Pulmonary

Question 1

What is the definitive test for suspected pneumonia due to Mycoplasma pneumoniae?

Answer 1

Serum Mycoplasma pneumoniae IgM

Question 2

… is characterized as loss of normal shoulders of the subglottic airway (subglottic narrowing) and associated with …

Answer 2

Steeple sign; Croup

Question 3

… is characterized as thickening of aryepiglottic fold and epiglottis and is associated with …

Answer 3

Thumbprint sign; Epiglottis

Question 4

What is the most likely diagnosis for patient with recurrent pneumonia and sinusitis, digital clubbing, nasal polyps, barrel chest and bronchiectasis on CXR?

Answer 4

Cystic Fibrosis

Question 5

What is the most likely diagnosis of patient developing acute respiratory distress in toxic appearing child with previous symptoms of croup (other viral illness) and when intubated found to have thick purulent secretions and formation of ulcerations and pseudomembranes?

Answer 5

Bacterial tracheitis

mostly due to S. aureus secondary infection

Question 6

What is the most likely cause of vocal cord paralysis in young child?

Answer 6

hx of difficulty breech delivery results injury to recurrent laryngeal nerve

Question 7

What are the 6 possible side effects of chronic high dose inhaled steroid use?

Answer 7

1. oral candidiasis
2. cataracts (rare)
3. changes in growth velocity
4. suppression of HPA axis
5. dermal thinning
6. easy bruising

Question 8

What is the treatment (1st and 2nd line) for exercise induced asthma?

Answer 8

1st- short acting beta agonist 10-15 minutes prior to exercise
2nd- leukotriene receptor antagonist (Singulair)

Question 9

What is the next step in management of newborn with newborn screen positive for IRT/ DNA?

Answer 9

Sweat chloride test

to confirm cystic fibrosis if more than 36 weeks of age and 2 kg

Question 9

What is the next step in management of newborn with newborn screen positive for IRT/ DNA?

Answer 9

Sweat chloride test

to confirm cystic fibrosis if more than 36 weeks of age and 2 kg

Question 10

What is the most likely diagnosis for patient presenting wtih cough, fever, pleuritic chest pain and CXR showing hilar adenopathy with focal alveolar infiltrates after being in cave in Ohio?

Answer 10

Histoplasmosis

Question 11

What does expiratory versus inspiratory stridor indicate?

Answer 11

expiratory- below thoracic inlet

inspiratory- above thoracic inlet

Question 12

What is the treatment for bronchogenic cyst?

Answer 12

surgical removal

Question 13

What two infections are more common to result in Stevens Johnson Syndrome?

Answer 13

1. Mycoplasma pneumoniae

2. CMV (cytomegalovirus)

Question 14

What is the most common manifestation of alpha 1 anti-trypsin deficiency disorder in children?

Answer 14

hepatic manifestations

pulmonary manifestations are more common in adults

Question 15

What is the next step in management for asthmatic patient developing hypotension with use of Magnesium infusion?

Answer 15

pause Mg infusion, give IV bolus, restart Mg at lower rate

Question 16

What is the most likely diagnosis for patient presenting with fever, cough, pleuritic chest pain after camping in central/ mid-atlantic United States and has broad budding yeast on sputum culture?

Answer 16

Blastomycosis

Question 17

What is the most likely diagnosis for patient with recurrent pulmonary infections and pneumothorax?

Answer 17

Bronchogenic cyst

Question 18

What is the pathophysiology associated with bronchogenic cyst?

Answer 18

abnormal budding of tracheal diverticulum in utero