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Aseptic meningitis
Spread of the pneumonia to other lobes
Empyema
Enterocolitis
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Nephritis
If several days later a diagnosis of pneumococcal pneumonia is established, a danger to be
especially watched for thereafter is
Empyema
The emergence of drug-resistant strain of pneumococci
Destruction of a substantial portion f the right lower lobe
Congestive cardiac failure
Pneumothorax
A 55 year-old man who has smoked 30 cigarettes daily since he was 25 is seen because of
hemoptysis. He reports no symptoms except for a cough that produces 5-10 ml of sputum
each morning. Results found on physical examination and x-ray are normal. The most likely
cause of hemoptysis is
Bronchogenic carcinoma
Pulmonary tuberculosis
Bronchiectasis
Chronic bronchitis
Empyema
A 40 year-old woman in good general health has sudden chest pain, fever and shortness of
breath. She is a heavy smoker and takes no medicines. Tachypnea and a temperature of 38C
are found on physical examination. Chest auscultation, percussion and x-ray findings are
normal. The most likely diagnosis is
Tracheobronchitis
Atypical pneumonia
Pulmonary embolus
Bacterial pneumonia
Lung cancer
The most likely microorganism involved in lobar pneumonia is
Streptococcus pneumoniae (Pneumococcus)
Candida albicans
Hemophilus influenza
Staphylococcus aureus
Cytomegalovirus
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Asthma
Cystic fibrosis
Pneumonia
Laryngitis
Epiglottitis
The management of patient with asthma includes the following, except:
Admit to the hospital
Breathing treatments with selective beta-2 agonists
Oxygen
Steroids intravenous
Cyclophosphamide
Which f the following is more likely to be a complication in the course of asthma
Pneumothorax
Pneumomediastinum
Hyperglycemia
Restrictive lung disease
Pleuritis
Which of the following treatments would be mostly beneficial in the treatment of a 20 yearold woman with an acute exacerbation of asthma?
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Magnesium sulfate
Mucolytic agents
Theophylline
What findings on physical examination are suggestive of a pleural effusion?
Dullness to percussion
Diminished breath sounds
Reduced vocal fremitus
None of above
All of above
An exudative pleural effusion meets which one of the following criteria:
Pleural fluid protein/serum protein ratio>0.5
Pleural fluid LDH/serum LDH>0.6
Pleural fluid LDH>two-thirds the upper limit of normal for serum
One or more of above
None of above
When an empyema should be suspected:
The pleural fluid has a high WBC count
The plcural fluid has high protein (>3g/dl)
The pleural fluid has low glucose (<40mg/dl)
The pleural fluid has high LDH (>600 mg/dl), and low PH (<7.2)
All of above
What is the most common cause of community-acquired pneumonia?
S. pneumoniae (Pneumococcus)
Mycoplasma
Legionella
Haemophilus influenza
Viruses
Which community-acquired pneumonias are seen more commonly in the alcoholic patient?
Klebsiella pneumonia
Pneumococcal pneumonia
Mycoplasma pneumoniae
Viral pneumonia
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Legionella pneumonia
What are the common risk factors for the development of anaerobic pneumonia?
Loss of consciousness (seizures or alcohol-related )
Poor oral hygiene
Endobronchial obstruction
Any risk factor for aspiration
All of above
Which one of the risk factors predispose for the development of hospital-acquired
(nosocomial) pneumonia?
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What are the predisposing factors for the development of pulmonary emboli?
Surgury of the pelvis and lower extremities
Previous history of deep venous thrombosis
Pregnancy and postpartum period
Immobility
All of above
What is the most common cause of chronic obstructive pulmonary disease?
Cigarette smoking
Air pollution
Allergic factors
Hereditary factors
Occupational factors
Severe emphysema indicated by:
Over distention of lungs in stable state, low diaphragmatic position
Decreased intensity of breath and heart sounds
Pursed-lip breathing
Use of accessory respiratory muscles
All of above
Airflow obstruction evidenced by:
Dyspnea
Wheezing during auscultation on slow or forced breathing
Prolonged forced expiratory phase
All of above
None of above
What complications are associated with COPD?
Chronic cor pulmonale
Spontaneous pneumothorax
Acute and chronic respiratory failure
None of above
All of above
Cor pulmonale can be caused by:
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Anticholinergic agents
Beta-adrenergic agonists
Methylxanthins
All of above
None of above
Which is therapeutic range of theophylline?
10-20 mcg/ml
20-30 mcg/ml
5-15 mcg/ml
30-35 mcg/ml
None of above
What are the toxic effects of theophylline therapy?
Cardiac: various arrhythmias
GI: nausea, vomiting, diarrhea and abdominal pain
Neurologic: headache, nervousness, insomnia, tremor, seizures
None of above
All of above
What are common causes of a restrictive ventilatory defect?
Interstitial lung disease (fibrosis, pneumoconiosis)
Chest wall disease (kyphoscoliosis)
Pleural disease (effusion, pneumothorax)
Extrathoracic conditions (obesity, ascites, pregnancy)
All of above
Which one of these diseases may cause restrictive ventilatory defect?
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Pulmonary fibrosis
Kyphoscoliosis
Obesity
None of above
All of above
Which one of the following may cause an exudative effusion?
Neoplasma
Infection
Collagen vascular diseases
None of above
All of above
Which one of the following may cause transudative effusion?
Congestive heart failure
Nephrotic syndrome
Cirrhosis
All of above
None of above
A pleural effusion represents an increase in fluid in the pleural space, which may be due:
Increased hydrostatic pressure
Decreased oncotic pressure
Obstruction of lymphatic drainage
Increased permeability
All of above
What are common causes of an obstructive respiratory defect?
Emphysema
Bronchitis
Asthma
Bronchiolitis
All of above
What are the pulmonary function tests (PFT) findings suggestive of a restrictive ventilatory
defect?
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Polycythemia
Thrombocytosis
Leukocytosis
Leukopenia
What ECG findings are suggestive of cor pulmonale?
Peaked P waves
Right axis deviation
Deep S waves in lead V6
All of above
None of above
Which of the following are characteristic for cor pulmonale:
Cyanosis
Distended neck veins
Enlarged and tender liver
Dependent edema
All of above
What are the signs of cor pulmonale?
Distended neck veins
Clubbing
RV heave or gallop
Epigastric pulsations
All of above
What are echocardiogram signs of cor pulmonale?
RV dilation
RA dilation
Normal LV size
None of above
All of above
Which one of the following statements are true regarding asthma:
Asthma is a chronic inflammatory disorder of the airways
The airway inflammation underlies asthma chronicity and contributes to airway
hyperresponsiveness
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None of above
Clinical symptoms of a patient with COPD most often are, except
Cough (chronic, productive)
Wheezing
Dyspnea
Normal vital capacity and expiratory flow rates
Prolonged forced expiratory phase
Which are the complications associated with COPD?
Sleep disturbances due to nocturnal desaturation
Acute and chronic respiratory failure
Chronic cor pulmonale
Spontaneus pneumothorax
All of above
Which of the following statements is true regarding advanced COPD disease type A: Pink
Puffer (Emphysema Predominant)
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Chronic productive cough, dyspnea usually mild, chest is noisy with rhonchi
Patients frequently overweight and cyanotic
Peripheral edema is common
Hemoglobin usually elevated
All of above
LITERATURE:
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CURRENT Medical Diagnosis & Treatment. 2008. Edited by Stephen J. McPhee. MD."
University of California, San Francisco.
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