PULMONARY ROSH REVIEW EXAM LATEST 2024-2025 WITH 189
ACTUAL QUESTIONS AND CORRECT VERIFIED ANSWERS WITH
DETAILED EXPLANATIONALREADY GRADED A+ 100%
GUARANTEED PASS! !
A 30-year old woman presents with shortness of breath. She has
a history of asthma since childhood. She says that she uses her
rescue inhaler 3 days each week. On average, she wakes up in
the middle of the night with symptoms approximately three times
a month. Her vital signs are BP 120/76, HR 112, RR 26, and
oxygen saturation 92% on room air. The patient appears to be in
mild distress with intercostal retractions present, and respiratory
exam is remarkable for diffuse wheezing. This patient is
diagnosed with an acute asthma exacerbation. Which of the
following best classifies this patient's asthma?
Intermittent
Mild persistent
Moderate persistent
Severe persistent - ANSWER -Correct Answer ( B )
Explanation:
This patient's asthma is classified as mild persistent. Symptoms
of asthma most frequently include shortness of breath and
wheezing, but patients may also complain of cough and chest
tightness. Mild persistent asthma is classified as symptoms more
,than twice per week but not daily, nocturnal symptoms three or
four times each month, exacerbations causing minor limitations
in activity and sleep, and the use of an inhaled short-acting beta-
2-agonist more than twice a week but not daily. These patients
are generally treated with a low-dose inhaled corticosteroid with a
short acting beta-agonist as needed.
17-year-old girl with a history of well-managed cystic fibrosis is
being evaluated for a steadily worsening chronic cough with
shortness of breath and wheezing. She is producing copious
purulent malodorous sputum and occasional hemoptysis.
Crackles are heard at her bilateral lung bases. Which of the
following findings would be most expected on this patient's chest
radiograph?
Dilated, thickened bronchi with "tram-track" marks
Low lung volumes and ground glass opacities
Lung hyperinflation with flattening of the
diaphragm Normal chest radiograph -
ANSWER -Correct Answer ( A ) Explanation:
Dilated, thickened bronchi are classic radiograph findings in
patients with bronchiectasis, the most likely disease in this
patient. The bronchi are often described as having "tram-track" or
ring-like markings. Scattered, irregular opacities, atelectasis, or
focal consolidations may also be noted. A suspicion of
,bronchiectasis based on radiographic findings and patient
symptoms warrants a high-resolution CT scan which is a more
precise diagnostic study. Bronchiectasis is suspected in patients
who have a chronic cough, dyspnea, wheezing, and heavy
production of purulent, foul-smelling sputum. Pleuritic chest pain,
weight loss, and anemia are commonly associated. An exam
usually reveals crackles at the lung bases and nail clubbing in
severe disease. In the United States, the greatest percentage of
patients with bronchiectasis develop it secondary to cystic
fibrosis. Lung infections, tumor presence, and immunodeficiency
states are other less common causes. Antibiotics are usually
needed with the choice being guided by sputum cultures.
Haemophilus influenza, Streptococcus pneumonia, and
Staphylococcus aureus are often isolated. In addition to proper
antibiotic coverage, bronchiectasis should be treated with daily
chest physiotherapy and inhaled bronchodilators.
A 29-year-old woman presents to the ED complaining of pain on
inspiration. Over the previous 3 days, she has experienced a low-
grade fever, sore throat, and body aches. Auscultation of her
lungs reveals normal breath sounds. Her upright chest
radiograph is seen above. Which of the following is the most
appropriate next step in management?
D-dimer
, Doxycycline
Inspiratory and expiratory radiographic
views Supportive care - ANSWER -Correct
Answer ( D ) Explanation:
This patient has pleuritic chest pain in the setting of a recent
upper respiratory infection (URI). Viral pleuritis and pulmonary
infarction are commonly associated with pleuritic chest pain. The
patient's history often helps to establish the diagnosis of pleural
inflammation. The pain of viral pleuritis usually is preceded by
several days of a typical viral prodrome, with low-grade fever,
sore throat, and other upper respiratory or constitutional
symptoms. Management of viral pleuritis includes supportive
care with NSAIDs. In the absence of these prodromal symptoms,
an alternative etiology for pleuritis should be sought. A patient
history of congestive heart failure, liver disease, uremia, or
malignancy should direct further evaluation.
A 16-month-old boy and his adoptive parents present to your
office with a complaint of cough and concern about the patient's
weight. The parents indicate that they don't have much
information about the patient's birth parents and since adopting
him four months ago they have noticed daily shortness of breath,
cough and wheezing. He is also a fussy eater and is in the second
percentile of weight on the growth chart. Which lab finding is
most consistent with the diagnosis?
ACTUAL QUESTIONS AND CORRECT VERIFIED ANSWERS WITH
DETAILED EXPLANATIONALREADY GRADED A+ 100%
GUARANTEED PASS! !
A 30-year old woman presents with shortness of breath. She has
a history of asthma since childhood. She says that she uses her
rescue inhaler 3 days each week. On average, she wakes up in
the middle of the night with symptoms approximately three times
a month. Her vital signs are BP 120/76, HR 112, RR 26, and
oxygen saturation 92% on room air. The patient appears to be in
mild distress with intercostal retractions present, and respiratory
exam is remarkable for diffuse wheezing. This patient is
diagnosed with an acute asthma exacerbation. Which of the
following best classifies this patient's asthma?
Intermittent
Mild persistent
Moderate persistent
Severe persistent - ANSWER -Correct Answer ( B )
Explanation:
This patient's asthma is classified as mild persistent. Symptoms
of asthma most frequently include shortness of breath and
wheezing, but patients may also complain of cough and chest
tightness. Mild persistent asthma is classified as symptoms more
,than twice per week but not daily, nocturnal symptoms three or
four times each month, exacerbations causing minor limitations
in activity and sleep, and the use of an inhaled short-acting beta-
2-agonist more than twice a week but not daily. These patients
are generally treated with a low-dose inhaled corticosteroid with a
short acting beta-agonist as needed.
17-year-old girl with a history of well-managed cystic fibrosis is
being evaluated for a steadily worsening chronic cough with
shortness of breath and wheezing. She is producing copious
purulent malodorous sputum and occasional hemoptysis.
Crackles are heard at her bilateral lung bases. Which of the
following findings would be most expected on this patient's chest
radiograph?
Dilated, thickened bronchi with "tram-track" marks
Low lung volumes and ground glass opacities
Lung hyperinflation with flattening of the
diaphragm Normal chest radiograph -
ANSWER -Correct Answer ( A ) Explanation:
Dilated, thickened bronchi are classic radiograph findings in
patients with bronchiectasis, the most likely disease in this
patient. The bronchi are often described as having "tram-track" or
ring-like markings. Scattered, irregular opacities, atelectasis, or
focal consolidations may also be noted. A suspicion of
,bronchiectasis based on radiographic findings and patient
symptoms warrants a high-resolution CT scan which is a more
precise diagnostic study. Bronchiectasis is suspected in patients
who have a chronic cough, dyspnea, wheezing, and heavy
production of purulent, foul-smelling sputum. Pleuritic chest pain,
weight loss, and anemia are commonly associated. An exam
usually reveals crackles at the lung bases and nail clubbing in
severe disease. In the United States, the greatest percentage of
patients with bronchiectasis develop it secondary to cystic
fibrosis. Lung infections, tumor presence, and immunodeficiency
states are other less common causes. Antibiotics are usually
needed with the choice being guided by sputum cultures.
Haemophilus influenza, Streptococcus pneumonia, and
Staphylococcus aureus are often isolated. In addition to proper
antibiotic coverage, bronchiectasis should be treated with daily
chest physiotherapy and inhaled bronchodilators.
A 29-year-old woman presents to the ED complaining of pain on
inspiration. Over the previous 3 days, she has experienced a low-
grade fever, sore throat, and body aches. Auscultation of her
lungs reveals normal breath sounds. Her upright chest
radiograph is seen above. Which of the following is the most
appropriate next step in management?
D-dimer
, Doxycycline
Inspiratory and expiratory radiographic
views Supportive care - ANSWER -Correct
Answer ( D ) Explanation:
This patient has pleuritic chest pain in the setting of a recent
upper respiratory infection (URI). Viral pleuritis and pulmonary
infarction are commonly associated with pleuritic chest pain. The
patient's history often helps to establish the diagnosis of pleural
inflammation. The pain of viral pleuritis usually is preceded by
several days of a typical viral prodrome, with low-grade fever,
sore throat, and other upper respiratory or constitutional
symptoms. Management of viral pleuritis includes supportive
care with NSAIDs. In the absence of these prodromal symptoms,
an alternative etiology for pleuritis should be sought. A patient
history of congestive heart failure, liver disease, uremia, or
malignancy should direct further evaluation.
A 16-month-old boy and his adoptive parents present to your
office with a complaint of cough and concern about the patient's
weight. The parents indicate that they don't have much
information about the patient's birth parents and since adopting
him four months ago they have noticed daily shortness of breath,
cough and wheezing. He is also a fussy eater and is in the second
percentile of weight on the growth chart. Which lab finding is
most consistent with the diagnosis?
