Rosh Pulmonolgy UPDATED ACTUAL Questions and CORRECT Answers
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 for a latent tuberculosis
fampin 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 and a cough for 3 days.
symptoms 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 consolidation. 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 after application of
volumes noninvasive positive pressure ventilation in a patient presenting with an acute
, exacerbation of chronic obstructive pulmonary disease?
A. Increased alveolar dead space
B. Increased LV afterload
C. Increased tidal volumes
D. Increased venous return
5. Administer pneu- A 45-year-old patient with newly diagnosed diabetes mellitus type 2 presents to
mococcus and your oflce for her annual exam. She has had her hepatitis B vaccination, but wants
annual influenza to know if she needs any additional vaccinations because of her new diagnosis.
vaccines 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 vaccines
C. Administer pneumonia prophylaxis with trimethoprim-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 six-day history of a mu-
phan copurulent 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. Labo-
ratory studies show a slightly elevated white blood count. Which of the following
medications is most appropriate to administer for this patient's cough?
, A. Aspirin
B. Dextromethorphan
C. Penicillin
D. Prednisone
8. Cough What is the most common complaint seen in acute bronchitis?
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, myal-
gias, headache, and malaise. There have been multiple cases of influenza in the
community and her influenza swab is positive. Which one of the following is rec-
ommended 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 fever, cough, and wheez-
swab for ing for the last two days. Physical exam reveals prolonged expiration and mild
fluorescent subcostal retractions. Lung auscultation reveals diffuse expiratory wheezing and
antibody staining 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 history and no hospital-
with oral antibi- izations, presents with cough, green sputum, and fever. Her vitals are T 100.7°F,
HR 94 bpm, BP 123/76 mm Hg, RR 18/min, and oxygen saturation 97%. She is
, otics and fol- well appearing, and her blood work (CBC and BMP) is unremarkable. A chest
low-up 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 antibiotics
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).
Auscultation of the lungs shows rhonchi and wheezing. Chest X-ray shows thicken-
ing 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 influenza B. Which of the following is the most appropriate therapy?
A. Acyclovir
B. Amantadine
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 for a latent tuberculosis
fampin 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 and a cough for 3 days.
symptoms 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 consolidation. 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 after application of
volumes noninvasive positive pressure ventilation in a patient presenting with an acute
, exacerbation of chronic obstructive pulmonary disease?
A. Increased alveolar dead space
B. Increased LV afterload
C. Increased tidal volumes
D. Increased venous return
5. Administer pneu- A 45-year-old patient with newly diagnosed diabetes mellitus type 2 presents to
mococcus and your oflce for her annual exam. She has had her hepatitis B vaccination, but wants
annual influenza to know if she needs any additional vaccinations because of her new diagnosis.
vaccines 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 vaccines
C. Administer pneumonia prophylaxis with trimethoprim-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 six-day history of a mu-
phan copurulent 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. Labo-
ratory studies show a slightly elevated white blood count. Which of the following
medications is most appropriate to administer for this patient's cough?
, A. Aspirin
B. Dextromethorphan
C. Penicillin
D. Prednisone
8. Cough What is the most common complaint seen in acute bronchitis?
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, myal-
gias, headache, and malaise. There have been multiple cases of influenza in the
community and her influenza swab is positive. Which one of the following is rec-
ommended 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 fever, cough, and wheez-
swab for ing for the last two days. Physical exam reveals prolonged expiration and mild
fluorescent subcostal retractions. Lung auscultation reveals diffuse expiratory wheezing and
antibody staining 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 history and no hospital-
with oral antibi- izations, presents with cough, green sputum, and fever. Her vitals are T 100.7°F,
HR 94 bpm, BP 123/76 mm Hg, RR 18/min, and oxygen saturation 97%. She is
, otics and fol- well appearing, and her blood work (CBC and BMP) is unremarkable. A chest
low-up 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 antibiotics
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).
Auscultation of the lungs shows rhonchi and wheezing. Chest X-ray shows thicken-
ing 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 influenza B. Which of the following is the most appropriate therapy?
A. Acyclovir
B. Amantadine
