AAFP Respiratory

Question 0

Who should not get the live attenuated influenza vaccine?

Answer 0

#Under age five, over age 49
#Guillain-Barre
#Pregnant patient
#Pediatric patients with long-term aspirin therapy
#chronic pulmonary or cardiovascular disease (including severe persistent asthma)

Question 1

Who should get a second dose of pneumococcal vaccine?

Answer 1

#Sickle cell
#Immunocompromised
#renal failure
#Leukemia
#HIV infected

Question 2

Exercise-induced bronchoconstriction defined as

Answer 2

10% lowering of FEV1 when challenged with exercise

Question 3

When can a spontaneous pneumothorax be managed by oxygen alone?

Answer 3

If it involves less than 15-20% volume

Question 4

Patient presents with nasal stuffiness, purulent nasal discharge, facial pain – suspected diagnosis? Treatment? If fails? If fails?

Answer 4

Acute sinusitis

Bactrim. Then augmentin (amoxicillin + clavulanate)

If antibiotics fails, then get CT scan

Question 5

Treatments for influenza A?

Not recommended?

Answer 5

#Oseltamivir 
#Zanamivir (if over 7 years old)

Amantadine or rimantadine not recommended for influenza A

Question 6

Asthma therapy not recommended for daily use? Why?

Answer 6

Short and long acting beta agonist (can cause tachyphylaxis)

Question 7

When to give rotavirus vaccine?

Answer 7

2/4/6 months

Question 8

Treatment for cough and cold symptoms and child under two?

Answer 8

#Nasal saline bulk section
#Humidified air
#Hydration

Question 9

Restricted airway disease PFT pattern?

Answer 9

#Low FVC
#normal FEV1
#Ratio over .7

Question 10

Obstructive airway disease PFT pattern?

Answer 10

#Normal FVC
#low FEV1
#Ratio under .7

Question 11

A single spirometry suggests a restricted ventilator problem – next step?

If obstructive?

Answer 11

PFTs for static lung volume measurements and diffusion capacity

Question 12

Pleural plaques suggestive of?

Answer 12

Asbestos

Question 26

Evacuation of a hemothorax prevents development of?

Answer 26

Empyema or fibrosis

Question 27

When does oxygen have a mortality benefit for COPD?

Answer 27

O2 sat 88% or less

Question 28

Drugs to decrease COPD exacerbations?

Answer 28

#tiotropium
#Albuterol
#Fluticasone (and help steroid)

Question 29

Hospital management of acute asthma exacerbation?

Answer 29

#Short-acting bronchodilators
#Systemic corticosteroids (oral prednisone equivalent to IV methylprednisolone)

Question 30

CXR of newborn shows patchy atelectasis – diagnosis?

If CXR shows wet silhouette, diffuse parenchymal infiltrates and interlobar fluid ?

If CXR shows homogenous opaque infiltrates with broncograms?

Pt under one year with Peribronchiolar edema?

Answer 30

Meconium aspiration

Transient tachypnea of newborn

Hyaline membrane disease

RSV (supportive care)

Question 31

Went to give young child in respiratory distress supplemental oxygen?

Answer 31

SpO2 under 90

Question 32

Palivizumab?

Answer 32

Preventative measure for RSV

Question 33

When to use a nasal lavage in an adult with sinusitis?

Answer 33

CHRONIC sinusitis

Question 34

Healthy patient with community acquired pneumonia – treatment?

If Patient has been treated with antibiotics within last three months?

Answer 34

macrolide or doxycycline

Fluoroquinolone OR beta-lactam plus macrolide

Question 35

Two doses of influenza vaccine recommended for who?

Answer 35

Unvaccinated children under nine

Question 36

Large supplemental doses of beta-carotene in adults is associated with?

Answer 36

Higher incidence of lung cancer

Question 37

Significance of positivity the first versus second phase of a two-step PPD?

Answer 37

None – both indicate same thing

Question 38

Key factors in diagnosing streptococcal pharyngitis?

Answer 38

``` #Fever over 100.4 #Tonsillar exudates #Anterior cervical lymphadenopathy #No cough ``` More likely to be strep if under 15 years of age; if 10 to 25, think mono