Respiratory 2

Question 1

chronic bronchitis - lung auscultation will reveal

Answer 1

expiratory wheezing, rhonchi, and coarse crackles

Question 2

what is the FEV1/FVC cutoff score for dx COPD

Answer 2

FEV1/FVC 0.7; as <0.7 = <70% of lung function

Question 3

preferred choice of therapy for mild COPD (Group A) is

Answer 3

long acting bronchodilator

Question 4

COPD/smoker w/ PNA is at higher risk for what bacteria

Answer 4

H. influenzae

Question 5

what med is recommended for all patients with COPD for relief of dyspnea and early tx of exacerbations

Answer 5

SABAs

Question 6

when you are treating a COPD patient for PNA, pick an abx that has what coverage

Answer 6

H. influenzae (gram neg) and step pnuemoniae (gram postivie)

Question 7

group A med rec

Answer 7

either a short or long acting bronchodilator

Question 8

group B med recs

Answer 8

LAMA and LABA combo

Question 9

group E med recs

Answer 9

LAMA and LABA combo

Question 10

acute bronchitis - tx for wheezing

Answer 10

albuterol inhaler QID or nebulized tx PRN

Question 11

acute bronchitis - tx for severe wheezing

Answer 11

consider short term oral steroid

Question 12

atypical pneumonia #1 organism

Answer 12

mycoplasma pneumoniae

Question 13

paroxysms of dry and severe cough that interrupts sleep

Answer 13

acute bronchitis

Question 14

cough lasting 3 weeks or longer; pleuritic chest pain; hemoptysis w/ fatigue; weight loss; night sweats

Answer 14

TB

Question 15

intermittent cough that becomes more severe with inspiratory whoop; cough worse at night

Answer 15

pertussis

Question 16

atypical pneumonia is most common in who

Answer 16

children and young adults

Question 17

top two bacteria in atypical pneumonia

Answer 17

M. pneumoniae
chlamydia pneumoniae

Question 18

gold standard to dx atypical pnuemonia with mycoplasma pneumoniae

Answer 18

polymerase chain reaction PCR of sputum or oropharyngeal swab

Question 19

atypical PNA tx abx
4

Answer 19

azithromycin or clarithromycin
doxy
levofloxacin

Question 20

top two bacteria in CAP

Answer 20

strep pneumoniae
H. influenzae

Question 21

rust colored or blood tinged sputum in CAP more likely points to what bacteria

Answer 21

S. pneumoniae

Question 22

gold standard test for dx CAP

Answer 22

chest x ray

Question 23

CAP tx for patient < 65 years old with no comorbidities

Answer 23

first line monotherapy amoxicillin 1 G TID 5-7 days OR doxy OR macrolide

Question 24

CAP tx for patient with comorbidities

Answer 24

combo therapy (beta lactam plus macrolide or doxy); Augmentin plus macrolide OR doxy

Question 25

pertussis aka

Answer 25

whooping cough

Question 26

pertussis is caused by

Answer 26

bordetella pertussis bacteria - gram neg

Question 27

pertussis is a

Answer 27

highly contagious coughing illness of at least 14 days duration with one of the following findings - paroxysmal coughing, inspiratory whooping, or post tussive vomiting w/o apparent cause

Question 28

severe hacking cough for over two weeks, low grade fever, cough then becomes severe with inspiratory sound

Answer 28

whooping cough

Question 29

pertussis - less than 2 weeks (and 2-4 weeks) cough cold standard lab test

Answer 29

nasopharyngeal swab for culture and PCR for B. pertussis

Question 30

pertussis first line treatment

Answer 30

azithromycin

Question 31

adolescents should get Tdap when

Answer 31

11-12 y.o.

Question 32

what vaccine do pregnant patients get weeks 27-36

Answer 32

Tdap

Question 33

adult who has never received Tdap

Answer 33

administer a single dose of Tdap followed by a Td or Tdap booster every 10 years