Kettering Clinical Simulation
Pathology
Assessment of a 3 month old infant reveals accessory muscle use during inspiration,
substernal and intercostal, increased HR, BP, Qt, low grade fever, cyanosis, and
diminished breath sounds with inspiratory stridor what should the therapist suspect? -
CORRECT ANSWER-Croup
A lateral neck x-ray reveals haziness in the subglottic area, steeple sign, pencil point,
picket fence, hour glass narrowing of the upper airway indicating the presence of? -
CORRECT ANSWER-croup
Treatment and management of a mild case of croup? (6) - CORRECT ANSWER-1.
supportive care
2. adequate hydration and humidification of inspired air
3. close monitoring
4. oxygen therapy 30-40%
5. cool aerosol mist (face mask)
6. drug therapy
A patient with emphysema will typically have a body build described as? - CORRECT
ANSWER-think and underweight
A patient with chronic bronchitis will typically have a body build described as? -
CORRECT ANSWER-stocky and overweight
A patient with emphysema and/or chronic bronchitis will typically have a past medical
history of? - CORRECT ANSWER-tobacco use
A patient with emphysema will typically have a chest appearance described as? -
CORRECT ANSWER-barrel chest, increased A-P diameter, Hoover's sign
A patient with chronic bronchitis will typically have a chest appearance described as? -
CORRECT ANSWER-occasional barrel chest
What type of respiratory patterns will a patient with emphysema have? - CORRECT
ANSWER-dyspnea, pursed-lip breathing, accessory muscle use, especially during
exacerbation
What type of respiratory patterns will a patient with chronic bronchitis have? -
CORRECT ANSWER-use of accessory muscleless common
,Patients with emphysema typically appear what color? - CORRECT ANSWER-pink
Patients with chronic bronchitis typically appear what color? - CORRECT ANSWER-
cyanotic
Will performing diagnostic chest percussion on a patient with emphysema the therapy
will typically hear? - CORRECT ANSWER-hyperresonant/tympanic note
While performing diagnostic chest percussion on a patient with chronic bronchitis the
therapy will typically hear? - CORRECT ANSWER-normal
Auscultation of breath sound of a patient with emphysema will commonly be described
as? - CORRECT ANSWER-Diminished breath songs, prolonged expiration
Auscultation of breath sound of a patient with chronic bronchitis will commonly be
described as? - CORRECT ANSWER-ronchi, crackles, wheezes
A chest x-ray is described as translucent (dark) lung fields, depressed or flattened
diaphragms, long and narrow heart , increased intersternal air space, and possibly
hypertrophy of right ventricle what is the diagnosis? - CORRECT ANSWER-
emphysema
A chest x-ray is described as translucent (dark) lung fields, depressed or flattened
diaphragms, and possibly hypertrophy of right ventricle what is the diagnosis? -
CORRECT ANSWER-Chronic bronchitis
A PFT reveals decreased flow rates (FEV1, FEF25-75%, FEV1/FVC, and PEFR) and
decreased DLco the therapist should suspect? - CORRECT ANSWER-emphysema
A PFT reveals decreased flow rates (FEV1, FEF25-75%, FEV1/FVC, and PEFR) and
normal DLco the therapist should suspect? - CORRECT ANSWER-chronic bronchitis
A CBC determined increased RBC/Hb/Hct in the late stages of the disease process
what should the therapist suspect? - CORRECT ANSWER-emphysema
A CBC determined increased RBC/Hb/Hct in the early and late stages of the disease
process what should the therapist suspect? - CORRECT ANSWER-chronic bronchitis
A sputum culture of a patient with emphysema would typically find? - CORRECT
ANSWER-normal
A sputum culture of a patient with persistent productive cough identified streptococcus
pneumonia, heamophilus influenzae, and moraxella catarrhalis with should the therapist
suspect? - CORRECT ANSWER-chronic bronchitis
, Oxygen treatment for patient with COPD is? - CORRECT ANSWER-Low flow oxygen at
1-2 L/min or 24-28% air entrainment mask
A patient has been diagnosed with COPD what medications should the therapist
recommend? - CORRECT ANSWER-Bronchodilators (SABA, LABA, anticholinergic),
inhaled corticosteroids, and antibiotics if indicated by sputum culture
What should a therapist recommend for a patient with acute exacerbate of ventilatory
failure? - CORRECT ANSWER-NPPV
Chronic dilation and distortion of one or more bronchi as a result of excessive
inflammation and destruction of bronchial walls, blood vessels, elastic tissue and
smooth muscle. Results in impaired mucocillary clearance causing accumulation of
copious amounts of bronchial secretions is known as? - CORRECT ANSWER-
bronchiectasis
A patient with a past medical history of recurrent pulmonary infections, cystic fibrosis, or
kartagener's syndrome would likely have? - CORRECT ANSWER-Bronchiectasis
A patient has cough that is productive with purulent foul smelling sputum, hemoptysis
and 3 layers sputum, may be blood streaked would likely be suffering from ? -
CORRECT ANSWER-bronchiectasis
A patient with bronchiectasis will typically have what breath sounds? - CORRECT
ANSWER-diminished and wheezing
Diagnostic chest percussion of a patient with bronchiectasis will typically reveal? -
CORRECT ANSWER-hyperresonant/tympanic note
one or both lungs can be affected, commonly limited to a lobe or segment, frequently
found in lower lobes, and can create an obstructive or restrictive pattern, or a
combination of both indicates? - CORRECT ANSWER-bronchiectasis
A chest x-ray reveals hyper lucent lung fields, depressed or flattened diaphragm,
enlarged or elongated heart will commonly indicate? - CORRECT ANSWER-
Bronchiectasis
How will bronchiectasis affect flow rates? - CORRECT ANSWER-decrease flow rates
Treatment and management of bronchiectasis may include?(9) - CORRECT ANSWER-
1. bronchopulmonary hygiene
2. lung expansion therapy
3. antibiotics for infection
4. expectoration
5. aerosolized medication
6. surgical resection of involved segments if necessary
Pathology
Assessment of a 3 month old infant reveals accessory muscle use during inspiration,
substernal and intercostal, increased HR, BP, Qt, low grade fever, cyanosis, and
diminished breath sounds with inspiratory stridor what should the therapist suspect? -
CORRECT ANSWER-Croup
A lateral neck x-ray reveals haziness in the subglottic area, steeple sign, pencil point,
picket fence, hour glass narrowing of the upper airway indicating the presence of? -
CORRECT ANSWER-croup
Treatment and management of a mild case of croup? (6) - CORRECT ANSWER-1.
supportive care
2. adequate hydration and humidification of inspired air
3. close monitoring
4. oxygen therapy 30-40%
5. cool aerosol mist (face mask)
6. drug therapy
A patient with emphysema will typically have a body build described as? - CORRECT
ANSWER-think and underweight
A patient with chronic bronchitis will typically have a body build described as? -
CORRECT ANSWER-stocky and overweight
A patient with emphysema and/or chronic bronchitis will typically have a past medical
history of? - CORRECT ANSWER-tobacco use
A patient with emphysema will typically have a chest appearance described as? -
CORRECT ANSWER-barrel chest, increased A-P diameter, Hoover's sign
A patient with chronic bronchitis will typically have a chest appearance described as? -
CORRECT ANSWER-occasional barrel chest
What type of respiratory patterns will a patient with emphysema have? - CORRECT
ANSWER-dyspnea, pursed-lip breathing, accessory muscle use, especially during
exacerbation
What type of respiratory patterns will a patient with chronic bronchitis have? -
CORRECT ANSWER-use of accessory muscleless common
,Patients with emphysema typically appear what color? - CORRECT ANSWER-pink
Patients with chronic bronchitis typically appear what color? - CORRECT ANSWER-
cyanotic
Will performing diagnostic chest percussion on a patient with emphysema the therapy
will typically hear? - CORRECT ANSWER-hyperresonant/tympanic note
While performing diagnostic chest percussion on a patient with chronic bronchitis the
therapy will typically hear? - CORRECT ANSWER-normal
Auscultation of breath sound of a patient with emphysema will commonly be described
as? - CORRECT ANSWER-Diminished breath songs, prolonged expiration
Auscultation of breath sound of a patient with chronic bronchitis will commonly be
described as? - CORRECT ANSWER-ronchi, crackles, wheezes
A chest x-ray is described as translucent (dark) lung fields, depressed or flattened
diaphragms, long and narrow heart , increased intersternal air space, and possibly
hypertrophy of right ventricle what is the diagnosis? - CORRECT ANSWER-
emphysema
A chest x-ray is described as translucent (dark) lung fields, depressed or flattened
diaphragms, and possibly hypertrophy of right ventricle what is the diagnosis? -
CORRECT ANSWER-Chronic bronchitis
A PFT reveals decreased flow rates (FEV1, FEF25-75%, FEV1/FVC, and PEFR) and
decreased DLco the therapist should suspect? - CORRECT ANSWER-emphysema
A PFT reveals decreased flow rates (FEV1, FEF25-75%, FEV1/FVC, and PEFR) and
normal DLco the therapist should suspect? - CORRECT ANSWER-chronic bronchitis
A CBC determined increased RBC/Hb/Hct in the late stages of the disease process
what should the therapist suspect? - CORRECT ANSWER-emphysema
A CBC determined increased RBC/Hb/Hct in the early and late stages of the disease
process what should the therapist suspect? - CORRECT ANSWER-chronic bronchitis
A sputum culture of a patient with emphysema would typically find? - CORRECT
ANSWER-normal
A sputum culture of a patient with persistent productive cough identified streptococcus
pneumonia, heamophilus influenzae, and moraxella catarrhalis with should the therapist
suspect? - CORRECT ANSWER-chronic bronchitis
, Oxygen treatment for patient with COPD is? - CORRECT ANSWER-Low flow oxygen at
1-2 L/min or 24-28% air entrainment mask
A patient has been diagnosed with COPD what medications should the therapist
recommend? - CORRECT ANSWER-Bronchodilators (SABA, LABA, anticholinergic),
inhaled corticosteroids, and antibiotics if indicated by sputum culture
What should a therapist recommend for a patient with acute exacerbate of ventilatory
failure? - CORRECT ANSWER-NPPV
Chronic dilation and distortion of one or more bronchi as a result of excessive
inflammation and destruction of bronchial walls, blood vessels, elastic tissue and
smooth muscle. Results in impaired mucocillary clearance causing accumulation of
copious amounts of bronchial secretions is known as? - CORRECT ANSWER-
bronchiectasis
A patient with a past medical history of recurrent pulmonary infections, cystic fibrosis, or
kartagener's syndrome would likely have? - CORRECT ANSWER-Bronchiectasis
A patient has cough that is productive with purulent foul smelling sputum, hemoptysis
and 3 layers sputum, may be blood streaked would likely be suffering from ? -
CORRECT ANSWER-bronchiectasis
A patient with bronchiectasis will typically have what breath sounds? - CORRECT
ANSWER-diminished and wheezing
Diagnostic chest percussion of a patient with bronchiectasis will typically reveal? -
CORRECT ANSWER-hyperresonant/tympanic note
one or both lungs can be affected, commonly limited to a lobe or segment, frequently
found in lower lobes, and can create an obstructive or restrictive pattern, or a
combination of both indicates? - CORRECT ANSWER-bronchiectasis
A chest x-ray reveals hyper lucent lung fields, depressed or flattened diaphragm,
enlarged or elongated heart will commonly indicate? - CORRECT ANSWER-
Bronchiectasis
How will bronchiectasis affect flow rates? - CORRECT ANSWER-decrease flow rates
Treatment and management of bronchiectasis may include?(9) - CORRECT ANSWER-
1. bronchopulmonary hygiene
2. lung expansion therapy
3. antibiotics for infection
4. expectoration
5. aerosolized medication
6. surgical resection of involved segments if necessary
