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Clinical Medicine - ARF, COPD, OSA, etc.

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Acute Respiratory Failure/ Asthma/COPD/Sleep Apnea/ Pulmonary Infections
campbellpa2017
Quiz by campbellpa2017, updated more than 1 year ago
campbellpa2017
Created by campbellpa2017 about 9 years ago
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Resource summary

Question 1

Question
Acute respiratory failure (ARF) is not a diagnosis.
Answer
  • True
  • False

Question 2

Question
Which of the following PO2 & PCO2 values would be indicative of ARF? (Choose all that apply)
Answer
  • PO2: 80 mmHg
  • PCO2: 80 mmHg
  • PO2: 55 mmHg
  • PCO2: 55 mmHg
  • PCO2: 30

Question 3

Question
Which of the following signs and/or symptoms are NOT shared by both hypoxemia and hypercapnia: (select all that apply)
Answer
  • cyanosis
  • tachypnea
  • AMS
  • asterixis

Question 4

Question
For pts with chronic hypercapnia, a [blank_start]low-flow O2[blank_end] may be used to avoid [blank_start]hypoventilation[blank_end].
Answer
  • low-flow O2
  • high-flow O2
  • hypoventilation
  • hyperventilation

Question 5

Question
Which of the following ventilatory supports would be most appropriate for a patient w/ an acute lung injury, ARDS, and/or severe hypoexmia?
Answer
  • NPPV (CPAP or BiPAP)
  • Intubation
  • Non-rebreather mask
  • Nasal cannula

Question 6

Question
Which of the following might be considered indications for intubation? (select all that apply)
Answer
  • inability to clear secretions
  • mental status decline
  • respiratory acidosis
  • fatigue, tachypnea, and accessory muscle use

Question 7

Question
Which of the following may be a complication of mechanical ventilation?
Answer
  • barotrauma
  • acute respiratory alkalosis
  • hypotension
  • A & B only
  • All of the above

Question 8

Question
Deliberate hypoventilation to avoid barotrauma - even to the point of hypercapnia - is permissible when using mechanical ventilation.
Answer
  • True
  • False

Question 9

Question
Which of the following need be of concern when a pt is on mechanical ventilation? (select all that apply)
Answer
  • minimizing sedatives, hypnotics, and/or opiates
  • DVT prophylaxis
  • decubitus ulcers
  • avoidance of hypokalemia and/or hypophosphatemia

Question 10

Question
Which of the following is the strongest predisposing factor to asthma?
Answer
  • obesity
  • genetic predisposition
  • male
  • female
  • atopy (atopic syndrome)

Question 11

Question
Which of the following may trigger an asthma exacerbation? (select all that apply)
Answer
  • Weather
  • Exercise
  • GERD
  • NSAIDs
  • Menstruation

Question 12

Question
Which of the following may be signs and/or symptoms of asthma? (select all that apply)
Answer
  • nasal polyps
  • eczema/atopic dermatitis
  • prolonged inspiratory phase
  • use of accessory muscles
  • nasal mucosal swelling

Question 13

Question
Which of the following are common findings in diagnosing asthma? (select all that apply)
Answer
  • reduced FEV1/FVC
  • increased FEV1/FVC
  • abnormal CXR
  • improved by bronchodilator
  • exacerbated by methacholine

Question 14

Question
"Control" of asthma is expressed in terms of impairments and risks.
Answer
  • True
  • False

Question 15

Question
The most effective treatment for long-term control of asthma is:
Answer
  • SABA
  • LABA
  • ICS
  • Leukotriene modifiers
  • Exercise

Question 16

Question
Which of the following is/are best used to treat exercise-induced asthma?
Answer
  • Leukotriene modifiers
  • SABAs
  • ICS + SABA
  • Cromolyn sodium & nedocromil
  • Anticholinergics

Question 17

Question
Which of the following is the best treatment for short-term control (quick relief) of asthma sxs?
Answer
  • SABAs
  • LABAs
  • ICS
  • Anticholinergics
  • Systemic corticosteroids

Question 18

Question
Anticholinergics (e.g. ipratropium) are best used in conjunction with systemic corticosteroids.
Answer
  • True
  • False

Question 19

Question
An asthmatic suffering from an acute exacerbation may have a normal to below normal respiration rate.
Answer
  • True
  • False

Question 20

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

Question 21

Question
80% of COPD is caused by tobacco smoking.
Answer
  • True
  • False

Question 22

Question
An uncommon cause of COPD in a young, non-smoker may be related to:
Answer
  • Asbestos
  • Atopy (Atopic Triad)
  • Sampter's Triad
  • Alpha-1-antitrypsin deficiency
  • SARS

Question 23

Question
Late stages of COPD may include:
Answer
  • pulmonary HTN
  • cor pulmonale
  • chronic respiratory failure
  • A & C only
  • All of the above

Question 24

Question
Common COPD findings: (select all that apply)
Answer
  • PFT: increased FEV1/FVC
  • EKG: multifocal atrial tachycardia
  • CXR: flattening of diaphragm
  • ECHO: pulmonary HTN
  • ABG: respiratory alkalosis (chronic hypocapnia)

Question 25

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

Question 26

Question
Common COPD treatment(s): (select all that apply)
Answer
  • Daily Oxygen Use
  • ICS/LABA + Anticholinergic
  • SABA PRN
  • Long-term oral steroids
  • Prophylaxis Antibiotics

Question 27

Question
Possible signs of Obstructive Sleep Apnea (OSA) include: (select all that apply)
Answer
  • HTN
  • Pulm HTN
  • Cor Pulmonale
  • Erythropenia
  • Nasal obstruction

Question 28

Question
Which of the following are real surgical procedures used to tx OSA? (select all that apply)
Answer
  • oronasoseptotomy
  • nasal septoplasty
  • tracheotomy
  • nasopharyngeal resection
  • uvulopalatopharyngoplasty

Question 29

Question
Community-acquired pneumonia is the most deadly infection disease in the U.S.
Answer
  • True
  • False

Question 30

Question
All of the following are considered risk factors for CAP, EXCEPT:
Answer
  • ETOH abuse/dependence
  • decreased BUN
  • AMS
  • tachypnea
  • All of the following are considered risk factors

Question 31

Question
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.
Answer
  • True
  • False

Question 32

Question
Hospital (or Health Care) Associated Pneumonia typically develops within 48 hours of admission.
Answer
  • True
  • False

Question 33

Question
Most common cause of HCA PNA:
Answer
  • S. pneumo
  • P. aeruginosa
  • K. pneumoniae
  • H. flu
  • Adenovirus

Question 34

Question
Which of the following is an empiric tx for MRSA?
Answer
  • amoxicillin-clavulanate
  • Clindamycin + B-lactam
  • Macrolide + ICS
  • B-lactam + Aminoglycoside
  • None of the above

Question 35

Question
Aspiration PNA is most commonly associated w/ aerobic bacterial infections.
Answer
  • True
  • False

Question 36

Question
Foul-smelling sputum in PNA is classically associated w/
Answer
  • anaerobic bacteria
  • aerobic bacteria
  • dental abscesses
  • empyema
  • TB

Question 37

Question
Pulmonary infection often associated with HIV pts:
Answer
  • Mycobacteria
  • Pneumocystis Pneumonia
  • Aspergillus
  • SARS

Question 38

Question
Mycoplasma tuberculosis (TB) is the most common infectious cause of death in the world.
Answer
  • True
  • False

Question 39

Question
TB is eradicated in 95% of cases in which the host is not immunocompromised.
Answer
  • True
  • False

Question 40

Question
Which of the following statements is NOT accurate regarding TB:
Answer
  • 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

Question 41

Question
Which of the following is NOT commonly associated w/ TB:
Answer
  • 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)

Question 42

Question
Routine TB skin tests in low-risk persons is not generally recommended.
Answer
  • True
  • False

Question 43

Question
The tuberculin skin test identifies infected individuals but does not differentiate between active and latent infection.
Answer
  • True
  • False

Question 44

Question
TB skin tests are read by measuring:
Answer
  • erythema
  • induration
  • color of area
  • sensitivity/tenderness of area
  • all of the above

Question 45

Question
It may take up to 10 weeks for an immune response to develop to TB infection.
Answer
  • True
  • False

Question 46

Question
Which of the following TB skin test induration measurements would be considered positive: (select any that apply)
Answer
  • 6mm in HIV pt.
  • 8mm in pt. w/ HA-PNA
  • 12mm Non-immunocompromised pt.
  • 8mm in organ transplant pt.
  • 6mm in an infant

Question 47

Question
Pyridoxine (vit. B-6) is given in TB tx to decrease the neurological side effects
Answer
  • True
  • False

Question 48

Question
TB may migrate to all areas of the body, including the brain, heart, bones, muscles, and lymph nodes.
Answer
  • True
  • False

Question 49

Question
Treatment of latent TB usually involves:
Answer
  • BCG vaccine
  • Isoniazid for 6-9 months
  • No treatment (only monitoring via serial CXRs)
  • TST
  • Both A & B

Question 50

Question
The BCG vaccine is not given in the U.S.
Answer
  • True
  • False
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