Respiratory

Question 1

What diagnosis are peak flows used to monitor ongoing response?

Answer 1

Asthma

Question 2

Which diagnosis is most likely to have dry non-productive cough and/or excessive vomiting or regurgitation?

Answer 2

GERD

Question 3

Which is a multifactorial disease with heterogenous clinical phenotype and complex genetic inheritence?

Answer 3

Asthma

Question 4

Disease of reversible airway obstruction

Answer 4

Asthma

Question 5

Abrupt onset of symptoms, history of choking, UNILATERAL monophonic wheeze is most often associated with:

Answer 5

Airway foreign body

Question 6

The five major steps of “Ask, Advise, Assess, Assist, and Arrange” are used to help the clinician in reducing the progression and burden of chronic lung disease related to?

Answer 6

Smoking

Question 7

A major predisposing factor for developing asthma as a child.

Answer 7

Atopy

Question 8

Female sex, family history, atopy, bronchial hyper-responsiveness, obesity, and rhinitis/sinusitis are:

Answer 8

Factors that predict persistence of asthma from childhood to adulthood

Question 9

Symptoms, night time-awakening, use of rescue inhaler, ability to do normal activities

Answer 9

Parameters defining level of asthma severity/level of asthma control

Question 10

Wheezing during normal breathing, prolonged phase of forced expiration, hyper-expansion of thorax, use of accessory muscles

Answer 10

Physical findings of asthma exacerbation

Question 11

Sound heard as air passes through fluid-filled airways

Answer 11

Crackles

Question 12

Abnormal breath sounds associated with PNA and/or CHF

Answer 12

Crackles

Question 13

Sound heard secondary to narrowing of the airway d/t asthma or bronchitis

Answer 13

Wheezes

Question 14

Tone of this sound varies depending on which area of the airway is affected; may be musical (polyphonic) or hoarse (monophonic) in nature

Answer 14

Wheezes

Question 15

Which age-related population are these considerations for?
Due to shorter stature, upper airway sounds are frequently transmitted to lower airway, making the exam more challenging in this patient.

Answer 15

Peds

Question 16

Which age-related population are these considerations for?
Diagnostic testing of pulmonary function/lung volumes may need to be delayed in this population.

Answer 16

Peds

Question 17

Key history/PE findings:
-Mildly ill
-Fever presenting around (less than or =)100F for first few days then resolved
-Lung exam normal or wheezing/rhonchi clearing with cough

Answer 17

Acute bronchitis

Question 18

Acute bacterial infection of the lower respiratory tract characterized by cough, febrile (>100.6), tachypnea, tachycardia, and crackles on lung exam

Answer 18

PNA

Question 19

Direct testing designed to detect the volume and capacity of the lungs to determine overall functioning of the respiratory system

Answer 19

Spirometry (PFTs)

Question 20

Key Findings:
productive cough, dyspnea, nasal congestion, headache, fever, substernal or chest wall pain, cough lasting 2-6 weeks

Answer 20

Acute bronchitis

Question 21

Key Findings:
prodromal viral URI followed by increased resp effort and wheezing, rhinorrhea, cough, commonly seen in children over adults with AMS, activity level decline, decreased appetite

Answer 21

Bronchiolitis

Question 22

Key Findings:
chronic cough, dyspnea, sputum production, recurrent lower respiratory infections, chest tightness exacerbated by exercise (exercise intolerance)

Answer 22

COPD

Question 23

Key Findings:
persistent productive cough, wheezing, dyspnea, tachypnea, hyperinflation of lungs on CXR, PFTs consistent for obstruction, recurrent lung infections, bronchiectasis with impaired mucociliary clearance, OSA; often genetic with the presence of a CFTR gene

Answer 23

Cystic fibrosis

Question 24

Key Findings:
cough, fever, sore throat, malaise, often seen in the fall/winter

Answer 24

Influenza

Question 25

Patients with a poorly explained cough, hemoptysis, SOB, CP, unintentional weight loss, hoarseness, bone pain, headaches, vision changes, confusion, nausea, constipation, weakness, and/or clubbing should be screened for…

Answer 25

Lung cancer

Question 26

Key Findings:
Loud snoring, frequent arousals and disruption of sleep, EKG changes

Answer 26

OSA

Question 27

Key Findings:
incubation period of 3-5 days, peaks in late summer/early fall, most serious in infants; runny nose, sneezing, mild cough, low-grade fevers, apnea/cyanosis in infants, posttussive vomiting in adults

Answer 27

Pertussis

Question 28

What is a useful tool to guide treatment of PNA in older adults (>65 y/o)?

Answer 28

CURB-65 PNA severity scale

Question 29

Key Findings:
cough (can be pink-tinged or hemoptysis), CP, fatigue, weight loss, growth delay in children, chills, anorexia, fever, night sweats, recent travel to high exposure risk areas or living in high-risk congregate settings, immunocompromised

Answer 29

TB

Question 30

What is an important aspect to assess with respiratory symptoms?

Answer 30

Timing (time of day symptoms occur), habits, recreational/occupational exposures

Question 31

When is smoking status assessed?

Answer 31

With every patient encounter

Question 32

What should the inspiration to expiration ratio be?

Answer 32

1:2