PULMONARY ROSH REVIEW EXAM|
LATEST 2024 QUESTIONS WITH VERIFIED
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What is the most common symptom seen in acute bronchitis?
Chest pain
Cough
Fever
Sputum - Ans > Correct Answer ( B )
Explanation:
Bronchitis is defined as inflammation of the lower airways and is
typically caused by viral pathogens. The most common presenting
complaint is cough in these patients. In healthy adult patients, acute
bronchitis is typically caused by a viral pathogen. As such, it is not
amenable to antibiotic therapy. In patients with chronic bronchitis or
chronic obstructive pulmonary disease (COPD), exacerbations of
symptoms may be the result of bacterial pathogens causing acute
bronchitis on top of their chronic bronchitis. Treatment with antibiotics
should be considered in this subset of patients with bronchitis.
,Chest pain (A) often occurs as a result of coughing in patients with
bronchitis. Fever (C) may or may not be present and does not indicate a
higher likelihood of bacterial infection. Sputum (D) is present in about
half of patients with acute bronchitis.
A 22-year-old man presents with an asthma exacerbation. Which of the
following is true regarding treatment modalities?
Anticholinergic agents promote bronchodilation by decreasing cyclic
adenosine monophosphate
Beta-2-agonists promote bronchodilation by increasing cyclic adenosine
monophosphate
The onset of action for beta-2-agonists is 10 minutes
The peak effect of corticosteroids occurs within 3-5 hours - Ans > Correct
Answer ( B )
Explanation:
Asthma is responsible for nearly two million Emergency Department
visits per year. The mainstay of treatment consists of inhaled beta-2-
agonists, inhaled anticholinergics, and corticosteroids. The combination
of these drugs results in decreased rates of hospitalization and
improvements in pulmonary function in the first 90 minutes. Beta-2-
,agonists promote bronchodilation by increasing cyclic adenosine
monophosphate (cAMP). Their primary effect is on small peripheral
airways with onset of action in less than five minutes. Studies have
shown that administration of beta-2-agonists via metered-dose inhaler
with a spacer provides similar bronchodilation when compared with
nebulization. While use of the MDI may be more economical and take
less time, it does require more supervision to ensure adequate use.
Anticholinergic agents promote bronchodilation by decreasing cyclic
guanosine monophosphate (cGMP), not cyclic adenosine
monophosphate (A). Their primary effect is on the larger airways. Onset
of action is also longer than with beta-2-agonists, taking up to one to
two hours for peak effect. Corticosteroids work by inhibiting
recruitment of inflammatory cells. They are indicated in all cases of
moderate to severe asthma and in those who demonstrated limited
response to beta-2-agonists. Onset of action is one to two hours with
peak effect in about 24 hours, not three to five hours (C). Many studies
have shown that oral and intravenous steroids provide equal benefit.
Onset of action for beta-2-agonists is less than five minutes, not 10
minutes (D).
Which of the following is the most common sign seen in patients
presenting with a pulmonary embolism?
Hemoptysis
Hypoxia
, Swollen calf
Tachypnea - Ans > Correct Answer ( D )
Explanation:
Tachypnea is the most common vital sign abnormality seen in acute
pulmonary embolism (PE). PE is a common, life-threatening disease
caused by the occlusion of pulmonary arteries by blood clots. The
majority of these clots originate in the deep venous system (more
commonly in the legs than in the upper body). Patients can present
with various symptoms including weakness, shortness of breath,
malaise, syncope, dizziness or chest pain. In addition, PE can cause
changes to all of the major vital signs. Sinus tachycardia is the most
common abnormality found on ECG.
A 58-year-old man presents with shortness of breath for 2 days. He
complains of a six-month history of a dry cough, unintentional weight
loss, and night sweats. He has no past medical history, but he has a 40
pack-year smoking history. In the ED, his vital signs are BP 132/76, HR
72, RR 16, oxygen saturation 96% on room air, and temperature 98.8°F.
An ECG reveals no acute abnormality, and a chest X-ray shows a right
middle lobe irregular mass and a right-sided pleural effusion. A
thoracentesis is performed. What findings would be expected on
pleural fluid analysis?
Fluid:Blood LDH ratio < 0.6
Fluid:Blood Protein ratio < 0.5
LATEST 2024 QUESTIONS WITH VERIFIED
ANSWERS |LATEST VERSION| PASS 100%
GUARANTEED!
What is the most common symptom seen in acute bronchitis?
Chest pain
Cough
Fever
Sputum - Ans > Correct Answer ( B )
Explanation:
Bronchitis is defined as inflammation of the lower airways and is
typically caused by viral pathogens. The most common presenting
complaint is cough in these patients. In healthy adult patients, acute
bronchitis is typically caused by a viral pathogen. As such, it is not
amenable to antibiotic therapy. In patients with chronic bronchitis or
chronic obstructive pulmonary disease (COPD), exacerbations of
symptoms may be the result of bacterial pathogens causing acute
bronchitis on top of their chronic bronchitis. Treatment with antibiotics
should be considered in this subset of patients with bronchitis.
,Chest pain (A) often occurs as a result of coughing in patients with
bronchitis. Fever (C) may or may not be present and does not indicate a
higher likelihood of bacterial infection. Sputum (D) is present in about
half of patients with acute bronchitis.
A 22-year-old man presents with an asthma exacerbation. Which of the
following is true regarding treatment modalities?
Anticholinergic agents promote bronchodilation by decreasing cyclic
adenosine monophosphate
Beta-2-agonists promote bronchodilation by increasing cyclic adenosine
monophosphate
The onset of action for beta-2-agonists is 10 minutes
The peak effect of corticosteroids occurs within 3-5 hours - Ans > Correct
Answer ( B )
Explanation:
Asthma is responsible for nearly two million Emergency Department
visits per year. The mainstay of treatment consists of inhaled beta-2-
agonists, inhaled anticholinergics, and corticosteroids. The combination
of these drugs results in decreased rates of hospitalization and
improvements in pulmonary function in the first 90 minutes. Beta-2-
,agonists promote bronchodilation by increasing cyclic adenosine
monophosphate (cAMP). Their primary effect is on small peripheral
airways with onset of action in less than five minutes. Studies have
shown that administration of beta-2-agonists via metered-dose inhaler
with a spacer provides similar bronchodilation when compared with
nebulization. While use of the MDI may be more economical and take
less time, it does require more supervision to ensure adequate use.
Anticholinergic agents promote bronchodilation by decreasing cyclic
guanosine monophosphate (cGMP), not cyclic adenosine
monophosphate (A). Their primary effect is on the larger airways. Onset
of action is also longer than with beta-2-agonists, taking up to one to
two hours for peak effect. Corticosteroids work by inhibiting
recruitment of inflammatory cells. They are indicated in all cases of
moderate to severe asthma and in those who demonstrated limited
response to beta-2-agonists. Onset of action is one to two hours with
peak effect in about 24 hours, not three to five hours (C). Many studies
have shown that oral and intravenous steroids provide equal benefit.
Onset of action for beta-2-agonists is less than five minutes, not 10
minutes (D).
Which of the following is the most common sign seen in patients
presenting with a pulmonary embolism?
Hemoptysis
Hypoxia
, Swollen calf
Tachypnea - Ans > Correct Answer ( D )
Explanation:
Tachypnea is the most common vital sign abnormality seen in acute
pulmonary embolism (PE). PE is a common, life-threatening disease
caused by the occlusion of pulmonary arteries by blood clots. The
majority of these clots originate in the deep venous system (more
commonly in the legs than in the upper body). Patients can present
with various symptoms including weakness, shortness of breath,
malaise, syncope, dizziness or chest pain. In addition, PE can cause
changes to all of the major vital signs. Sinus tachycardia is the most
common abnormality found on ECG.
A 58-year-old man presents with shortness of breath for 2 days. He
complains of a six-month history of a dry cough, unintentional weight
loss, and night sweats. He has no past medical history, but he has a 40
pack-year smoking history. In the ED, his vital signs are BP 132/76, HR
72, RR 16, oxygen saturation 96% on room air, and temperature 98.8°F.
An ECG reveals no acute abnormality, and a chest X-ray shows a right
middle lobe irregular mass and a right-sided pleural effusion. A
thoracentesis is performed. What findings would be expected on
pleural fluid analysis?
Fluid:Blood LDH ratio < 0.6
Fluid:Blood Protein ratio < 0.5
