Pulmonology SmartyPANCE || A+ Verified Solutions.
A 62 year-old female is admitted to a nursing home during an outbreak of influenza. In review of
her records, you note that she did not receive the flu vaccine this year. Which of the following is the most appropriate drug of choice for influenza prophylaxis in this patient?
A. Ciprofloxacin
B. Zanamivir C. Clarithromycin
D. Alpha-2b interferon correct answers B. Zanamivir Zanamivir or oseltamivir are indicated for ppx use against influenza A or B
Which of the following is the most appropriate therapeutic agent for acute influenza?
A. azithromycin (Zithromax)
B. acyclovir (Zovirax)
C. tetracycline (Sumycin)
D. zanamivir (Relenza) correct answers D. zanamivir (Relenza)
Anti-viral agent - TOC for uncomplicated in patients >7
An 85-year-old nursing home resident presents with abrupt onset of cough, sore throat, headache,
myalgias, and malaise. On examination the patient's temperature is 102 degrees F; the rest of the exam is unremarkable. Nasal smear is positive for Influenza B. Which of the following is the treatment of choice in this patient?
A. Amantadine (Symmetrel)
B. Oseltamivir (Tamiflu)
C. Acyclovir (Zovirax)
D. Nevirapine (Viramune) correct answers B. Oseltamivir (Tamiflu)
Used to treat the flu
A 63-year-old male, heavy smoker, presents to your office with a low-grade fever and sudden onset of dry cough for the past 6 days. You diagnose him with acute bronchitis. What is the most
appropriate management at this time?
A. Amoxicillin/clavulanic acid 875 mg two times per day for 10 days
B. Doxycycline 100 mg PO two times per day for 14 days
C. Increased fluids and ibuprofen
D. Give the patient an albuterol inhaler correct answers C. Increased fluids and ibuprofen
Supportive therapy because MC cause is viral
You advise your patient from question one to take antipyretic drugs and get some rest. He returns
to your office 5 days later feeling worse and now has a fever with a cough productive of purulent
sputum. What is the most appropriate next step in the management of this patient?
A. Treat with a macrolide antibiotic
B. Administer penicillin intramuscularly C. Influenza titers
D. Pulmonary function tests correct answers A. Treat with a macrolide antibiotic
productive cough = bacterial when added to >12 days + fever
What is the most common cause of acute bronchitis?
A. H. influenzae
B. Viral infection
C. Fungal infection
D. Allergic reaction correct answers B. Viral infection
Which of the following can be considered an effective prophylaxis for acute bronchitis?
A. Oseltamivir 75 mg on day two of symptoms
B. Influenza vaccine
C. Inhaled corticosteroids
D. Nystatin correct answers B. Influenza vaccine
A 47 year-old HIV positive female presents with a complaint of a nonproductive cough. She is febrile, tachypneic and tachycardic. Lung exam reveals bilateral rales. Chest x-ray shows diffuse interstitial infiltrates. What is the recommended treatment in this patient?
A. trimethoprim-Sulfamethoxazole (Bactrim)
B. tetracycline (Sumycin)
C. amantadine (Symmetrel)
D. ticarcillin (Ticar) correct answers A. trimethoprim-Sulfamethoxazole (Bactrim)
DOC for all types of pneumocystis pt has HIV related PNA
A 45 year-old male presents with sudden onset of pleuritic chest pain, productive cough and fever for 1 day. He relates having symptoms of a "cold" for the past week that suddenly became worse yesterday. Which of the following findings will most likely be seen on physical examination of this patient?
A. spoken "ee" heard as "ay"
B. hyperresonant percussion note
C. wheezes over the involved area
D. vesicular breath sounds over involved area correct answers A. spoken "ee" heard as "ay"
Bacterial PNA w/ consolidation
A 42 year-old male with unremarkable past medical history is admitted to the general medical ward with community-acquired pneumonia. He has a 20 pack-year history of cigarette smoking. He is empirically started on ceftriaxone (Rocephin). Which of the following antibiotics would be
most appropriate to add to his empiric treatment regimen?
A. Piperacillin
B. Vancomycin
A 62 year-old female is admitted to a nursing home during an outbreak of influenza. In review of
her records, you note that she did not receive the flu vaccine this year. Which of the following is the most appropriate drug of choice for influenza prophylaxis in this patient?
A. Ciprofloxacin
B. Zanamivir C. Clarithromycin
D. Alpha-2b interferon correct answers B. Zanamivir Zanamivir or oseltamivir are indicated for ppx use against influenza A or B
Which of the following is the most appropriate therapeutic agent for acute influenza?
A. azithromycin (Zithromax)
B. acyclovir (Zovirax)
C. tetracycline (Sumycin)
D. zanamivir (Relenza) correct answers D. zanamivir (Relenza)
Anti-viral agent - TOC for uncomplicated in patients >7
An 85-year-old nursing home resident presents with abrupt onset of cough, sore throat, headache,
myalgias, and malaise. On examination the patient's temperature is 102 degrees F; the rest of the exam is unremarkable. Nasal smear is positive for Influenza B. Which of the following is the treatment of choice in this patient?
A. Amantadine (Symmetrel)
B. Oseltamivir (Tamiflu)
C. Acyclovir (Zovirax)
D. Nevirapine (Viramune) correct answers B. Oseltamivir (Tamiflu)
Used to treat the flu
A 63-year-old male, heavy smoker, presents to your office with a low-grade fever and sudden onset of dry cough for the past 6 days. You diagnose him with acute bronchitis. What is the most
appropriate management at this time?
A. Amoxicillin/clavulanic acid 875 mg two times per day for 10 days
B. Doxycycline 100 mg PO two times per day for 14 days
C. Increased fluids and ibuprofen
D. Give the patient an albuterol inhaler correct answers C. Increased fluids and ibuprofen
Supportive therapy because MC cause is viral
You advise your patient from question one to take antipyretic drugs and get some rest. He returns
to your office 5 days later feeling worse and now has a fever with a cough productive of purulent
sputum. What is the most appropriate next step in the management of this patient?
A. Treat with a macrolide antibiotic
B. Administer penicillin intramuscularly C. Influenza titers
D. Pulmonary function tests correct answers A. Treat with a macrolide antibiotic
productive cough = bacterial when added to >12 days + fever
What is the most common cause of acute bronchitis?
A. H. influenzae
B. Viral infection
C. Fungal infection
D. Allergic reaction correct answers B. Viral infection
Which of the following can be considered an effective prophylaxis for acute bronchitis?
A. Oseltamivir 75 mg on day two of symptoms
B. Influenza vaccine
C. Inhaled corticosteroids
D. Nystatin correct answers B. Influenza vaccine
A 47 year-old HIV positive female presents with a complaint of a nonproductive cough. She is febrile, tachypneic and tachycardic. Lung exam reveals bilateral rales. Chest x-ray shows diffuse interstitial infiltrates. What is the recommended treatment in this patient?
A. trimethoprim-Sulfamethoxazole (Bactrim)
B. tetracycline (Sumycin)
C. amantadine (Symmetrel)
D. ticarcillin (Ticar) correct answers A. trimethoprim-Sulfamethoxazole (Bactrim)
DOC for all types of pneumocystis pt has HIV related PNA
A 45 year-old male presents with sudden onset of pleuritic chest pain, productive cough and fever for 1 day. He relates having symptoms of a "cold" for the past week that suddenly became worse yesterday. Which of the following findings will most likely be seen on physical examination of this patient?
A. spoken "ee" heard as "ay"
B. hyperresonant percussion note
C. wheezes over the involved area
D. vesicular breath sounds over involved area correct answers A. spoken "ee" heard as "ay"
Bacterial PNA w/ consolidation
A 42 year-old male with unremarkable past medical history is admitted to the general medical ward with community-acquired pneumonia. He has a 20 pack-year history of cigarette smoking. He is empirically started on ceftriaxone (Rocephin). Which of the following antibiotics would be
most appropriate to add to his empiric treatment regimen?
A. Piperacillin
B. Vancomycin
