the past 4 mos. What is Workup? |
CBC
CXR peak flow measurement PFTs methacholine challenge test |
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56 y/o F
presents with SOB, as well as a productive cough that has occurred over the past 2 yrs. for at least 3 mos. each yr. She is a heavy smoker. What is Differential? |
COPD - chronic bronchitis
bronchiectasis lung cancer TB |
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56 y/o F
presents with SOB, as well as a productive cough that has occurred over the past 2 yrs. for at least 3 mos. each yr. She is a heavy smoker. What is Workup? |
CBC
sputum gram stain and culture CXR PFTs CT - chest PPD |
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58 y/o M
presents with pleuritic chest pain, fever, chills and cough with purulent yellow sputum. He is a heavy smoker. What is Differential? |
Pneumonia
bronchitis lung abscess lung cancer TB pericarditis |
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58 y/o M
presents with pleuritic chest pain, fever, chills and cough with purulent yellow sputum. He is a heavy smoker. What is Workup? |
CBC
sputum grain stain and culture CXR CT - chest EKG PPD |
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23 y/o F
presents with 2 wks of nonproductive cough. Three wks ago, she had a sore throat and a runny nose. What is Differential? |
Atypical pneumonia
reactive airway disease URI-associated(postinfectious) postnasal drip GERD |
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23 y/o F
presents with 2 wks of nonproductive cough. Three wks ago, she had a sore throat and a runny nose. What is Workup? |
CBC
induced sputum gram stain & Cx CXR IgM detection for M. pneumonia urine Legionella Ag |
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65 y/o M
presents with worsening cough over the past 6 mos. together with hemoptysis, dyspnea, weakness and weight loss. He is a heavy smoker. What is Differential? |
Lung cancer
TB lung abscess COPD vasculitis (e.g., Wegener's) interstitial lung disease CHF |
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65 y/o M
presents with worsening cough over the past 6 mos. together with hemoptysis, dyspnea, weakness and weight loss. He is a heavy smoker. What is Workup? |
CBC
sputum gram stain, culture and cytology CXR CT - chest PPD bronchoscopy |
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55 y/o M
presents with increased dyspnea and sputum production over the past 3 days. He has COPD and stopped using his inhalers last week. He also stopped smoking two days ago. What is Differential? |
COPD exacerbation (bronchitis)
lung cancer pneumonia URI CHF |
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55 y/o M
presents with increased dyspnea and sputum production over the past 3 days. He has COPD and stopped using his inhalers last week. He also stopped smoking two days ago. What is Workup? |
CBC
CXR PFTs sputum gram stain and culture CT - chest |
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34 y/o F nurse
presents with worsening cough of 6 wks' duration together with weight loss, fatigue, night sweats and fever. She has a h/o contact with TB pts. at work. What is Differential? |
TB
pneumonia lung abscess vasculitis lymphoma metastatic cancer HIV/AIDS |
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34 y/o F nurse
presents with worsening cough of 6 wks' duration together with weight loss, fatigue, night sweats and fever. She has a h/o contact with TB pts. at work. What is Workup? |
CBC
PPD sputum gram stain, acid-fast stain and culture CXR CT - chest bronchoscopy HIV Ab |
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35 y/o M
presents with SOB and cough. He has had unprotected sex with multiple sexual partners and was recently exposed to a pt. with active TB. What is Differential? |
TB
pneumonia - including PCP bronchitis CHF (cardiomyopathy) asthma |
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35 y/o M
presents with SOB and cough. He has had unprotected sex with multiple sexual partners and was recently exposed to a pt. with active TB. What is Workup? |
CBC
PPD sputum gram stain, culture, acid-fast stain, silver stain CXR HIV Ab |
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50 y/o M
presents with a cough that is exacerbated by lying down at night and improved by propping up on 3 pillows. He also reports exertional dyspnea. What is Differential? |
CHF
cardiac valvular disease GERD pulmonary fibrosis COPD postnasal drip |
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50 y/o M
presents with a cough that is exacerbated by lying down at night and improved by propping up on 3 pillows. He also reports exertional dyspnea. What is Workup? |
CBC
CXR EKG echocardiography PFTs BNP |
