Week 7 - Pleurisy

Question 1

A diagnosis of pleurisy (the condition) is best made when:

Select one:

a. a patient presents with mild pleuritic chest pain
b. pleuritic chest pain is occurring during or soon after a viral illness
c. life-threatening causes of pleuritic chest pain are ruled out
d. a young otherwise healthy patient has pleuritic chest pain

Answer 1

c. life-threatening causes of pleuritic chest pain are ruled out

Question 2

Chest radiography (chest x-ray) is recommended for all patients with pleuritic chest pain. What evidence is this recommendation based on?

Select one:

a. consistent, good quality patient-oriented evidence
b. inconsistent or limited-quality patient-oriented evidence
c. consensus, disease-oriented evidence, usual practice, expert opinion, or case series

Answer 2

c. consensus, disease-oriented evidence, usual practice, expert opinion, or case series

Question 3

Which of the following triggers is NOT a typical aggravating factor for pleuritic chest pain?

Select one:

a. inspiration
b. emotional upset
c. coughing
d. talking
e. sneezing

Answer 3

b. emotional upset

Question 4

Wells rule (aka Wells criteria) is a validated clinical decision making tool useful in diagnosing which of the following conditions?

Select one:

a. pneumonia
b. pulmonary embolism
c. pneumothorax
d. pericarditis
e. myocardial infarction

Answer 4

b. pulmonary embolism

Question 5

Chest radiography may be helpful in diagnosing all of the following causes of pleurisy EXCEPT:

Select one:

a. pneumonia
b. pneumothorax
c. pericarditis
d. pulmonary embolism
e. myocardial infarction

Answer 5

e. myocardial infarction

Question 6

Pleuritic chest pain that has an acute onset (symptoms develop over minutes to hours) is suggestive of which of the following causes?

Select one:

a. viral infection
b. malignancy
c. tuberculosis
d. pneumothorax

Answer 6

d. pneumothorax

MI, pulmonary embolism, and trauma also have an acute onset

Question 7

What is the most likely diagnosis in a patient who presents with acute onset of pleuritic chest pain and dyspnea with elevated heart rate and respiratory rate but no abnormal heart or lung sounds?
Select one:
a. pulmonary emobolism
b. pneumonia
c. pericarditis
d. pneumothorax

Answer 7

a. pulmonary emobolism

Question 8

What is the most likely diagnosis in a patient with pleuritic chest pain that began a couple weeks ago and is accompanied by fatigue, weight loss, low-grade fever, and chronic cough?

Select one:

a. pneumothorax
b. pulmonary embolism
c. tuberculosis
d. rheumatoid arthritis

Answer 8

c. tuberculosis

Question 9

Treatment for pleurisy involves managing pain and targeting the underlying cause. What is the first line recommendation for treating pleuritic chest pain?

Select one:

a. acetominophen
b. opiates
c. NSAIDs

Answer 9

c. NSAIDs

Question 10

If a patient presents with pleuritic chest pain and also complains of fever and joint pain, you should consider all of the following causes EXCEPT:

Select one:

a. viral pleurisy
b. lupus
c. rheumatoid arthritis
d. Familial Mediterranean fever

Answer 10

a. viral pleurisy