CMN 568 - UNIT 2 – ALL questions
with complete solutions
After @/exposure @/to @/toxic @/fumes, @/a @/pt @/gradually @/develops @/cough @/and @/dyspnea, @/he
@/most @/likely @/has: @/- @/correct @/Answers @/✔✔ @/-Acute @/Bronchiolitis
Risk @/factors @/for @/development @/of @/bronchiolitis @/in @/the @/adult @/pt @/include:
a. @/exposure @/to @/toxic @/fumes
b. @/viral @/infection
c. @/organ @/transplant
d. @/systemic @/lupus @/erythematosus
e. @/all @/of @/the @/above @/- @/correct @/Answers @/✔✔ @/-e. @/all @/of @/the @/above
Connective @/tissue @/disease @/(SLE)
Treatment @/for @/a @/pt @/with @/proliferative @/bronchiolitis @/includes________________ @/for @/___-
___ @/months, @/then @/tapered @/to @/20-40 @/mg/day @/- @/correct @/Answers @/✔✔ @/-Prednisone
@/1mg/kg/day @/for @/1-3 @/months
T @/or @/F: @/When @/narrowing @/the @/dif. @/dx @/of @/causes @/of @/pna @/in @/the
@/immunocompromised @/adult, @/remember @/- @/Defects @/in @/humoral @/immunity @/predispose @/to
@/bacterial @/infections; @/defects @/in @/cellular @/immunity @/lead @/to @/infections @/with @/viruses,
@/fungi, @/mycobacteria, @/and @/protozoa. @/- @/correct @/Answers @/✔✔ @/-True
- @/Antibiotic @/therapy @/in @/the @/preceding @/90 @/days.
- @/Acute @/care @/hospitalization @/for @/at @/least @/2 @/days @/in @/the @/preceding @/90 @/days.
- @/Residence @/in @/a @/nursing @/home @/or @/extended @/care @/facility.
- @/Home @/infusion @/therapy, @/including @/chemotherapy, @/within @/the @/past @/30 @/days.
- @/Long-term @/dialysis @/within @/the @/past @/30 @/days.
,- @/Home @/wound @/care.
- @/Family @/member @/with @/an @/infection @/involving @/a @/multiple @/drug-resistant @/pathogen.
- @/Immunosuppressive @/disease @/or @/immunosuppressive @/therapy. @/- @/correct @/Answers @/✔✔
@/-Risk @/factors @/for @/HCAP
Three @/factors @/distinguish @/nosocomial @/pneumonia @/from @/CAP: @/- @/correct @/Answers @/✔✔ @/-
(1) @/different @/infectious @/causes.
(2) @/different @/antibiotic @/susceptibility @/patterns, @/specifically, @/a @/higher @/incidence @/of @/drug
@/resistance.
(3) @/the @/patients' @/underlying @/health @/status @/that @/puts @/them @/at @/risk @/for @/more @/severe
@/infections.
Colonization @/of @/the @/________ @/and @/possibly @/the @/________ @/with @/bacteria @/is @/the @/most
@/important @/step @/in @/the @/pathogenesis @/of @/nosocomial @/pneumonia. @/- @/correct @/Answers
@/✔✔ @/-pharynx; @/stomach
Within @/___ @/hours @/of @/admission, @/___% @/of @/seriously @/ill @/hospitalized @/patients @/have
@/their @/upper @/airway @/colonized @/with @/organisms @/from @/the @/hospital @/environment. @/-
@/correct @/Answers @/✔✔ @/-48; @/75%
Patients @/with @/anaerobic @/pleuropulmonary @/infection @/usually @/present @/with @/constitutional
@/symptoms @/such @/as @/fever, @/weight @/loss, @/and @/malaise, @/dentition @/is @/often @/poor,
@/however, @/rarely @/edentulous; @/if @/so, @/an @/
________ @/________ @/________is @/usually @/present. @/- @/correct @/Answers @/✔✔ @/-obstructing
@/bronchial @/lesion
Representative @/material @/for @/culture @/of @/anaerobic @/organisms @/can @/be @/obtained @/only @/by
@/
a. @/transthoracic @/aspiration
b. @/thoracentesis
c. @/bronchoscopy @/with @/a @/protected @/brush. @/
d. @/all @/of @/the @/above @/- @/correct @/Answers @/✔✔ @/-d. @/all @/of @/the @/above
Expectoration @/is @/inappropriate.
This @/anaerobic @/pleuropulmonary @/infection @/appears @/as @/a @/thick-walled @/solitary @/cavity
@/surrounded @/by @/consolidation.
a. @/Empyema
,b. @/Necrotizing @/pna
c. @/Lung @/abscess
d. @/A @/and @/C @/- @/correct @/Answers @/✔✔ @/-c. @/Lung @/abscess
T @/or @/F: @/Refer @/all @/pts @/with @/CXR @/findings @/consistent @/with @/anaerobic @/pleuropulmonary
@/infection @/for @/hospital @/admission, @/IV @/abx, @/and @/most @/likely @/a @/chest @/tube. @/- @/correct
@/Answers @/✔✔ @/-True
____________ @/alone @/is @/inadequate @/treatment @/for @/anaerobic @/pleuropulmonary @/infections
@/because @/an @/increasing @/number @/of @/anaerobic @/organisms @/produce @/B-lactamases @/-
@/correct @/Answers @/✔✔ @/-PCN
Neutropenia @/and @/impaired @/granulocyte @/function @/predispose @/to @/infections @/from @/S
@/aureus, @/Aspergillus, @/gram-negative @/bacilli, @/and @/Candida. @/- @/correct @/Answers @/✔✔ @/-...
Knowledge @/of @/the @/underlying @/immunologic @/defect @/and @/the @/time @/course @/of @/infection
@/provides @/clues @/to @/the @/etiology @/of @/pneumonia @/in @/immunocompromised @/patients. @/-
@/correct @/Answers @/✔✔ @/-...
In @/the @/immunocompromised @/patient @/a @/__________ @/pneumonia @/is @/often @/caused @/by
@/bacterial @/infection, @/whereas @/an @/_________ @/pneumonia @/is @/more @/apt @/to @/be @/caused
@/by @/viral, @/fungal, @/protozoal, @/or @/mycobacterial @/infection. @/- @/correct @/Answers @/✔✔ @/-
Fulminant; @/insidious
Pneumonia @/occurring @/within @/2-4 @/weeks @/after @/organ @/transplantation @/is @/usually
@/__________, @/whereas @/several @/months @/or @/more @/after @/transplantation @/P @/jiroveci,
@/__________and @/_______ @/are @/encountered @/more @/often. @/- @/correct @/Answers @/✔✔ @/-
Bacterial; @/viruses; @/fungi
Substances @/with @/potential @/to @/embolize @/to @/the @/pulmonary @/circulation @/- @/correct
@/Answers @/✔✔ @/-air, @/amniotic @/fluid, @/fat, @/foreign @/bodies, @/parasite @/eggs
@/(schistosomiasis), @/septic @/emboli, @/tumor @/cells, @/thrombus @/(most @/commond)
Risk @/factors @/for @/PE @/and @/DVT @/- @/correct @/Answers @/✔✔ @/-Venous @/stasis, @/injury @/to @/the
@/vessel @/wall, @/and @/hypercoagulability @/-- @/VIRCHOW @/TRIAD
Causes @/of @/venous @/stasis... @/- @/correct @/Answers @/✔✔ @/-Immobility, @/hyperviscosity
@/(polycythemia), @/increased @/CVP @/(low @/CO, @/pregnancy)
Causes @/of @/hypercoagulability... @/- @/correct @/Answers @/✔✔ @/-Oral @/contraceptives, @/HRT,
@/malignancy/surgery, @/inherited @/gene @/defects @/(Factor @/V @/Leiden)
Massive @/pulmonary @/thrombus @/may @/cause... @/- @/correct @/Answers @/✔✔ @/-Right @/Ventricular
@/Failure
, T @/or @/F: @/Common @/S/S @/of @/PE @/are @/specific @/to @/the @/disorder. @/- @/correct @/Answers @/✔✔
@/-False
3 @/S/S @/seen @/in @/most @/pts @/presenting @/with @/PE... @/- @/correct @/Answers @/✔✔ @/-Dyspnea,
@/CP @/with @/breathing, @/tachypnea.
2 @/Common @/ECG @/changes @/with @/PE: @/- @/correct @/Answers @/✔✔ @/-ST @/and @/nonspecific @/ST
@/& @/T @/wave @/changes.
Profound_______ @/with @/a @/normal_____in @/the @/absence @/of @/preexisting @/lung @/disease @/is
@/highly @/suspicious @/for @/PE. @/- @/correct @/Answers @/✔✔ @/-Hypoxia, @/CXR
A @/D-Dimer @/< @/__________ @/provides @/strong @/evidence @/against @/PE. @/- @/correct @/Answers
@/✔✔ @/-500 @/ng/ml
Initial @/diagnostic @/study @/used @/for @/suspected @/PE: @/- @/correct @/Answers @/✔✔ @/-Helical @/CT
@/pulmonary @/angiography
Radiolabeled @/microaggregated @/albumin @/is @/injected @/into @/the @/venous @/system, @/allowing
@/the @/particles @/to @/embolize @/to @/the @/pulmonary @/capillary @/bed. @/- @/correct @/Answers @/✔✔
@/-Perfusion @/Scan
Patient @/breathes @/a @/radioactive @/gas @/or @/aerosol @/while @/the @/distribution @/of @/radioactivity
@/in @/the @/lungs @/is @/recorded. @/- @/correct @/Answers @/✔✔ @/-Ventilation @/Scan
___% @/of @/pts @/with @/PE @/will @/have @/a @/DVT @/on @/eval. @/- @/correct @/Answers @/✔✔ @/-70
Test @/of @/choice @/to @/detect @/proximal @/DVT @/- @/correct @/Answers @/✔✔ @/-Venous @/U/S
On @/a @/venous @/U/S, @/what @/is @/diagnostic @/of @/first-episode @/DVT @/in @/symptomatic @/pts? @/-
@/correct @/Answers @/✔✔ @/-Inability @/to @/compress @/the @/common @/femoral @/or @/popliteal
@/veins.
What @/is @/the @/reference @/(gold) @/standard @/for @/the @/diagnosis @/of @/DVT? @/- @/correct
@/Answers @/✔✔ @/-Contrast @/Venogram @/- @/although @/venous @/U/S @/remains @/diagnostic
@/procedure @/of @/choice.
What @/is @/the @/reference @/(gold) @/standard @/for @/the @/diagnosis @/of @/PE? @/- @/correct @/Answers
@/✔✔ @/-Pulmonary @/Angiography
The @/v/q @/scan @/is @/useful @/for @/pts @/who @/are @/not @/able @/to @/udergo @/CTA, @/for @/example...
@/- @/correct @/Answers @/✔✔ @/-Pts @/with @/renal @/failure.
If @/the @/PE @/Dichotomous @/Clinical @/Probability @/Assessment @/score @/= @/4, @/what @/is @/your
@/next @/step @/in @/the @/algorithm? @/- @/correct @/Answers @/✔✔ @/-Order @/a @/Rapid @/quantitative
@/ELISA @/D-dimer
with complete solutions
After @/exposure @/to @/toxic @/fumes, @/a @/pt @/gradually @/develops @/cough @/and @/dyspnea, @/he
@/most @/likely @/has: @/- @/correct @/Answers @/✔✔ @/-Acute @/Bronchiolitis
Risk @/factors @/for @/development @/of @/bronchiolitis @/in @/the @/adult @/pt @/include:
a. @/exposure @/to @/toxic @/fumes
b. @/viral @/infection
c. @/organ @/transplant
d. @/systemic @/lupus @/erythematosus
e. @/all @/of @/the @/above @/- @/correct @/Answers @/✔✔ @/-e. @/all @/of @/the @/above
Connective @/tissue @/disease @/(SLE)
Treatment @/for @/a @/pt @/with @/proliferative @/bronchiolitis @/includes________________ @/for @/___-
___ @/months, @/then @/tapered @/to @/20-40 @/mg/day @/- @/correct @/Answers @/✔✔ @/-Prednisone
@/1mg/kg/day @/for @/1-3 @/months
T @/or @/F: @/When @/narrowing @/the @/dif. @/dx @/of @/causes @/of @/pna @/in @/the
@/immunocompromised @/adult, @/remember @/- @/Defects @/in @/humoral @/immunity @/predispose @/to
@/bacterial @/infections; @/defects @/in @/cellular @/immunity @/lead @/to @/infections @/with @/viruses,
@/fungi, @/mycobacteria, @/and @/protozoa. @/- @/correct @/Answers @/✔✔ @/-True
- @/Antibiotic @/therapy @/in @/the @/preceding @/90 @/days.
- @/Acute @/care @/hospitalization @/for @/at @/least @/2 @/days @/in @/the @/preceding @/90 @/days.
- @/Residence @/in @/a @/nursing @/home @/or @/extended @/care @/facility.
- @/Home @/infusion @/therapy, @/including @/chemotherapy, @/within @/the @/past @/30 @/days.
- @/Long-term @/dialysis @/within @/the @/past @/30 @/days.
,- @/Home @/wound @/care.
- @/Family @/member @/with @/an @/infection @/involving @/a @/multiple @/drug-resistant @/pathogen.
- @/Immunosuppressive @/disease @/or @/immunosuppressive @/therapy. @/- @/correct @/Answers @/✔✔
@/-Risk @/factors @/for @/HCAP
Three @/factors @/distinguish @/nosocomial @/pneumonia @/from @/CAP: @/- @/correct @/Answers @/✔✔ @/-
(1) @/different @/infectious @/causes.
(2) @/different @/antibiotic @/susceptibility @/patterns, @/specifically, @/a @/higher @/incidence @/of @/drug
@/resistance.
(3) @/the @/patients' @/underlying @/health @/status @/that @/puts @/them @/at @/risk @/for @/more @/severe
@/infections.
Colonization @/of @/the @/________ @/and @/possibly @/the @/________ @/with @/bacteria @/is @/the @/most
@/important @/step @/in @/the @/pathogenesis @/of @/nosocomial @/pneumonia. @/- @/correct @/Answers
@/✔✔ @/-pharynx; @/stomach
Within @/___ @/hours @/of @/admission, @/___% @/of @/seriously @/ill @/hospitalized @/patients @/have
@/their @/upper @/airway @/colonized @/with @/organisms @/from @/the @/hospital @/environment. @/-
@/correct @/Answers @/✔✔ @/-48; @/75%
Patients @/with @/anaerobic @/pleuropulmonary @/infection @/usually @/present @/with @/constitutional
@/symptoms @/such @/as @/fever, @/weight @/loss, @/and @/malaise, @/dentition @/is @/often @/poor,
@/however, @/rarely @/edentulous; @/if @/so, @/an @/
________ @/________ @/________is @/usually @/present. @/- @/correct @/Answers @/✔✔ @/-obstructing
@/bronchial @/lesion
Representative @/material @/for @/culture @/of @/anaerobic @/organisms @/can @/be @/obtained @/only @/by
@/
a. @/transthoracic @/aspiration
b. @/thoracentesis
c. @/bronchoscopy @/with @/a @/protected @/brush. @/
d. @/all @/of @/the @/above @/- @/correct @/Answers @/✔✔ @/-d. @/all @/of @/the @/above
Expectoration @/is @/inappropriate.
This @/anaerobic @/pleuropulmonary @/infection @/appears @/as @/a @/thick-walled @/solitary @/cavity
@/surrounded @/by @/consolidation.
a. @/Empyema
,b. @/Necrotizing @/pna
c. @/Lung @/abscess
d. @/A @/and @/C @/- @/correct @/Answers @/✔✔ @/-c. @/Lung @/abscess
T @/or @/F: @/Refer @/all @/pts @/with @/CXR @/findings @/consistent @/with @/anaerobic @/pleuropulmonary
@/infection @/for @/hospital @/admission, @/IV @/abx, @/and @/most @/likely @/a @/chest @/tube. @/- @/correct
@/Answers @/✔✔ @/-True
____________ @/alone @/is @/inadequate @/treatment @/for @/anaerobic @/pleuropulmonary @/infections
@/because @/an @/increasing @/number @/of @/anaerobic @/organisms @/produce @/B-lactamases @/-
@/correct @/Answers @/✔✔ @/-PCN
Neutropenia @/and @/impaired @/granulocyte @/function @/predispose @/to @/infections @/from @/S
@/aureus, @/Aspergillus, @/gram-negative @/bacilli, @/and @/Candida. @/- @/correct @/Answers @/✔✔ @/-...
Knowledge @/of @/the @/underlying @/immunologic @/defect @/and @/the @/time @/course @/of @/infection
@/provides @/clues @/to @/the @/etiology @/of @/pneumonia @/in @/immunocompromised @/patients. @/-
@/correct @/Answers @/✔✔ @/-...
In @/the @/immunocompromised @/patient @/a @/__________ @/pneumonia @/is @/often @/caused @/by
@/bacterial @/infection, @/whereas @/an @/_________ @/pneumonia @/is @/more @/apt @/to @/be @/caused
@/by @/viral, @/fungal, @/protozoal, @/or @/mycobacterial @/infection. @/- @/correct @/Answers @/✔✔ @/-
Fulminant; @/insidious
Pneumonia @/occurring @/within @/2-4 @/weeks @/after @/organ @/transplantation @/is @/usually
@/__________, @/whereas @/several @/months @/or @/more @/after @/transplantation @/P @/jiroveci,
@/__________and @/_______ @/are @/encountered @/more @/often. @/- @/correct @/Answers @/✔✔ @/-
Bacterial; @/viruses; @/fungi
Substances @/with @/potential @/to @/embolize @/to @/the @/pulmonary @/circulation @/- @/correct
@/Answers @/✔✔ @/-air, @/amniotic @/fluid, @/fat, @/foreign @/bodies, @/parasite @/eggs
@/(schistosomiasis), @/septic @/emboli, @/tumor @/cells, @/thrombus @/(most @/commond)
Risk @/factors @/for @/PE @/and @/DVT @/- @/correct @/Answers @/✔✔ @/-Venous @/stasis, @/injury @/to @/the
@/vessel @/wall, @/and @/hypercoagulability @/-- @/VIRCHOW @/TRIAD
Causes @/of @/venous @/stasis... @/- @/correct @/Answers @/✔✔ @/-Immobility, @/hyperviscosity
@/(polycythemia), @/increased @/CVP @/(low @/CO, @/pregnancy)
Causes @/of @/hypercoagulability... @/- @/correct @/Answers @/✔✔ @/-Oral @/contraceptives, @/HRT,
@/malignancy/surgery, @/inherited @/gene @/defects @/(Factor @/V @/Leiden)
Massive @/pulmonary @/thrombus @/may @/cause... @/- @/correct @/Answers @/✔✔ @/-Right @/Ventricular
@/Failure
, T @/or @/F: @/Common @/S/S @/of @/PE @/are @/specific @/to @/the @/disorder. @/- @/correct @/Answers @/✔✔
@/-False
3 @/S/S @/seen @/in @/most @/pts @/presenting @/with @/PE... @/- @/correct @/Answers @/✔✔ @/-Dyspnea,
@/CP @/with @/breathing, @/tachypnea.
2 @/Common @/ECG @/changes @/with @/PE: @/- @/correct @/Answers @/✔✔ @/-ST @/and @/nonspecific @/ST
@/& @/T @/wave @/changes.
Profound_______ @/with @/a @/normal_____in @/the @/absence @/of @/preexisting @/lung @/disease @/is
@/highly @/suspicious @/for @/PE. @/- @/correct @/Answers @/✔✔ @/-Hypoxia, @/CXR
A @/D-Dimer @/< @/__________ @/provides @/strong @/evidence @/against @/PE. @/- @/correct @/Answers
@/✔✔ @/-500 @/ng/ml
Initial @/diagnostic @/study @/used @/for @/suspected @/PE: @/- @/correct @/Answers @/✔✔ @/-Helical @/CT
@/pulmonary @/angiography
Radiolabeled @/microaggregated @/albumin @/is @/injected @/into @/the @/venous @/system, @/allowing
@/the @/particles @/to @/embolize @/to @/the @/pulmonary @/capillary @/bed. @/- @/correct @/Answers @/✔✔
@/-Perfusion @/Scan
Patient @/breathes @/a @/radioactive @/gas @/or @/aerosol @/while @/the @/distribution @/of @/radioactivity
@/in @/the @/lungs @/is @/recorded. @/- @/correct @/Answers @/✔✔ @/-Ventilation @/Scan
___% @/of @/pts @/with @/PE @/will @/have @/a @/DVT @/on @/eval. @/- @/correct @/Answers @/✔✔ @/-70
Test @/of @/choice @/to @/detect @/proximal @/DVT @/- @/correct @/Answers @/✔✔ @/-Venous @/U/S
On @/a @/venous @/U/S, @/what @/is @/diagnostic @/of @/first-episode @/DVT @/in @/symptomatic @/pts? @/-
@/correct @/Answers @/✔✔ @/-Inability @/to @/compress @/the @/common @/femoral @/or @/popliteal
@/veins.
What @/is @/the @/reference @/(gold) @/standard @/for @/the @/diagnosis @/of @/DVT? @/- @/correct
@/Answers @/✔✔ @/-Contrast @/Venogram @/- @/although @/venous @/U/S @/remains @/diagnostic
@/procedure @/of @/choice.
What @/is @/the @/reference @/(gold) @/standard @/for @/the @/diagnosis @/of @/PE? @/- @/correct @/Answers
@/✔✔ @/-Pulmonary @/Angiography
The @/v/q @/scan @/is @/useful @/for @/pts @/who @/are @/not @/able @/to @/udergo @/CTA, @/for @/example...
@/- @/correct @/Answers @/✔✔ @/-Pts @/with @/renal @/failure.
If @/the @/PE @/Dichotomous @/Clinical @/Probability @/Assessment @/score @/= @/4, @/what @/is @/your
@/next @/step @/in @/the @/algorithm? @/- @/correct @/Answers @/✔✔ @/-Order @/a @/Rapid @/quantitative
@/ELISA @/D-dimer
