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Acute Respiratory Failure/ Asthma/COPD/Sleep Apnea/ Pulmonary Infections

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1_Clinical Medicine - ARF, COPD, OSA, etc.

Question 1 of 50

1

Acute respiratory failure (ARF) is not a diagnosis.

Select one of the following:

  • True
  • False

Explanation

Question 2 of 50

1

Which of the following PO2 & PCO2 values would be indicative of ARF? (Choose all that apply)

Select one or more of the following:

  • PO2: 80 mmHg

  • PCO2: 80 mmHg

  • PO2: 55 mmHg

  • PCO2: 55 mmHg

  • PCO2: 30

Explanation

Question 3 of 50

1

Which of the following signs and/or symptoms are NOT shared by both hypoxemia and hypercapnia:
(select all that apply)

Select one or more of the following:

  • cyanosis

  • tachypnea

  • AMS

  • asterixis

Explanation

Question 4 of 50

1

Select from the dropdown lists to complete the text.

For pts with chronic hypercapnia, a ( low-flow O2, high-flow O2 ) may be used to avoid ( hypoventilation, hyperventilation ).

Explanation

Question 5 of 50

1

Which of the following ventilatory supports would be most appropriate for a patient w/ an acute lung injury, ARDS, and/or severe hypoexmia?

Select one of the following:

  • NPPV (CPAP or BiPAP)

  • Intubation

  • Non-rebreather mask

  • Nasal cannula

Explanation

Question 6 of 50

1

Which of the following might be considered indications for intubation?
(select all that apply)

Select one or more of the following:

  • inability to clear secretions

  • mental status decline

  • respiratory acidosis

  • fatigue, tachypnea, and accessory muscle use

Explanation

Question 7 of 50

1

Which of the following may be a complication of mechanical ventilation?

Select one of the following:

  • barotrauma

  • acute respiratory alkalosis

  • hypotension

  • A & B only

  • All of the above

Explanation

Question 8 of 50

1

Deliberate hypoventilation to avoid barotrauma - even to the point of hypercapnia - is permissible when using mechanical ventilation.

Select one of the following:

  • True
  • False

Explanation

Question 9 of 50

1

Which of the following need be of concern when a pt is on mechanical ventilation? (select all that apply)

Select one or more of the following:

  • minimizing sedatives, hypnotics, and/or opiates

  • DVT prophylaxis

  • decubitus ulcers

  • avoidance of hypokalemia and/or hypophosphatemia

Explanation

Question 10 of 50

1

Which of the following is the strongest predisposing factor to asthma?

Select one of the following:

  • obesity

  • genetic predisposition

  • male

  • female

  • atopy (atopic syndrome)

Explanation

Question 11 of 50

1

Which of the following may trigger an asthma exacerbation? (select all that apply)

Select one or more of the following:

  • Weather

  • Exercise

  • GERD

  • NSAIDs

  • Menstruation

Explanation

Question 12 of 50

1

Which of the following may be signs and/or symptoms of asthma? (select all that apply)

Select one or more of the following:

  • nasal polyps

  • eczema/atopic dermatitis

  • prolonged inspiratory phase

  • use of accessory muscles

  • nasal mucosal swelling

Explanation

Question 13 of 50

1

Which of the following are common findings in diagnosing asthma? (select all that apply)

Select one or more of the following:

  • reduced FEV1/FVC

  • increased FEV1/FVC

  • abnormal CXR

  • improved by bronchodilator

  • exacerbated by methacholine

Explanation

Question 14 of 50

1

"Control" of asthma is expressed in terms of impairments and risks.

Select one of the following:

  • True
  • False

Explanation

Question 15 of 50

1

The most effective treatment for long-term control of asthma is:

Select one of the following:

  • SABA

  • LABA

  • ICS

  • Leukotriene modifiers

  • Exercise

Explanation

Question 16 of 50

1

Which of the following is/are best used to treat exercise-induced asthma?

Select one of the following:

  • Leukotriene modifiers

  • SABAs

  • ICS + SABA

  • Cromolyn sodium & nedocromil

  • Anticholinergics

Explanation

Question 17 of 50

1

Which of the following is the best treatment for short-term control (quick relief) of asthma sxs?

Select one of the following:

  • SABAs

  • LABAs

  • ICS

  • Anticholinergics

  • Systemic corticosteroids

Explanation

Question 18 of 50

1

Anticholinergics (e.g. ipratropium) are best used in conjunction with systemic corticosteroids.

Select one of the following:

  • True
  • False

Explanation

Question 19 of 50

1

An asthmatic suffering from an acute exacerbation may commonly have a normal to below normal respiration rate.

Select one of the following:

  • True
  • False

Explanation

Question 20 of 50

1

Select from the dropdown lists to complete the text.

Types of COPD include: 1) ( Chronic Bronchitis, Emphysema, Asthma, ARF, ARDS ) (the blue bloater) characterized by excessive secretions and daily productive cough, and 2) ( Chronic Bronchitis, Emphysema, Asthma, ARF, ARDS ) (the pink puffer) characterized by abnormal airspace enlargement distal to terminal bronchiole w/ wall destruction.

Explanation

Question 21 of 50

1

80% of COPD is caused by tobacco smoking.

Select one of the following:

  • True
  • False

Explanation

Question 22 of 50

1

An uncommon cause of COPD in a young, non-smoker may be related to:

Select one of the following:

  • Asbestos

  • Atopy (Atopic Triad)

  • Sampter's Triad

  • Alpha-1-antitrypsin deficiency

  • SARS

Explanation

Question 23 of 50

1

Late stages of COPD may include:

Select one of the following:

  • pulmonary HTN

  • cor pulmonale

  • chronic respiratory failure

  • A & C only

  • All of the above

Explanation

Question 24 of 50

1

Common COPD findings:
(select all that apply)

Select one or more of the following:

  • PFT: increased FEV1/FVC

  • EKG: multifocal atrial tachycardia

  • CXR: flattening of diaphragm

  • ECHO: pulmonary HTN

  • ABG: respiratory alkalosis (chronic hypocapnia)

Explanation

Question 25 of 50

1

In COPD, daily oxygen use is positively correlated with longer survival rates, reduced hospitalizations, and better quality of life.

Select one of the following:

  • True
  • False

Explanation

Question 26 of 50

1

Common COPD treatment(s):
(select all that apply)

Select one or more of the following:

  • Daily Oxygen Use

  • ICS/LABA + Anticholinergic

  • SABA PRN

  • Long-term oral steroids

  • Prophylaxis Antibiotics

Explanation

Question 27 of 50

1

Possible signs of Obstructive Sleep Apnea (OSA) include:
(select all that apply)

Select one or more of the following:

  • HTN

  • Pulm HTN

  • Cor Pulmonale

  • Erythropenia

  • Nasal obstruction

Explanation

Question 28 of 50

1

Which of the following are real surgical procedures used to tx OSA?
(select all that apply)

Select one or more of the following:

  • oronasoseptotomy

  • nasal septoplasty

  • tracheotomy

  • nasopharyngeal resection

  • uvulopalatopharyngoplasty

Explanation

Question 29 of 50

1

Community-acquired pneumonia is the most deadly infectious disease in the U.S.

Select one of the following:

  • True
  • False

Explanation

Question 30 of 50

1

All of the following are considered risk factors for CAP, EXCEPT:

Select one of the following:

  • ETOH abuse/dependence

  • decreased BUN

  • AMS

  • tachypnea

  • All of the following are considered risk factors

Explanation

Question 31 of 50

1

Because the clearing of lung infiltrates in CAP may take 6 weeks or longer, there is no need to repeat a CXR unless a pt is not doing well clinically.

Select one of the following:

  • True
  • False

Explanation

Question 32 of 50

1

Hospital (or Health Care) Associated Pneumonia typically develops within 48 hours of admission.

Select one of the following:

  • True
  • False

Explanation

Question 33 of 50

1

Most common cause of HCA PNA:

Select one of the following:

  • S. pneumo

  • P. aeruginosa

  • K. pneumoniae

  • H. flu

  • Adenovirus

Explanation

Question 34 of 50

1

Which of the following is an empiric tx for MRSA?

Select one of the following:

  • amoxicillin-clavulanate

  • Clindamycin + B-lactam

  • Macrolide + ICS

  • B-lactam + Aminoglycoside

  • None of the above

Explanation

Question 35 of 50

1

Aspiration PNA is most commonly associated w/ aerobic bacterial infections.

Select one of the following:

  • True
  • False

Explanation

Question 36 of 50

1

Foul-smelling sputum in PNA is classically associated w/

Select one of the following:

  • anaerobic bacteria

  • aerobic bacteria

  • dental abscesses

  • empyema

  • TB

Explanation

Question 37 of 50

1

Pulmonary infection often associated with HIV pts:

Select one of the following:

  • Mycobacteria

  • Pneumocystis Pneumonia

  • Aspergillus

  • SARS

Explanation

Question 38 of 50

1

Mycoplasma tuberculosis (TB) is the most common infectious cause of death in the world.

Select one of the following:

  • True
  • False

Explanation

Question 39 of 50

1

TB is eradicated in 95% of cases in which the host is not immunocompromised.

Select one of the following:

  • True
  • False

Explanation

Question 40 of 50

1

Which of the following statements is NOT accurate regarding TB:

Select one of the following:

  • Latent TB can still be transmitted to others in blood and plasma

  • TB has a 50% reactivation rate in pts w/ HIV

  • 90% of adult TB is activation of latent TB

  • Extrapulmonary TB is common in HIV

  • Drug resistance is a major problem

Explanation

Question 41 of 50

1

Which of the following is NOT commonly associated w/ TB:

Select one of the following:

  • calcified hilar nodules (latent)

  • Ghon and Ranke complexes (latent)

  • infiltrates in lower areas of lungs (active)

  • hilar LAD (active)

  • miliary pattern w/ hematogenous spread (active)

Explanation

Question 42 of 50

1

Routine TB skin tests in low-risk persons is not generally recommended.

Select one of the following:

  • True
  • False

Explanation

Question 43 of 50

1

The tuberculin skin test identifies infected individuals but does not differentiate between active and latent infection.

Select one of the following:

  • True
  • False

Explanation

Question 44 of 50

1

TB skin tests are read by measuring:

Select one of the following:

  • erythema

  • induration

  • color of area

  • sensitivity/tenderness of area

  • all of the above

Explanation

Question 45 of 50

1

It may take up to 10 weeks for an immune response to develop to TB infection.

Select one of the following:

  • True
  • False

Explanation

Question 46 of 50

1

Which of the following TB skin test induration measurements would be considered positive: (select any that apply)

Select one or more of the following:

  • 6mm in HIV pt.

  • 8mm in pt. w/ HA-PNA

  • 12mm Non-immunocompromised pt.

  • 8mm in organ transplant pt.

  • 6mm in an infant

Explanation

Question 47 of 50

1

Pyridoxine (vit. B-6) is given in TB tx to decrease the neurological side effects

Select one of the following:

  • True
  • False

Explanation

Question 48 of 50

1

TB may migrate to all areas of the body, including the brain, heart, bones, muscles, and lymph nodes.

Select one of the following:

  • True
  • False

Explanation

Question 49 of 50

1

Treatment of latent TB usually involves:

Select one of the following:

  • BCG vaccine

  • Isoniazid for 6-9 months

  • No treatment (only monitoring via serial CXRs)

  • TST

  • Both A & B

Explanation

Question 50 of 50

1

The BCG vaccine is not given in the U.S.

Select one of the following:

  • True
  • False

Explanation

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