ANSWERS SET A+
✔✔Hypertensive Retinopathy - ✔✔AV nicking, copper wire arterioles, and flame
hemorrhages
✔✔COPD Treatment - ✔✔First assess pulse oxygen saturation.
When treating this patient: pick antibiotic with coverage against both Gram negative and
gram positive (H influenza and Streptpcoccus pneumonia)
✔✔Gold Standard Test for COPD - ✔✔Pulmonary function testing
(FEV1)
✔✔COPD - ✔✔chronic lung disease- permanent loss of elastic recoil of lungs, alveolar
damage, airflow limitation, chronic inflammation, and changes in pulmonary vasculature.
Most common symptom: chronic and progressive dyspnea
FEV1/FVC < 0.7 is diagnosing score.
✔✔Chronic Bronchitis - ✔✔Coughing with excessive mucus production for at least 3 or
more months for a minimum of 2 or more consecutive years. Airway hyper secretion
and inflammation.
"Blue-Bloater" bluish tinge to skin (due to chronic hypoxia and hypercapnia)
Wheezing, rhonchi, coarse crackles
✔✔Emphysema - ✔✔"Pink puffer" pink skin color (adequate oxygen saturation), thin,
and tachypneic and uses accessory muscles to breathe and pursed-lip breathing. Barrel
chest common.
, Decreased breath and heart sounds
✔✔COPD Category A Treatment - ✔✔Minimally symptomatic
-SABA alone or in combo with
SAMA/anticholinergic
✔✔COPD Category B Treatment - ✔✔More symptomatic
-LABA or LAMA or SABA for symptom relief PRN
✔✔COPD Category C Treatment - ✔✔Minimally symptomatic but high risk of future
exacerbations
-LAMA first line;
SABA for symptoms relief PRN
✔✔COPD Category D Treatment - ✔✔High risk; refer to pulmonologist
✔✔SABAs - ✔✔Albuterol, Levalbuterol (Xopenex)
✔✔LABAs - ✔✔Salmeterol, formoterol
✔✔SAMAs - ✔✔Ipratropium (Atrovent)
✔✔LAMAs - ✔✔Tiotropium bromide (Spiriva)
✔✔CAP - ✔✔#1 cause: Streptococcus Pneumoniae (gram positive)
-acute onset, high fever and chills. Productive cough an large amounts of green to rust-
colored sputum. Pleuritic chest pain with cough.
Crackles, decreased breath sounds, dull.
✔✔Atypical Pneumonia - ✔✔#1 cause: Mycoplasma pneumonia
-CXR: shows lobar infiltrates
Gradual onset, low-grade fever, headache, sore throat, cough, wheezing, rash
(sometimes). Intersitital to patchy infiltrates.
✔✔Viral Pneumonia Influenza (RSV) - ✔✔Fever, cough, pleurisy, SOB. Scanty sputum
production. Myalgias. Breath sounds decreased, rales
✔✔Gold Standard to Diagnose CAP - ✔✔Chest X-ray, repeat within 6 weeks to
document clearing.
-Lobar consolidation in classic cases