Respiratory

Question 1

Egophony

Answer 1

Increased resonance of voice sounds/patient says the vowel “E”, normal lung tissue will sound like “eee”, consolidated lungs will sound like “aaay”

Question 2

Tactile fremitus

Answer 2

Vibration of chest wall when patient speaks” “99”/fremitus increases or decreases in abnormalities

Question 3

Whispered pectoriloquy

Answer 3

Refers to increased loudness of whispering during lung auscultation

Question 4

FEV1 percent of intermittent asthma

Answer 4

> 80%

Question 5

FEV1 percent of mild persistent asthma

Answer 5

> 80%

Question 6

FEV1 percent of moderate persistent asthma

Answer 6

60%-80%

Question 7

FEV1 percent of severe asthma

Answer 7

< 60%

Question 8

What are the four clinical classifications of asthma?

Answer 8

Intermittent, mild persistent, moderate persistent, and severe persistent

Question 9

Peak expiratory flow volume is determined by what three things?

Answer 9

Height, age, and gender, think HAG

Question 10

Pulsus paradoxus

Answer 10

Systolic pressure drops during inspiration/response to increased pressures

Question 11

What two pulmonary disorders may cause pulsus paradoxus?

Answer 11

Asthma and emphysema, any condition that can affect internal body pressures

Question 12

What are the three cardiac causes of pulsus paradoxus?

Answer 12

Tamponade, pericarditis, and cardiac effusion, any condition that affects internal body pressures

Question 13

Consolidation of the lungs is not present in what kind of pneumonia?

Answer 13

Atypical pneumonia

Question 14

What is the most common cause of atypical pneumonia?

Answer 14

Mycoplasma pneumoniae

Question 15

What three populations are at highest risk for atypical pneumonia?

Answer 15

College students, school-aged children, and military recruits

Question 16

Most common location of TB in the lungs

Answer 16

Upper lobes

Question 17

What class of antibiotics in considered first line therapy for community-acquired pneumonia without comorbidity?

Answer 17

Macrolides such as azithromycin

Question 18

Most common bacterial pathogen that causes acute bronchitis in smokers

Answer 18

H. Flu

Question 19

Most common bacterial pathogen that causes acute bronchitis

Answer 19

Pertussis

Question 20

Most common cause of acute bronchitis in general

Answer 20

Viral pathogens

Question 21

Best antibiotic choice for pertussis infection

Answer 21

Macrolides or Bactrim if allergic

Question 22

Best antibiotic choice for pregnant women when treating CAP

Answer 22

Amoxicillin

Question 23

CAP follow up chest x-ray in adults

Answer 23

8-12 weeks

Question 24

FEV1 % post bronchodilator to diagnose COPD

Answer 24

< 0.70 %

Question 25

Two drug classes to treat COPD

Answer 25

Beta agonists and inhaled anticholinergics

Question 26

Beta agonists

Answer 26

Short acting or long acting “LABA’s and SABAS” think drugs that end in “terol”

Question 27

Beta agonist mechanism of action

Answer 27

Stimulate beta receptors in heart and lungs, bronchodilation

Question 28

Inhaled anticholinergics mechanism of action

Answer 28

Blocks acetylcholine in the brain, which is responsible for smooth muscle contraction, prevents bronchoconstriction, think drugs that end in “tropium”

Question 29

Sequence of treating asthma

Answer 29

SABA, low dose ICS, LABA, refer for severe asthma

Question 30

Positive TB skin test reading of 5 mm or greater

Answer 30

Those with HIV, immunocompromised, recent contract with TB, < age 5 with close TB contact

Question 31

Positive TB skin test reading of 10 mm or greater

Answer 31

Recent immigrants within 5 years from high prevalence countries, child younger than 4 exposed to TB, IV drug use, homeless, healthcare worker, employees of high risk areas like jails and nursing homes

Question 32

Positive TB skin test reading of 15 mm or greater

Answer 32

The rest of the population with no known risk factors

Question 33

Recommended age for pneumonia vaccine

Answer 33

Age 65 or older

Question 34

Sequence of pneumonia vaccination

Answer 34

Start with PCV13, then PPSV23 one year later

Question 35

Does PCV13 need to be given again?

Answer 35

No

Question 36

What should be done if patient is given PCV13 before age 65?

Answer 36

Do not repeat PCV13, give PPSV23 if patient has not received it in last 5 years

Question 37

First line treatment for mild COPD

Answer 37

SABA or short-acting anticholinergic, start with SABA, then move to short-acting anticholinergic

Question 38

Sequence of COPD medication treatment

Answer 38

SABA, short-acting anticholinergic, LABA or LAMA, combo meds, ICS, refer

Question 39

Optimal treatment for latent TB

Answer 39

Isoniazid