A thin patient w/ a slight build present with constant difficulty breathing and
clear mucus. A physical exam also indicates an increased chest
anteroposterior diameter and hyperresonance on percussion. Given the most
likely diagnosis, which class of medications is best suited for long-term tx?
Right Ans - anticholinergics
Which of these manifestations is LEAST likely to present with the onset of
asthma?
A. Plugging the airways by thick mucus
B. Hypertrophy of the mucus glands
C. Thinning of the epithelial basement membrane
D. Hypertrophy of smooth muscle Right Ans - C
Your patient was seen by a pulmonologist 2 months ago and diagnosed with
asthma. The pulmonologist ordered a short acting beta-2 agonist for initial
symptom relief. However, on today's visit to your office, the patient states, "I
don't think this stuff is really working because I'm still short of breath." You
refer the patient back to the pulmonologist. Which of the following would you
anticipate being the next step in the patient's management following the latest
national guidelines? Right Ans - an inhaled corticosteroid (ICS)
Jackie, a 25-yo female, comes to the clinic experiencing respiratory distress
and difficulty speaking. Her lungs are hyperresonant and show hyperinflation
on the x-ray. Which result would most strongly indicate that Jackie should be
admitted to a hospital?
A. Forced expiratory volume is below 30%
B. Respiratory rate is 25 breaths/minute
C. Pulsus paradoxus of 8 mmHg
D. Pulse is 112 bpm Right Ans - A
Which of these is NOT a common indoor trigger for asthma?
Cockroaches
Dust mites
Exercise
Termites Right Ans - termites
,Upon examination, you notice that Alex, an obese 63yo male, has moderate
dyspnea and purulent sputum. His lungs are normal upon percussion.
Laboratory results reveal an increased hematocrit level. Given the most likely
diagnosis, which of the following drugs would you be LEAST likely to
prescribe for the patient's condition?
A. Ipratropium bromide
B. Albuterol
C. Budesonide
D. Montelukast Right Ans - D. montelukast
Which of the following medications is considered to be the mainstay of
treatment for chronic obstructive pulmonary disease?
A. Budesonide
B. Ipratropium bromide
C. Salmeterol
D. Triamcinolone Right Ans - B
Victor, a stocky 40yo male, presents to the clinic with complaints of difficulty
breathing and "endless amounts of gunk whenever he coughs." During the
visit, he coughs up a substantial amount of yellow phlegm. A blood test reveals
an increased hematocrit level, and a physical exam detects lungs that are
normal upon percussion. You order a pulmonary lab for the patient. Given the
most likely condition, which of the following findings would you LEAST
expect?
A. Increased forced expiratory volume in 1 second
B. Increased total lung capacity
C. Increased functional residual capacity
D. Increased residual volume Right Ans - A. (this is an indication of healthy
lung functioning)
Winston, a 42yo male, is an HIV-positive patient whose TB skin test returns
with an elevation of 5mm. After confirming a diagnosis of TB, you prescribe a
traditional drug regimen. For what minimum period of time is Winston
expected to continue his regimen? Right Ans - 9 months
Common symptoms of COPD are: Right Ans - cough, dyspnea, sputum
production
, Is a chest x-ray needed to diagnose COPD? Right Ans - No. Chest x-ray may
show hyperinflation, but PFTs are the standard for diagnosis. PFT may be able
to diagnose prior to the presentation of symptoms.
What is the PFT result need for diagnosis of COPD? Right Ans - FEV1 <0.7
Does every patient with asthma need a SABA? Right Ans - yes
30yo patient with persistent asthma, what are the essential components of
their care plan? (select all that apply)
A. Asthma action plan
B. Flu and pneumonia vaccine
C. Rescue inhaler
D. LABA Right Ans - A, B, C
T or F: Asthma patients and COPD pts both need rescue inhalers? Right Ans
- true
Most common side effects of long-term inhaled steroid use? Right Ans -
Bone demineralization (osteopenia) and cataracts
A 12yo patient presents to the clinic with wheezing, SOB, a feeling of tightness
in the chest. He is afebrile. Which of the following would be the best test to
confirm diagnosis? Right Ans - PFT
T or F: USPSTF recommends screening with low-dose helical CT scans for lung
cancer? Right Ans - true (small vs large cell carcinoma)
T or F: Women are more likely to be diagnosed with mesothelioma? Right
Ans - false
What are symptoms of TB? Right Ans - Cough (3+ weeks), hemoptysis,
chest pain, sputum production, weight loss, anorexia, fatigue
TB interpretation of the Mantoux test: What are some patient populations that
a >10mm induration would be classified as positive? Right Ans - At risk
peds, lab workers, healthcare workers, IV drug users
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