Rita's Respiratory questions Flashcards
An 8yo presents with cough and fever. PE shows basilar crackles in the LLL. Chest x-rays show small infiltrate the left lower lung. What is the most likely dx?
a) Tuberculosis
b) Strep pneumonia
c) Mycoplasma
d) Staph
b) Strep pneumonia
–if 18yo, may be mycoplasma…
A 6 month old presents with new onset of a low-grade fever, runny nose, and mild wheezing. What is the most likely dx?
a) pneumonia
b) bronchiolitis
c) pneumothorax
d) asthma
b) bronchiolitis
wheezing: indicates lower airway involvement
w/ pneumonia: would not have low-grade fever
A 2yo presents to the office with sudden respiratory distress and decreased BS at the right base. What is the most likely dx?
a) Asthma
b) Pneumonia
c) Pneumothorax
d) Pleural effusion
c) Pneumothorax
Which of the following is usually not seen in croup?
a) high fever
b) brassy cough
c) running nose
a) high fever
–v. atypical: w/high fever, looking toxic –> worry about bronchiolitis
An 8yo with a hx of asthma presents with chest pain and decreased breath sounds on the right without wheezing or crackles. What is the most likely dx?
a) asthma
b) pneumonia
c) atelectasis
c) atelectasis
- -> v. common to see on chest x-ray of someone with asthma
What is the main cause of pneumonia in a child
c) RSV
What are the x-ray findings in bronchiolitis?
a) Normal x-ray
b) Hyperinflation with a flattened diaphragm
c) Peribronchial cuffing
d) Streaky infiltrate
b) Hyperinflation with a flattened diaphragm
What drugs do you treat a 5yo with for mild intermittent asthma?
a) Singular
b) Long acting beta agonist and Flovent
c) Short acting beta agonist
c) Short acting beta agonist
A child presents with recurrent right lower lobe pneumonia. Which one of the following is not included in your differential dx?
a) Foreign body
b) Aspiration
c) Cystic fibrosis
d) Recurrent mycoplasma pneumonia
d) Recurrent mycoplasma pneumonia
What would you expect to hear on auscultation of the back under the clavicle of an asthmatic during an acute exacerbation?
a) Normal breath sounds
b) Inspiratory sound is longer and louder than expiratory phase
c) Expiratory phase is longer than inspiratory phase
d) Inspiratory and expiratory breath sounds are equal
c) Expiratory phase is longer than inspiratory phase
–prolonged expiratory phase = bronchial breath sounds
What is the most common cause of pneumonia in a school-aged child?
a) Strep pneumonia
b) Mycoplasma pneumonia
c) H. influenza
a) Strep pneumonia
A 4yo child with a hx of pneumonia presents with dullness to percussion, decreased air entry, decreased tactile and vocal fremitus, and voice egophany. What is the most likely dx?
a) Pneumothorax
b) Viral pneumonia
c) Pleural effusion
c) Pleural effusion
What is the most common cause of pleural effusion?
a) viral pneumonia
b) bacterial pneumonia
c) foreign body
b) bacterial pneumonia
You are seeing a 5 month old baby with retractions, wheezing, slight rales, hyperinflation and atelectasis on x-ray. What is the most likely dx?
a) bronchiolitis
b) pneumonia
c) URI
d) foreign body
a) bronchiolitis
A 16yo teenager presents afebrile with bursts of coughing for 6 weeks. What is the organism?
a) Strep pneumonia
b) Mycoplasma pneumonia
c) Pertussis
d) Tuberculosis
c) Pertussis
**key = “bursts” of coughing
What kind of breath sounds would be found in the left lower part of the thoracic cavity?
a) Bronchial BS
b) Bronchovesicular BS
c) Vesicular BS heard over most of the lung
d) Tracheal BS
c) Vesicular BS heard over most of the lung
What do normal breath sounds sound like?
a) inspiration greater than expiration
b) expiration is equal to inspiration
c) expiration is greater than inspiration
a) inspiration greater than expiration
Which of the following is a contraindication to weight lifting?
a) coughing
b) hypertension
c) allergic rhinitis
d) gastroenteritis
b) hypertension
What is the first-line tx of choice for pertussis in a child over 1 month?
a) Bactrim
b) Amoxil
c) Azithromycin
d) Erythromycin
c) Azithromycin
( –> when in doubt, choose this!)
erythromycin really not good for the stomach…
Based on the new guidelines, which of the following is recommended in caring for a full term 5 month old with normal O2 sat, wheezing, and a dx of bronchiolitis?
a) Ribavirin should be routinely used in this disease
b) Inhaled corticosteroids are effective in caring for pts with this disease
c) Antibiotics should be used in patients with fever and RSV bronchiolitis
d) Bronchodilators should not be routinely used
d) Bronchodilators should not be routinely used
