Quiz #3

Question 1

CHA2DS2-VASc

Answer 1

CHF (1)
HTN (1)
Age > 75 (2)
DM (1)
Stroke/TIA (2)
Vascular dz (1)
Age 65-74 (1)
Sex female (1)

Question 2

Tx for Atrial Fibrillation w/o LV dysfunction or HF

Answer 2

Beta blocker
Amiodarone
Diltiazem
Verapamil

Question 3

Tx for Atrial Fibrillation w/ LV dysfunction or HF

Answer 3

Beta blocker, Digoxin, Amiodarone

Question 4

Anticoagulation Options for Positive CHA2DS2-VASc Score

Answer 4

Warfarin
Dabigatran
Rivaroxaban
Apixaban

Question 5

Treatment for Stage B HF Patients

Answer 5

ACE/ARB

Beta Blockers

Question 6

Treatment for Stage C HF Patientst

Answer 6

ACE/ARB
Beta Blockers
Diuretics
Aldosterone antagonist (Spironolactone)

Question 7

Examples of diuretics

Answer 7

HCTZ
Chlorothiazide
Furosemide
Torsemide
Bumetanide
Spironolactone

Question 8

Preferred Beta Blocker for HF Treatment

Answer 8

Metoprolol

Carvediolol

Question 9

Preferred ACE Inhibitor for HF Treatment

Answer 9

Enalapril

Question 10

Preferred diuretic for HF treatment

Answer 10

Furosemide (Lasix)

Question 11

Symptoms of Heart Failure

Answer 11

Fatigue
Shortness of Breath
Orthopnea
PND
Chronic cough

Question 12

Physical Exam Signs of Heart Failure

Answer 12

Pedal Edema
Jugular Venous Distention
Ascites
S3 Gallop/S4 Gallop
Crackles in lungs

Question 13

Secondary Causes of Hypertension

Answer 13

Renovascular Dz
Hyperaldosteronism 
Pheochromocytoma
Cushing's Dz
Sleep Apnea
Coarctation of the Aorta

Question 14

Fundoscopy findings from long term HTN

Answer 14

Cotton Wool Spots
Hard Exudates
AV Nicking
Copper Wiring

Question 15

Steps for Statin Use Algorithm

Answer 15

1. 21 y/o and candidate for statin use?
2. Clinical ASCVD?
3. LDL >/= 190?
4. Diabetic?
5. ASCVD Risk > 7.5% and 40-75 y/o?

Question 16

10 Year ASCVD Risk Calculator Components

Answer 16

Age 40-75
Diabetes
Sex, Race
Smoker
Total Cholesterol, HDL
Systolic Blood Pressure
Treated for HTN?

Question 17

High Intensity Statins

Answer 17

Atorvastatin 80 mg

Rosuvastatin 20 mg

Question 18

Moderate Intensity Statins

Answer 18

Atorvastatin 10 mg
Rosuvastatin 10 mg
Simvastatin 20-40 mg
Pravastatin 40 mg
Lovastatin 40 mg

Question 19

Low Intensity Statins

Answer 19

Pravastatin 10-20 mg

Lovastatin 20 mg

Question 20

Symptoms of spontaneous pneumothorax

Answer 20

Dyspnea
Chest pain
Diminished breath sounds

Question 21

Symptoms of tension pneumothorax

Answer 21

Rapid labored breathing
Tachycardia
Cyanosis

Question 22

Acute infection of lung parenchyma which must have occurred before or at most 48 hours after hospitalization

Answer 22

Community Acquired

Question 23

Most common etiology of community acquired pneumonia

Answer 23

Streptococcus pneumoniae

Question 24

Defined as pneumonia developing 48 hours after hospitalization

Answer 24

Healthcare associated pneumonia

Question 25

Common etiologies of HAP

Answer 25

Pseudomonas E. coli MRSA

Question 26

Symptoms of CAP/HAP

Answer 26

Productive Cough Fever Pleuritic Chest Pain

Question 27

Physical Exam Signs of CAP/HAP

Answer 27

Increased fremitus Dullness to percussion Egophony Crackles

Question 28

Diagnosis of CAP/HAP

Answer 28

CXR (infiltrates) | Sputum culture

Question 29

CAP/HAP associated with rust colored sputum

Answer 29

Pneumococcus

Question 30

CAP/HAP associated with currant jelly sputum and alcoholic (aspiration)

Answer 30

Klebsiella

Question 31

CAP/HAP associated with bullous myringitis, cold agglutinin hemolysis

Answer 31

Mycoplasma

Question 32

CAP/HAP associated with GI sx and confusion. Contaminated water sources.

Answer 32

Legionella

Question 33

CAP/HAP associated with influenza

Answer 33

Staph aureus

Question 34

CAP/HAP associated with COPD

Answer 34

Haemohphilus influenza

Question 35

CAP/HAP associated with AIDs (strep still most common)

Answer 35

Pneumocystis

Question 36

Tx for CAP in healthy individuals who have not received ABX in last 3 mo

Answer 36

Macrolide (Azithromycin, Clarithromycin, Doxycycline)

Question 37

Tx for CAP in pts with comorbidities or recent ABX use

Answer 37

``` Respiratory fluoroquinolones (levofloxacin, moxifloxacin) Amoxicillin or Augmentin or Ceftriaxone PLUS macrolide or doxycycline ```

Question 38

CURB-65

Answer 38

``` Confusion Uremia (BUN > 19) Respirations (> 30) Blood pressure (hypotension) Over 65 0-1: outpatient 2: outpatient w/ close obs or inpatient 3-5: inpatient ```

Question 39

Tx for inpatient CAP/HAP

Answer 39

``` Respiratory fluoroquinolone (Levofloxacin/Moxifloxacin) Ceftriaxone plus macrolide ```

Question 40

Samter's Triad

Answer 40

Aspirin allergy, nasal polyps, asthma

Question 41

Management of asthma exacerbations

Answer 41

O2 SABA Systemic corticosteroids Consider IV MgSO4

Question 42

Stepwise approach to asthma

Answer 42

1. SABA prn 2. Low dose ICS 3. Low dose ICS + LABA 4. Med dose ICS + LABA 5. High dose ICS + LABA 6. High dose ICS + LABA + oral corticosteroid

Question 43

Examples of SABA

Answer 43

Albuterol, levalbuterol, pirbuterol

Question 44

Examples of ICS

Answer 44

Beclomethasone, Budesonide, Fluticasone, Mometasone

Question 45

Examples of LABA

Answer 45

Salmeterol, Formoterol

Question 46

Sx of COPD

Answer 46

DOE and productive cough

Question 47

Dx for COPD

Answer 47

CXR (hyperinflation - increased AP ratio and flattened diaphragm) CBC (increased hematocrit due to chronic hypoxemia) CMP - respiratory acidosis and metabolic alkalosis PFTs: FEV1 < 80%, FEV1/FVC ratio < .70 EKG: multifocal atrial tachycardia associated with COPD

Question 48

Stepwise treatment of COPD

Answer 48

1. SABA or ipratropium 2. LABA or tiotropium 3. ICS

Question 49

Mild COPD

Answer 49

FEV1/FVC < 0.70 | FEV1 > 80% predicted

Question 50

Moderate COPD

Answer 50

FEV1/FVC < 0.70 | FEV1 < 80% > 50%

Question 51

Severe COPD

Answer 51

FEV1/FVC < 0.70 | FEV1 < 50% > 30%

Question 52

Very Severe COPD

Answer 52

FEV1/FVC < 0.70 | FEV1 < 30%