Respiratory ROSH review Questions And Answers Rated A+ New Update Assured Satisfaction

A 10-year-old boy presents to the clinic with his mother with cold-like symptoms for 4 days. He has a wet-cough that has been persistent over the last 4 days and interferes with outside play. His mother would like to get something for his cough. Which of the following is the most appropriate initial management for his cough? ADextromethorphan BGuaifenesin CPromethazine-codeine DWarm fluids and honey - Answer-D A 10-year-old girl presents with fever, sore throat, cough, headache, and general malaise worsening over the past 4 days. Lung auscultation reveals rales in the lower left lobe. A chest radiograph demonstrates interstitial infiltrates in the lower left lobe. Which of the following is the most likely causative pathogen? AKlebsiella pneumoniae BParainfluenza virus CRespiratory syncytial virus DStreptococcus pneumoniae - Answer-D A 12-year-old boy with asthma symptoms presents to clinic. His symptoms of wheeze and cough presented at age four and are most prominent in a seasonal pattern. Spirometry reveals FEV1 90% and normal FEV1/FVC ratio. Daytime symptoms occur 1-2 days per week but not on a daily basis. He has had nocturnal symptoms one time in the previous month. He uses his budesonide-formoterol inhaler once per week. He has had no hospitalizations or steroid use within the previous year. How would you classify his asthma? AHe does not have asthma BMild intermittentCorrect Answer CMild persistent DModerate persistent - Answer-B A 14-month-old girl presents to the office with a three-day history of rhinorrhea and low-grade temperature. Today the patient has developed a cough and parents note some changes in her breathing. She has no history of asthma or any other pulmonary problems. On examination, there is diffusewheezing, mild substernal retractions, and mild tachypnea. Which of the following is the most likely diagnosis? AAcute bronchiolitisCorrect Answer BAsthma exacerbation CBacterial pneumonia DCroup - Answer-A A 14-year-old active boy with no significant medical history presents to the clinic with his father with complaints of feeling short of breath and a cough. The boy states that his symptoms occur one to two times per week and one time at night within the past month. The nurse practitioner notes wheezing at the end of expiration. Which of the following is the most appropriate next step in management for this patient? AAlbuterolYour Answer BAzithromycin CChest X-ray DSpirometry - Answer-D A 15-year-old boy who recently migrated from Pakistan presents with severe coughing spells. One week ago, he experienced malaise, rhinorrhea, and fever. During the exam, the boy experiences prolonged coughing spells followed by vigorous inspirations. Between the spells, the boy appears well and has few symptoms. Which of the following is the most likely diagnosis? ABordetella pertussisCorrect Answer BCorynebacterium diphtheriae CInfluenza virus DMycoplasma pneumoniae - Answer-A A 16-year-old boy presents to the clinic with recurrent respiratory tract infections. He contracts bronchitis and pneumonia at least once a year, and he has been hospitalized for respiratory distress due to infection three times. He reports a chronic cough that is productive of purulent, yellow sputum for almost one year. He also has a history of recurrent sinus infections. He denies headaches, chest pain, abdominal pain, and urinary changes. He reports occasionally passing oily, foul-smelling stool. A sweat chloride test performed one week ago is measured at 45 mmol/L. Which of the following clinical features is the patient also likely to have? AFunctional ciliary motilityBNephrocalcinosisCorrect Answer CPresence of cholesterol gallstones DSecondary polycythemia - Answer-B A 16-year-old boy presents to the clinic with wheezing for three months. He reports that when he exercises or is in an environment with dust or smoke, his breaths are high-pitched and he has difficulty catching his breath. Although he has never been evaluated for his symptoms, he reports being unable to participate in certain sports and activities. His symptoms do not wake him up at night. He also reports intermittent cough, which is usually dry but occasionally productive of clear-white mucus. He denies fever, lightheadedness, chest pain, palpitations, or abdominal pain. The patient's past medical history is remarkable only for seasonal respiratory illnesses, and he has no known allergies. He does not smoke or use recreational drugs, although he has an older brother who smokes at home. Vital signs include BP 128/87 mm Hg, HR 82 bpm, T 98.3°F, RR 18/minute, and O2 saturation 95%. Which of the following findings on ch - Answer-B A 2-year-old girl presents to the office with a barky cough, hoarse voice, and stridor when crying that resolves at rest. She is diagnosed with mild croup. What would be most appropriate next step? AAdministration of supplemental oxygen BReferral to the emergency department CTreatment with a single dose of oral dexamethasoneCorrect Answer DTreatment with nebulized epinephrine - Answer-C A 21-year-old woman presents with two weeks of a "wet" cough following an upper respiratory infection. She is worried because she is coughing up green phlegm. She has no significant pulmonary disease history and is only mildly short of breath during "cough fits." On exam, she is afebrile with normal vital signs. She does have rhonchi in bilateral lung fields that clears with coughing. Which of the following is this patient's most likely diagnosis? AAcute bronchitisCorrect Answer BBacterial pneumonia CCroup DInfluenza - Answer-AA 21-year-old woman with a history of asthma has cough and wheezing on a daily basis. She is awakened by the cough at least two nights per week. Which one of the following would be the most appropriate treatment for this patient? ALeukotriene receptor antagonist daily BMedium-dose inhaled corticosteroid dailyCorrect Answer COmalizumab injection monthly DShort-acting β agonist as needed - Answer-B A 22-year-old man presents to the clinic with cough. He reports it has been going on for over 8 weeks. He initially had a fever and sore throat, but that resolved many weeks ago. The lingering cough has been bothering him, and he notices it worsens at night and after he exercises. He denies tickling in his throat, a sore throat, changes to his voice, or any metallic taste in his mouth. His vital signs are within normal limits, including oxygen saturation of 98%. There are no abnormalities on physical exam. Which of the following is the most likely diagnosis? AAsthmaCorrect Answer BGastroesophageal reflux disease CPostinfectious coughYour Answer DUpper airway cough syndrome - Answer-A A 23-year-old man with no significant history presents to the clinic reporting shortness of breath and wheezing. He explains that his symptoms worsen during the week and improve or even resolve over the weekend. He also states that he regularly plays basketball at night with friends and does not experience similar symptoms. Which of the following would be the most important to assess for? AFamily history BOccupationCorrect Answer CPhysical activity DSmoking history - Answer-B A 23-year-old man with no significant past medical history presents to the clinic with an acute cough for 10 days. He states that he initially had rhinorrhea and a sore throat, but these symptoms have improved. Vital signs are normal and lungs are clear to auscultation. Which of the following is the best treatment? AAmoxicillin BAzithromycinCPrednisone DSupportive care - Answer-D A 26-year-old G2P0010 woman at 11 weeks gestation presents to establish care. She has a history of asthma and reports using her rescue inhaler at least five times per week during the day and one to two times per week at night. Addition of which one of the following would be recommended? AHigh-dose inhaled corticosteroid and theophylline BLeukotriene receptor antagonist CMedium-dose inhaled corticosteroid and salmeterolCorrect Answer DOral corticosteroid - Answer-C A 3-week-old female infant presents to the clinic with a history of fever, runny nose, nasal congestion, and cough for the past two days. Her fever has been 101°F at home rectally. On exam, the infant has a heart rate of 168 bpm, respiratory rate of 72 with mild expiratory wheezing, and pulse oximetry of 94% on room air. She is currently afebrile in the clinic. She has no cyanosis. She does exhibit mild nasal flaring but has no retractions or grunting. What is the most likely diagnosis for this infant? ABacterial pneumonia BInfluenza CPneumonitis DRespiratory syncytial virus - Answer-D A 30-year-old man presents to the clinic coughing up blood due to a lung abscess. Which of the following explains the pathogenesis of this patient's hemoptysis? AElevations in pulmonary capillary pressure BInflammation of the tracheobronchial mucosa CInjury to the bronchial mucosa DInjury to the pulmonary vasculature - Answer-D A 30-year-old man with a history of a cough, dyspnea with exertion, wheezing, malaise, fatigue, and fevers presents to the clinic to review his most recent chest X-ray. The chest X-ray reveals bilateral hilar lymphadenopathy. The clinician wants to start treatment. Which of the following is the most effective management?AAmoxicillin-clavulanic acidYour Answer BFluticasone CLevofloxacin DPrednisone - Answer-D A 34-year-old man presents to the clinic with insomnia for 6 months. He states that it takes him several hours to fall asleep, and he wakes up every 2-3 hours. He reports eating before going to bed. He has no significant past medical history. Which of the following is the most appropriate initial step in management? AAvoid large meals before sleepCorrect Answer BBegin cognitive behavioral therapyYour Answer CStart zolpidem 5 mg daily DTake an afternoon nap daily - Answer-A A 35-year-old man presents to the clinic with a persistent cough for the past 8 days. He reports a sore throat and mild sputum production but no fever, runny nose, or difficulty breathing. Auscultation reveals rhonchi that are cleared with coughing. He is otherwise healthy with no chronic health issues, and all vital signs are stable. These observations suggest that the diagnosis is a result of which of the following causes? ABordetella pertussis BEnvironmental allergens CRhinovirusCorrect Answer DStreptococcus pneumoniae - Answer-C A 36-year-old woman presents to the clinic reporting a gradual worsening of dyspnea, dry cough, fatigue, and numerous maculopapular lesions on the face. Additionally, she notes enlarged, nontender lymph nodes in her neck. She does not smoke. Laboratory evaluation reveals an elevated serum angiotensinconverting enzyme level and erythrocyte sedimentation rate level. Which of the following is most likely to be seen on chest radiograph? AApical infiltration BBilateral hilar adenopathyCorrect Answer CDiffuse nodular densities DLobar consolidation - Answer-BA 38-year-old man has had a runny nose, sneezing, low-grade fever, and an occasional cough for one week. During the second week of his symptoms, his cough began to occur in paroxysmal episodes, especially at night. The cough was also associated with an inspiratory whoop. Which medication is indicated for this patient? AAmoxicillin BAzithromycinCorrect Answer CBenzathine penicillin G DMetronidazole - Answer-B A 4-year-old boy presents to the office with a chronic wet cough for the past 5 weeks. On exam, the patient is afebrile with normal breath sounds bilaterally. He has a history of asthma and has been using his usual bronchodilators with no improvement in the cough. There is no known history of gagging or choking episodes. Further workup reveals a normal chest radiograph and spirometry. Which of the following is the most likely cause of this patient's chronic cough? AAsthma exacerbation BBronchiectasisYour Answer CForeign body aspiration DProtracted bacterial bronchitis - Answer-D