Cough

Question 1

Distinguishing coughs:
Acute
Persistent
Chronic

Answer 1

acute =     < 3 weeks
persistent =    3-8 weeks
chronic =    > 8 weeks

Question 2

Acute cough: most due to ______-

Answer 2

viral infections

Question 3

persistent cough with phlegm increases the likelihood of_______

Answer 3

COPD

Question 4

This should be expected in adolescents and adults with persistent or severe cough lasting more than 3 weeks (selected geographic areas)

Answer 4

Pertussis

Question 5

Cardiac medication that causes persistent cough

Answer 5

ace inhibitors

Question 6

cause of cough

No acute causes ACE inhibitor, acute respiratory infection, and CXR normal

Answer 6

postnasal drip, asthma, GERD or combo.

Question 7

dyspnea requires assessment for ______

Answer 7

Chronic lung disease, HF or anemia

Dyspnea at rest or with exertion is not commonly reported among patients with persistent cough.

Question 8

This si suspected when cough is accompanied by unexplained weight loss, hemoptysis, and fevers with night sweats, particularly in persons with significant tobacco or occupational exposures.

Answer 8

Bronchogenic carcinoma

Question 9

Persistent and chronic cough accompanied by excessive mucus secretions increases the likelihood of_____

Answer 9

COPD

Question 10

This is expected when acute cough is accompanied by vital sign abnormalities.

Answer 10

Pneumonia

Question 11

Significant predictors of community-acquired pneumonia

Answer 11

findings suggestive of airspace consolidation (rales, decreased breath sounds, fremitus, egophony)

Question 12

Wheezing and rhonci are found in

Answer 12

acute bronchitis

Question 13

lab test to include for diagnostic accuracy for pneumonia in adults with acute cough

Answer 13

serum c-reactive protein

Question 14

test when pertussis is susspected

Answer 14

PCR on nasal swab

Question 15

suspected conditions for chronic cough

Answer 15

Post nasal drip, asthma, GERD

Question 16

treatment for flu is effective when innitated within

Answer 16

30-48 hrs

Question 17

treatment of pertussis

Answer 17

macrolide antibiotic, cough can last up to 6 mo

Question 18

chronic cough consider sensory dysfunction

Answer 18

sensory dysfunction of the laryngeal branches of the vagus nerve may contribute to persistent cough syndromes and may help explain the effectiveness of gabapentin in patient with chronic cough.

Question 19

a subjective experience or perception of uncomfortable breathing

Answer 19

dyspnea

Question 20

dyspnea can result from

Answer 20

conditions that increase the mechanical effort of breathing
conditions that produce compensatory tachypnea (hypoxemia, acidosis)
Psychogenic conditions

Question 21

dyspnea

what is the primary concern when cough and fever are present?

Answer 21

pulmonary disease (particularly infection):
myocarditis, pericarditis, and septic emboli can present in this manner.

Question 22

Dyspnea

chest pain should be characterized as:

Answer 22

acute or chronic

pleuritic or exertional

Question 23

pleuritic chest pain is the rule in:

Answer 23

acute pericarditis and pneumothorax

in OP setting, viral respiratory tract infection

Question 24

Periodic chest pain that precedes the onset of dyspnea suggests _____________

Answer 24

myocardial ischemia or pulmonary embolism.

Question 25

dyspnea associated with wheezing

Answer 25

acute bronchitis

other = new onset asthma, foreign body and vocal cord dysfunction

Question 26

Kussmal breathing

Answer 26

breathing seen in metabolic acidosis

Question 27

patients with impending upper airway obstuction (epiglottitis, foreign body) or seere asthma exacerbation assume this position

Answer 27

tripod position

Question 28

oxygen saturation values less than _______ almost always represent clinically significant hypoxemia

Answer 28

94%

Question 29

hemoptysis amount that is classified as massive

Answer 29

200-600 mL

Question 30

only symptom that has been found to be a specific predictor of lung cancer

Answer 30

hemoptysis

Question 31

symptoms that suggest large-volume hemorrhage

Answer 31

elevated pulse, hypotension and decreased oxygen sat

Question 32

Classic VTE risk factors

Answer 32

venous thromoboemolism
cancer
trauma
recent surgery
prolonged immobilzation
pregnancy
oral contraceptives
fm hx
prior hx

Question 33

MI common location for pain

Answer 33

retrosternal or left precordial

commonly referred to throat, lower jaw, shoulders, inner arms, upper abd, or back.

Question 34

ischemic pain may be precipitated or exacerbated by:

Answer 34

exertion
cold temp
meals
stress
como of these

Question 35

atypical presentation of ACS is more common in

Answer 35

elderly
women
DM

Question 36

a cardiac friction rub indicates _________ until proven otherwise

Answer 36

pericarditis

Question 37

Tamponade should be excluded in all clinically diagnosed pericarditis patients by assessing ____________

Answer 37

pulsus paradoxus

decrease in systolic pressure by > 10 mmHg during inspiration

Question 38

daily dietary requirements of folic acid

Answer 38

50-100 mcg

Question 39

total body stores of folic acid

Answer 39

5 mg

Question 40

most common cause of folic acid deficiency

Answer 40

inadequate dietary intake

Question 41

folic acid deficiency symptoms

Answer 41

persistent fatigue. weakness. lethargy. pale skin. shortness of breath. irritability.

Question 42

RBC folic acid deficiency level

Answer 42

< 150 ng/ml

Question 43

obtaining this vitamin level in a folic acid deficiency is paramount

Answer 43

B12

Question 44

hemoglobinuria

Answer 44

most often noticed in first morning urine due to drop in blood pH while sleeping that facilitates this hemolysis