Rosh Pulmonolgy
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1. Isoniazid A 47-year-old woman with diabetes mellitus is found to
have latent tuberculosis during a routine employee health
purified protein derivative (PPD) test. She should receive
supplementation with pyridoxine (vitamin B6) if her drug
regimen contains which of the following medications?
A. Ethambutol
B. Isoniazid
C. Pyrazinamide
D. Rifampin
2. Isoniazid plus ri- Which of the following is the first-line preferred treatment
fampin for a latent tuberculosis infection?
A. Doxycycline
B. Isoniazid plus rifampin
C. Lamivudine plus zidovudine
D. Penicillin
3. Recent viral A 67-year-old woman presents with shortness of breath
symptoms and a cough for 3 days. The patient admits to recently
having a fever, chills, rhinorrhea, and myalgias for 10
days. She had one episode of diarrhea and has been
nauseated. Her past medical history is positive for COPD.
She does not smoke but she drinks two cans of beer daily.
In the ED, her vital signs are BP 120/76, HR 108, RR
20, oxygen saturation 97% on room air, and temperature
101.2°F. A chest X-ray shows a left lower lobe consol-
idation. It is suspected that this patient has pneumonia
caused by Staphylococcus aureus. Which aspect of this
patient's history supports this suspicion?
A. Alcohol consumption
B. Gastrointestinal symptoms
C. History of COPD
D. Recent viral symptoms
4. Increased tidal Which of the following physiologic responses would occur
volumes after application of noninvasive positive pressure ventila-
tion in a patient presenting with an acute exacerbation of
chronic obstructive pulmonary disease?
A. Increased alveolar dead space
, Rosh Pulmonolgy
Study online at https://quizlet.com/_8zp9n1
B. Increased LV afterload
C. Increased tidal volumes
D. Increased venous return
5. Administer A 45-year-old patient with newly diagnosed diabetes mel-
pneumococcus litus type 2 presents to your office for her annual exam.
and annual She has had her hepatitis B vaccination, but wants to
influenza know if she needs any additional vaccinations because
vaccines of her new diagnosis. Which of the following is the most
appropriate next step in her management?
A. Administer annual influenza vaccine only
B. Administer pneumococcus and annual influenza vac-
cines
C. Administer pneumonia prophylaxis with trimetho-
prim-sulfamethoxazole
D. The patient does not need any additional vaccines
since she is up to date
6. Amoxicillin A 12-year-old girl presents to the clinic with acute onset
of productive cough, fever to 102°F, and extreme fatigue.
She is awake and alert but appears tired. Her oxygen
saturation is 96%, and respiratory rate is 15 breaths per
minute. Lung auscultation reveals fine crackles in the left
upper lobe. A chest radiograph reveals localized alveolar
infiltrates with consolidation. Which of the following is the
most appropriate treatment for this patient?
A. Amoxicillin
B. Azithromycin
C. Cefotaxime
D. Clindamycin
7. Dextromethor- A 56-year-old man comes to the clinic complaining of a
phan six-day history of a mucopurulent cough and worsening
shortness of breath. His temperature is 37.6°C (99.8°F).
Auscultation of the lungs reveals rhonchi and wheezing
throughout. Chest X-ray shows thickening of the bronchial
walls in both lower lobes. Laboratory studies show a
slightly elevated white blood count. Which of the following
medications is most appropriate to administer for this
, Rosh Pulmonolgy
Study online at https://quizlet.com/_8zp9n1
patient's cough?
A. Aspirin
B. Dextromethorphan
C. Penicillin
D. Prednisone
8. Cough What is the most common complaint seen in acute bron-
chitis?
A. Chest pain
B. Cough
C. Fever
D. Sputum
9. Oseltamivir A 26-year-old gravida 3 para 2 at 12 weeks gestation
presents with fever, myalgias, headache, and malaise.
There have been multiple cases of influenza in the com-
munity and her influenza swab is positive. Which one of
the following is recommended by the Centers for Disease
Control and Prevention in this situation?
A. Acyclovir
B. Oseltamivir
C. Rimantadine
D. Supportive therapy only
10. Nasopharyngeal An 8-month-old previously healthy boy presents with
swab for fever, cough, and wheezing for the last two days. Phys-
fluorescent ical exam reveals prolonged expiration and mild sub-
antibody costal retractions. Lung auscultation reveals diffuse ex-
staining piratory wheezing and tachypnea. His immunizations are
up-to-date. Which of the following tests is most likely to
confirm the suspected diagnosis?
A. Chest X-ray
B. Complete blood count
C. Nasopharyngeal swab for fluorescent antibody staining
D. Throat culture for Streptococcal infection
11. Discharge home A 47-year-old woman with no significant past medical his-
with oral antibi- tory and no hospitalizations, presents with cough, green
otics and fol- sputum, and fever. Her vitals are T 100.7°F, HR 94 bpm,
low-up BP 123/76 mm Hg, RR 18/min, and oxygen saturation
, Rosh Pulmonolgy
Study online at https://quizlet.com/_8zp9n1
97%. She is well appearing, and her blood work (CBC and
BMP) is unremarkable. A chest X-ray shows a left lower
lobe infiltrate. Which one of the following answer choices
represents the best management for this patient?
A. Discharge home with oral antibiotics and follow-up
B. Draw blood cultures and discharge home on oral antibi-
otics
C. Order a chest CT scan
D. Start IV antibiotics, draw blood cultures, and admit
12. Croup A 2-year-old girl presents to clinic with a gradual onset
of nasal congestion, hoarseness, and a barking cough.
Stridor is auscultated and the patient is sitting upright and
does not appear to be in acute respiratory distress. Which
of the following is the most likely diagnosis?
A. Croup
B. Epiglottitis
C. Foreign body aspiration
D. Peritonsillar abscess
13. Acute bronchitis A 53-year-old man comes to the emergency department
complaining of a 5-day history of a cough and shortness
of breath. His temperature is 37.6°C (99.8°F). Auscul-
tation of the lungs shows rhonchi and wheezing. Chest
X-ray shows thickening of the bronchial walls in both
lower lobes. Laboratory studies show a slightly elevated
white blood count. Which of the following is the most likely
diagnosis?
A. Acute bronchitis
B. Asthma
C. Influenza
D. Pneumonia
14. Oseltamivir A 68-year-old woman presents with abrupt onset of fever,
malaise, body aches, headache, and sore throat. Rapid
strep test is negative and nasal swab is positive for in-
fluenza B. Which of the following is the most appropriate
therapy?
A. Acyclovir
Study online at https://quizlet.com/_8zp9n1
1. Isoniazid A 47-year-old woman with diabetes mellitus is found to
have latent tuberculosis during a routine employee health
purified protein derivative (PPD) test. She should receive
supplementation with pyridoxine (vitamin B6) if her drug
regimen contains which of the following medications?
A. Ethambutol
B. Isoniazid
C. Pyrazinamide
D. Rifampin
2. Isoniazid plus ri- Which of the following is the first-line preferred treatment
fampin for a latent tuberculosis infection?
A. Doxycycline
B. Isoniazid plus rifampin
C. Lamivudine plus zidovudine
D. Penicillin
3. Recent viral A 67-year-old woman presents with shortness of breath
symptoms and a cough for 3 days. The patient admits to recently
having a fever, chills, rhinorrhea, and myalgias for 10
days. She had one episode of diarrhea and has been
nauseated. Her past medical history is positive for COPD.
She does not smoke but she drinks two cans of beer daily.
In the ED, her vital signs are BP 120/76, HR 108, RR
20, oxygen saturation 97% on room air, and temperature
101.2°F. A chest X-ray shows a left lower lobe consol-
idation. It is suspected that this patient has pneumonia
caused by Staphylococcus aureus. Which aspect of this
patient's history supports this suspicion?
A. Alcohol consumption
B. Gastrointestinal symptoms
C. History of COPD
D. Recent viral symptoms
4. Increased tidal Which of the following physiologic responses would occur
volumes after application of noninvasive positive pressure ventila-
tion in a patient presenting with an acute exacerbation of
chronic obstructive pulmonary disease?
A. Increased alveolar dead space
, Rosh Pulmonolgy
Study online at https://quizlet.com/_8zp9n1
B. Increased LV afterload
C. Increased tidal volumes
D. Increased venous return
5. Administer A 45-year-old patient with newly diagnosed diabetes mel-
pneumococcus litus type 2 presents to your office for her annual exam.
and annual She has had her hepatitis B vaccination, but wants to
influenza know if she needs any additional vaccinations because
vaccines of her new diagnosis. Which of the following is the most
appropriate next step in her management?
A. Administer annual influenza vaccine only
B. Administer pneumococcus and annual influenza vac-
cines
C. Administer pneumonia prophylaxis with trimetho-
prim-sulfamethoxazole
D. The patient does not need any additional vaccines
since she is up to date
6. Amoxicillin A 12-year-old girl presents to the clinic with acute onset
of productive cough, fever to 102°F, and extreme fatigue.
She is awake and alert but appears tired. Her oxygen
saturation is 96%, and respiratory rate is 15 breaths per
minute. Lung auscultation reveals fine crackles in the left
upper lobe. A chest radiograph reveals localized alveolar
infiltrates with consolidation. Which of the following is the
most appropriate treatment for this patient?
A. Amoxicillin
B. Azithromycin
C. Cefotaxime
D. Clindamycin
7. Dextromethor- A 56-year-old man comes to the clinic complaining of a
phan six-day history of a mucopurulent cough and worsening
shortness of breath. His temperature is 37.6°C (99.8°F).
Auscultation of the lungs reveals rhonchi and wheezing
throughout. Chest X-ray shows thickening of the bronchial
walls in both lower lobes. Laboratory studies show a
slightly elevated white blood count. Which of the following
medications is most appropriate to administer for this
, Rosh Pulmonolgy
Study online at https://quizlet.com/_8zp9n1
patient's cough?
A. Aspirin
B. Dextromethorphan
C. Penicillin
D. Prednisone
8. Cough What is the most common complaint seen in acute bron-
chitis?
A. Chest pain
B. Cough
C. Fever
D. Sputum
9. Oseltamivir A 26-year-old gravida 3 para 2 at 12 weeks gestation
presents with fever, myalgias, headache, and malaise.
There have been multiple cases of influenza in the com-
munity and her influenza swab is positive. Which one of
the following is recommended by the Centers for Disease
Control and Prevention in this situation?
A. Acyclovir
B. Oseltamivir
C. Rimantadine
D. Supportive therapy only
10. Nasopharyngeal An 8-month-old previously healthy boy presents with
swab for fever, cough, and wheezing for the last two days. Phys-
fluorescent ical exam reveals prolonged expiration and mild sub-
antibody costal retractions. Lung auscultation reveals diffuse ex-
staining piratory wheezing and tachypnea. His immunizations are
up-to-date. Which of the following tests is most likely to
confirm the suspected diagnosis?
A. Chest X-ray
B. Complete blood count
C. Nasopharyngeal swab for fluorescent antibody staining
D. Throat culture for Streptococcal infection
11. Discharge home A 47-year-old woman with no significant past medical his-
with oral antibi- tory and no hospitalizations, presents with cough, green
otics and fol- sputum, and fever. Her vitals are T 100.7°F, HR 94 bpm,
low-up BP 123/76 mm Hg, RR 18/min, and oxygen saturation
, Rosh Pulmonolgy
Study online at https://quizlet.com/_8zp9n1
97%. She is well appearing, and her blood work (CBC and
BMP) is unremarkable. A chest X-ray shows a left lower
lobe infiltrate. Which one of the following answer choices
represents the best management for this patient?
A. Discharge home with oral antibiotics and follow-up
B. Draw blood cultures and discharge home on oral antibi-
otics
C. Order a chest CT scan
D. Start IV antibiotics, draw blood cultures, and admit
12. Croup A 2-year-old girl presents to clinic with a gradual onset
of nasal congestion, hoarseness, and a barking cough.
Stridor is auscultated and the patient is sitting upright and
does not appear to be in acute respiratory distress. Which
of the following is the most likely diagnosis?
A. Croup
B. Epiglottitis
C. Foreign body aspiration
D. Peritonsillar abscess
13. Acute bronchitis A 53-year-old man comes to the emergency department
complaining of a 5-day history of a cough and shortness
of breath. His temperature is 37.6°C (99.8°F). Auscul-
tation of the lungs shows rhonchi and wheezing. Chest
X-ray shows thickening of the bronchial walls in both
lower lobes. Laboratory studies show a slightly elevated
white blood count. Which of the following is the most likely
diagnosis?
A. Acute bronchitis
B. Asthma
C. Influenza
D. Pneumonia
14. Oseltamivir A 68-year-old woman presents with abrupt onset of fever,
malaise, body aches, headache, and sore throat. Rapid
strep test is negative and nasal swab is positive for in-
fluenza B. Which of the following is the most appropriate
therapy?
A. Acyclovir
