CMN 568 ACTUAL EXAM QUESTIONS WITH CORRECT ANSWERS
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Course
CMN 568
Institution
CMN 568
CMN 568 ACTUAL EXAM QUESTIONS WITH CORRECT ANSWERS
What area of lung is most likely the target of aspiration pneumonia? - Answer right upper lobe in the supine patient
Common complication from ACUTE aspiration pneumonia - Answer lung abscess or empyema
common complication from CHRONIC a...
CMN 568 ACTUAL EXAM QUESTIONS
WITH CORRECT ANSWERS
What area of lung is most likely the target of aspiration pneumonia? - Answer ✔ right
upper lobe in the supine patient
Common complication from ACUTE aspiration pneumonia - Answer ✔ lung abscess or
empyema
common complication from CHRONIC aspiration pneumonia - Answer ✔ bronchiectasis
tx for acute aspiration pneumonia - Answer ✔ 1st line: IV clindamycin
key symptoms of mycoplasma pneumonia - Answer ✔ - greater than 5yr old
- dry cough at inset, then progressing to sputum production
- rales and chest pain
- bronchopneumonic infiltrates in middle/lower lobes
- pleural effusions
tx for mycoplasma pneumonia - Answer ✔ - 1st line: Azithromycin 10mg/kg PO x1, then
5mg/kg/day x4 days
- alternative: cipro
consequences of OSA in peds - Answer ✔ - FTT
- poor school performance
- pulmonary HTN
- cognitive deficits
- behavioral issues
SUIDS definition - Answer ✔ sudden unexplained infant death syndrome; sudden death
of infant <1yr that remains unexplained after investigation
when does SUIDS peak? - Answer ✔ 2-4mo; most occur at night
the fnp suspects SUIDS, what is the most consistent finding he/she should be looking
for? - Answer ✔ - brainstem gliosis
- extramedullary hemtopoiesis
- increase in peri-adrenal brown fat
- all findings suggestive of intermittent or chronic hypoxia before death
,apparent life threatening events (ALTE) - Answer ✔ acute, unexpected change in an
infants breathing, appearance, or behavior that is frightening to the observer, who may
fear that the infant has died or almost died; these infants are slightly younger than
SUIDS infants
tx plan for patient with ALTE - Answer ✔ hospitalization for further observation/ testing
when does croup typically occur? - Answer ✔ fall-winter
what age group does croup affect? - Answer ✔ kids younger than 5
most important cause of croup in kids - Answer ✔ parainfluenza virus
- types 1/2: cause croup in kids less than 5yr in the fall
- type 3: less than 3yr manifested as bronchiolitis and pneumonia
- type 4: year round circulation
human metapneumonia virus key symptoms - Answer ✔ - kids less than 5
- late fall-early spring
- cough
- coryza
- bronchiolitis or PNA
- no tx available
respiratory symptoms with pharyngoconjunctival fever - Answer ✔ NONE; FB sensation
in eye <1 week; conjunctivitis with preauricular adenopathy, fever, and pharyngitis
what should you rule out when suspecting flu in children? - Answer ✔ reyes syndrome
key symptoms of RSV - Answer ✔ - less than 2yr old
- diffuse whezing
- variable fever
- cough
- tachypnea
- difficulty feeding
- follows URI
- prolonged expiration
- detection of RSV antigen or nucleic acid in nasal secretions
CXR findings in RSV - Answer ✔ diffuse hyperinflation and peribronchiolar thickening
RSV tx peds - Answer ✔ - NO ABX
- NO ALBUTEROL OR SYSTEMIC CORTICOSTEROIDS
- ribavirin given continuous aerosolization (only used in infants with significant cardiac
and anatomical defects)
, who is at highest risk for pneumococcal meningitis infection? - Answer ✔ those with
cochlear implants
ratio of time spent in inspiration/expiration - Answer ✔ ratio of 2:3
what should you palpate on a respiratory exam? - Answer ✔ - trachea at suprasternal
notch
- posterior chest wall to gauge fremitus / transmission of spoken words through lungs
- anterior chest wall (assess cardiac impulse)
what do pulmonary function tests do? - Answer ✔ measures:
- air flow rates
- lung volumes
- ability of lung to transfer gas across alveoli-capillary membrane
should you perform a PFT on a patient with asthma exacerbation? - Answer ✔ no, PFTs
are contraindicated in acute severe asthma, respiratory distress, angina aggravated by
testing, pneumothorax, active TB, and hemoptysis
kussmauls respirations - Answer ✔ rapid LARGE VOLUME breathing due to intense
stimulation of respiratory center from metabolic acidosis
cheyne-stokes respirations - Answer ✔ rhythmic waxing/waning of rate and TV; regular
periods of apnea; seen in end-stage LV failure, neurologic dx, and sleeping at high
altitude
what causes clubbing? - Answer ✔ increased amounts of unsaturated Hgb in capillary
blood; not a reliable indicator of hypoxemia since cyanosis in polycythemia only means
mild hypoxia
what does bronchial lung sounds heard over the periphery of the lung indicate? -
Answer ✔ consolidation
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