Renal, Respiratory, Hematological and
Immune EXAM COMBO STUDY GUIDE
FREQUENTLY TESTED.
Keaton, age 6, comes to the clinic with his mother for a 3-month follow-up visit
for his asthma. His mother reports he has symptoms 2 days a week but not
more than once each day, he has had only 1 episode of nighttime awakening
because of his asthma, he is able to play soccer without provoking an attack,
and his peak flow personal best is 80% or higher. His current treatment includes
a short-acting beta agonist and a leukotriene receptor antagonist. Based on the
level of control, your plan for adjusting therapy includes:
1.
Considering a short course of oral systemic corticosteroids.
2.
Stepping up 1 step.
3.
Stepping up 2 steps.
4.
Maintaining the current step.
Maintaining the current step.
James, age 12, just moved from Texas. He presents with a headache, cough,
fever, rash on the legs and arms, myalgias, and dysuria. His white blood cell
count is 12.9 with 8% bands and 7% to 10% eosinophils. Electrolyte levels are
normal. Blood cultures are negative. Sputum is not available. A Mantoux skin
test so far is negative. What do you suspect?
1.
Pulmonary tuberculosis.
2.
Lymphoma.
3.
,Asthma.
4.
Coccidioidomycosis.
Coccidioidomycosis.
Michael, age 52, has had a gradual onset of dry cough, dyspnea, chills, fever,
general malaise, headache, confusion, anorexia, diarrhea, myalgias, and
arthralgias. Which diagnosis do you suspect?
1.
Bronchopneumonia.
2.
Legionnaires' disease.
3.
Primary atypical pneumonia.
4.
Pneumocystis jiroveci pneumonia.
Legionnaires' disease.
Mr. Tanner, age 67, presents to the clinic with fever, chills, a productive cough
with sputum that has changed color from clear to yellow, chest discomfort,
fatigue, and myalgias. His wife is concerned because he is confused at times.
His blood pressure is 100/54, his pulse rate is 92, and his respirations are 22
per minute. When percussing the chest, you detect dullness over the right lower
lobe and suspect that Mr. Tanner has pneumonia. Your plan for Mr. Tanner
includes:
1.
Outpatient treatment.
2.
Inpatient treatment.
3.
Macrolide antibiotic therapy.
4.
A respiratory fluoroquinolone.
Inpatient treatment.
You are examining the respiratory system of a 65-year-old female client in
whom you suspect "impaired gas exchange." This finding may be
,demonstrated by:
1.
Clubbing of the fingers.
2.
Nasal flaring.
3.
The use of accessory muscles.
4.
A cough.
Clubbing of the fingers.
A 55-year-old male presents to your primary care clinic complaining of a cough
for 3 months. He is a diabetic and is currently taking lisinopril, atorvastatin, and
metformin. He denies dyspnea, chest pain, and productive cough. He was
recently diagnosed with diabetes and has started all 3 of these medications
within the last 4 months. The patient's vital signs are within normal limits, and
his chest x-ray is negative. What is the etiology of the patient's cough?
1.
Upper respiratory infection (URI).
2.
Walking pneumonia.
3.
Lisinopril.
4.
Sinus infection.
Lisinopril.
Which of the following statements regarding sleep apnea is not true?
1.
Thirty percent of the male population in the United States has sleep apnea.
2.
Unmanaged sleep apnea is associated with worse control of atrial fibrillation.
3.
Central sleep apnea is the most common type of sleep apnea.
4.
Unmanaged sleep apnea increases a patient's coronary risk.
, Central sleep apnea is the most common type of sleep apnea.
An infant who has periodic breathing with persistent or prolonged apnea
(greater than 20 seconds) may have an increased risk of:
1.
Pneumonia.
2.
Left-sided congestive heart failure.
3.
Sudden infant death syndrome (SIDS).
4.
Anemia.
Sudden infant death syndrome (SIDS).
Dennis, age 54, has chronic obstructive pulmonary disease (COPD). He has
recently been experiencing difficulty in breathing. His arterial blood gas
screening reveals pH 7.3, Pao2 57 mm Hg, Paco2 54 mm Hg, and oxygen
saturation 84%. Dennis has:
1.
Respiratory acidosis.
2.
Respiratory alkalosis.
3.
Metabolic acidosis.
4.
Metabolic alkalosis.
Respiratory acidosis.
Sherri, age 49, has had asthma for several years but has never used a peak
expiratory flow (PEF) meter. Should you now recommend it?
1.
No, she has been managing fine without it.
2.
Yes, she might recognize early signs of a potential respiratory problem.
3.
Present the options and let Sherri decide.