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Pulmonology ABIM questions with complete solutions
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Pulmonology ABIM questions with complete solutions
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Pulmonology ABIMWhat is Asthma? - correct answer ✔✔wheeze, airway hyperresponsive, aspirin; dx-FEV1/FVC <0.
70,↑FEV₁ by 12%; (tx: β₂-agonist → low dose ICS → low dose ICS + LABA or medium dose ICS→medium
dose ICS + LABA)
What is Asthma Acute Exacerbation? - correct answer ✔✔O₂, SABA/SAMA, IV glucorticoids, IV Mg
What is Aspirin-exacerbated respiratory disease? - correct answer ✔✔worsened asthma, nasal polyps,
↑eosinophils;(tx- glucocorticoids, removal of NSAID/aspirin + leukotriene receptor antagonist/ singulair)
What is Asthma Step Up Algorithm? - correct answer ✔✔
What is Asthma Step Up Algorithm? - correct answer ✔✔1. Step 1: SABA
2. Step 2: low dose ICS
3. Step 3: low dose ICS + LABA or medium dose ICS
4. Step 4: medium dose ICS + LABA
5. Step 5: high dose ICS + LABA + omalizumab
What is Omalizumab (Xolair)? - correct answer ✔✔(1) symptoms inadequately controlled with inhaled
glucocorticoids
(2) evidence of allergies to perennial aeroallergens and...
(3) serum IgE levels, 30 and 700 U/mL
What is Mepolizumab (Nucala)? - correct answer ✔✔eosinophils >150/µL, severe persistent asthma >
two exacerbations/year despite treatment
What is Chronic Obstructive Pulmonary Disease? - correct answer ✔✔polycythemia, sputum production;
dx-PFT (spirometry), FEV1/FVC <0.7; orders-CXR, ABG, CPAP/BiPAP (tx: albuterol + ipratropium bromide +
home O2, PO₂ <55 or Osat <88%; airline travel-hypoxia altitude simulation test)
,Chronic Obstructive Pulmonary Disease: Acute Exacerbation-Mild - correct answer ✔✔prednisone,
azithromycin/ cephalosporin/ doxycyline
Chronic Obstructive Pulmonary Disease: Acute Exacerbation-Severe - correct answer ✔✔duonebs, IV
gluocorticoids, ceftriaxone + azithromycin, O2
What is Chronic Obstructive Pulmonary Disease Medication Management? - correct answer ✔✔
What is COPD Step Up Algorithm? - correct answer ✔✔1. Step 1: SABA
2. Step 2: SABA, LAMA or LABA
3. Step 3: SABA, LAMA, LABA + ICS
What is COPD Exacerbation? - correct answer ✔✔cough, dyspnea, sputum production; dx-clinical; (tx-
prednisone 40mg 5-7days + azithromycin/ doxycycline)
What is Asthma-COPD overlap syndrome? - correct answer ✔✔inhaled glucorticoid + long acting β
agonist
What is Long Term Oxygen Therapy? - correct answer ✔✔PaO2 < 55mmHg or O2sat <88%
What is Cor Pulmonale? - correct answer ✔✔dyspnea on exertion, ↑JPV with 'a' wave, TR, LE edema;
dx-EKG, right axis deviation, RBBB; (tx-O2 + diuretics)
When is Lung Volume Reduction Surgery Used? - correct answer ✔✔upper lobe emphysema
What is Bronchiectasis? - correct answer ✔✔mucopurulent sptum, daily cough, pseudomonas/ CF; dx-CT
high resolution; (tx-respiratory fluoroquinolone, levofloxacin/moxifloxacin
What is Interstitial Lung Disease? - correct answer ✔✔non-occupational (IPF, Sarcoidosis), Occupational
(organic-hypersensitivity pneumonitis; inorganic-abestosis, silicosis, beryillosis, coal workers'
pneumoconiosis)
, What is Diffuse Parenchymal Lung Disease? - correct answer ✔✔dyspnea, cough; cause-connective
tissue, smoking, radiation, hypersensitivity pneumonitis; dx-CXR, nodular infiltrates→CT, PFT (restrictive,
obstructive/restrictive); (tx-connective tissue disease, limiting drug/ occupational exposure, smoking
cessation)
What is Idiopathic Pulmonary Fibrosis? - correct answer ✔✔bibasilar crackles, clubbing, progressive
dyspnea on exertion; dx- CXR, honeycomb changes, HRCT traction bronchectasis; (tx- oxygen,
pirfenidone/ nintedanib → lung transplantation)
What is Idiopathic Pulmonary Fibrosis? - correct answer ✔✔
What is Hypersensitivity Pneumonitis? - correct answer ✔✔allergen induced, clubbing, crackles; dx-CT,
ground glass opacities→BAL, biopsy, noncaseating granuloas in lung periphery
What is Acute Radiation pneumonitis? - correct answer ✔✔thoracic-neck radiation, unresponsive to
antibiotics; (tx-prednisone)
What is Acute Eosinophilic Pneumonia? - correct answer ✔✔non productive cough, bibasilar inspiratory
crackles, new smokers; dx-eosinophilia, CXR-bilateral diffuse ground glass & reticular opacities
What is Chronic Eosinophilic Pneumonia? - correct answer ✔✔non-smokers, athma, weight↓, night
sweats; dx-CXR-bilateral infiltrates sparing perihilar & central lung regions, lung biopsy-multinucleated
giant cells
What is Sarcoidosis? - correct answer ✔✔bilateral hilar adenopathy,↑1,25-dihydroxyvitamin D3; dx-
endobronchial US, LN sampling, non-caseating granuloma; (tx- oral steroids-progressive symptoms &
pulmonary; topical steroids-skin lesions, anterior uveitis, inhaled-nasal polyps)
What is Sarcoidosis? - correct answer ✔✔
What is Lofgren Syndrome? - correct answer ✔✔hilar adenopathy, erythema nodosum, ankle arthritis;
dx-clinical; (tx-steroids)
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