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Pulmonary > Pulmonary: Multiple Choice & Other Questions > Flashcards

Pulmonary: Multiple Choice & Other Questions Flashcards

1
Q

What intervention has the greatest influence on slowing progression of COPD?

  1. Change in locale
  2. Flu and pneumonia vaccines
  3. Smoking cessation
  4. COVID vaccine
A
  1. Smoking cessation
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2
Q

Your patient agrees to attempt smoking cessation. Which pharmaceutical interventions are considered first-line therapy?

  1. Varenicline (Chantix)
  2. Nicotine patch
  3. Bupropion ER (Zyban)
    4, Combo nicotine patch and bupropion
A
  1. Varenicline (Chantix)
  2. Nicotine patch
  3. Bupropion ER (Zyban)
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3
Q

Which antibiotic should NOT be used to treat Community Acquired Pneumonia (CAP) in a patient with comorbidities and why not?

  1. Levofloxacin
  2. Moxifloxacin
  3. Ciprofloxacin
    4 Gemifloxacin
A
  1. Ciprofloxacin

It is not a respiratory quinolone, it kills bugs below the belt

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4
Q

Which 5-day antibiotics regimen is most likely to produce GI upset?

  1. Amoxicillin 1 gram TID
  2. Doxycycline 100 mg BID
  3. Azithromycin 500 mg x 1, 250 mg qd x 4
  4. These are all well tolerated
A
  1. Doxycycline 100 mg BID
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5
Q

What issues might contraindicate use of a quinolone antibiotic in a patient with Community Acquired Pneumonia (CAP)?

  1. Pregnancy
  2. Lactose intolerance
  3. History of QT prolongation
    4 Abdominal Aortic Aneurysm
  4. Dehydration
  5. Diabetes
  6. CrCl < 30 mL/min
A
  1. Pregnancy
  2. History of QT prolongation
    4 Abdominal Aortic Aneurysm
  3. Dehydration
  4. CrCl < 30 mL/min
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6
Q

A patient with newly-diagnosed COPD reports occasional dyspnea. What is appropriate to prescribe to treat his symptoms?

  1. Ipatropium only
  2. PRN prednisone
  3. Tiotropium
  4. Salmeterol
A
  1. Ipatropium only
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7
Q

What should be avoided by patients taking doxycycline. Select all that apply.

  1. Milk products
  2. Thiazide diuretics
  3. Alcohol
  4. Pregnancy
  5. Age > 65 years
  6. Prolonged exposure to sunlight
A
  1. Milk products
  2. Pregnancy
  3. Prolonged exposure to sunlight
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8
Q

How would you manage a 27 year-old asthma patient who uses his SABA 2 - 3 times daily for the past 3 days. He takes inhaled low-dose fluticasone. Select 2 choices.

  1. Continue SABA PRN, increase to moderate-dose fluticasone BID
  2. Continue SABA only, start formoterol BID
  3. Stop SABA and fluticasone, add formoterol/budesonide
  4. Stop SABA, add fluticasone/salmeterol
A
  1. Continue SABA PRN, increase to moderate-dose fluticasone BID
  2. Stop SABA and fluticasone, add formoterol/budesonide
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9
Q

Select all medications that are safe in combination:

  1. Tiotropium plus salmeterol
  2. Fluticasone plus salmeterol
  3. Albuterol plus salmeterol
  4. Ipratropium plus tiotropium
A
  1. Tiotropium plus salmeterol
  2. Fluticasone plus salmeterol
  3. Albuterol plus salmeterol

NOTE: #4. Ipratropium is a SAMA and tiotropium is a LAMA. SAMAs and LAMAs should not be given together.

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10
Q

An older adult has a 30 pack-year history of cigarette smoking and admits to progressive dyspnea on exertion and chronic cough. Select all facts that support a COPD diagnosis.

  1. Age
  2. FEV1/FVC ratio < 0.70
  3. Smoking history
  4. Progressive dyspnea
  5. Chronic cough
A

All:

  1. Age
  2. FEV1/FVC ratio < 0.70
  3. Smoking history
  4. Progressive dyspnea
  5. Chronic cough
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11
Q

Which of the following are common asthma triggers?

  1. Exercise
  2. Respiratory infection
  3. Changes in weather
  4. Allergan exposure
  5. Irritant exposure
A

All:

  1. Exercise
  2. Respiratory infection
  3. Changes in weather
  4. Allergan exposure
  5. Irritant exposure
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12
Q

A 23 year-old patient is in the office with suspected asthma. What 2 choices will help the NP most in making the diagnosis?

  1. History
  2. CXR
  3. Spirometry
  4. Peak-flow monitoring
  5. Pulmonary function tests
A
  1. History
  2. Spirometry
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13
Q

A patient with newly-diagnosed COPD reports symptoms of cough and dyspnea multiple times daily. What is appropriate to treat these symptoms?

  1. Ipratropium only
  2. PRN prednisone
    3 Tiotropium
  3. Fluticasone BID
A

3 Tiotropium

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14
Q

How would you manage a 27 year-old patient with asthma who reports using his SABA 2 - 3 times daily for the past 3 days? Select 2.

  1. Continue SABA PRN, add low-dose fluticasone BID
  2. Continue SABA, add formoterol BID
  3. Stop SABA, add formoterol/budesonide
  4. Stop SABA, add fluticasone/salmeterol
A
  1. Continue SABA PRN, add low-dose fluticasone BID
  2. Stop SABA, add formoterol/budesonide
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15
Q

A patient with newly-diagnosed COPD reports cough and dyspnea multiple times weekly. What is an initial option to treat his symptoms?

  1. Ipratropium
  2. PRN oral prednisone
  3. Tiotropium plus salmeterol
  4. Fluticasone/salmeterol combo
A
  1. Tiotropium plus salmeterol
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16
Q

How would you manage a 27 year-old asthma patient who uses his SABA 2 - 3 times daily for the past 3 days. He uses inhaled low-dose fluticasone/salmeterol BID. Select 2 choices.

  1. Continue SABA, increase to moderate-dose fluticasone/salmeterol BID
  2. Continue SABA, add budesonide/formoterol BID
  3. Use only formoterol/budesonide up to 8 puffs daily
  4. Stop SABA, add fluticasone/salmeterol BID
A
  1. Continue SABA, increase to moderate-dose fluticasone/salmeterol BID
  2. Use only formoterol/budesonide up to 8 puffs daily
17
Q

A 52 year-old male with pneumonia has taken amoxicillin 1 gram TID for 3 days. His fever of 100 - 101F persists. What now?

  1. Continue amoxicillin
  2. Stop amoxicillin, this is viral
  3. Get another CXR
  4. Change antibiotics
A
  1. Change antibiotics

Pulmonary (7 decks)

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