0 of 30 Questions completed
Questions:
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading…
You must sign in or sign up to start the quiz.
You must first complete the following:
0 of 30 Questions answered correctly
Your time:
Time has elapsed
You have reached 0 of 0 point(s), (0)
Earned Point(s): 0 of 0, (0)
0 Essay(s) Pending (Possible Point(s): 0)
A 57-year-old man has a 2 week history of progressive weakness without nausea or vomiting. Chest radiography shows a hilar mass with mediastinal adenopathy suspicious for small cell lung cancer. Which of the following lab abnormalities will be noted if the patient has a paraneoplastic syndrome associated with the cancer?
A 45-year-old woman has had increasing shortness of breath, fever, weight loss, and night sweats for the past 4 months. She works as a seamstress, is a non-smoker, takes no chronic medications and did not recently travel prior to her illness. On physical examination her temperature is 100 degrees F and there are fine rales heard in all lung fields. A chest X-ray reveals hilar lymphadenopathy and a reticulonodular pattern of small densities in all lung fields. She is anergic by skin testing to mumps and Candida antigens. A transbronchial biopsy shows numerous small pulmonary interstitial non-caseating granulomas. Which of the following is the most likely diagnosis?
A patient presents to the clinic with occasional wheezing and chest tightness that occurs approximately once a week and at night only about once a month. Peak expiratory flow is performed and demonstrates 85% of predicted. Which of the following is the most appropriate initial treatment?
A 59-year-old man has bronchogenic squamous cell carcinoma in the apex of his left lung. Which of the following is the most likely complication to occur in this patient?
Which of the following is common to patients who have asthma, atopic dermatitis, and allergic rhinitis?
A 15-year-old asymptomatic girl has recently immigrated from a country known to have a high incidence of tuberculosis. Her tuberculin skin test shows 10 mm induration. Chest radiography is normal. Which of the following is the most appropriate management?
Following a rib fracture, a patient presents with tachypnea and chest pain. On physical exam you reveal decreased tactile fremitus, hyperresonance on percussion and decreased breath sounds on the affected side. Which of the following is most compatible with this presentation?
A 37-year-old presents after being stung by a wasp. Within 15 minutes he developed a choking sensation in his throat, difficulty breathing, and diffuse wheals. His vital signs are BP: 98/54 mmHg; pulse: 106 bpm; respirations: 28 breaths/min (shallow). Which of the following medications is the best initial choice to order?
A 21-year-old pregnant female G2P1A0 presents with a sudden onset of sharp, right-sided chest pain one hour ago and becomes apprehensive, tachypneic, and diaphoretic while in the ER. Which of the following studies is the most useful diagnostic modality for this patient’s presentation?
Which of the following is a physical examination finding that is consistent with a diagnosis of lobar pneumonia?
A 68-year-old woman has a central venous catheter for ongoing chemotherapy. She now has a 2 week history of facial and bilateral arm swelling. Vital signs are normal. Examination shows facial edema, bilateral arm edema, and distention of arm and chest veins. Jugular venous pressure is elevated. Which of the following is the most likely diagnosis?
Infant respiratory distress syndrome is due to what abnormality?
Three weeks after having had a generalized seizure, a 26-year-old man with epilepsy is hospitalized with a lung abscess. Which of the following is the most likely infecting organism?
A 15-year-old girl uses an albuterol inhaler to treat her asthma. She uses the inhaler as needed and reports symptoms occurring 3-4 days per week. She experiences symptoms at night no more than once a month. Her spirometry during her most recent office visit is normal. What is the appropriate medical management of this patient?
A 3-month-old infant has suspected bacterial community acquired pneumonia. Which of the following is the preferred management?
A 47-year-old female with a history of bronchiectasis presents with a complaint of increased cough. She reports that she is producing copious amounts of thick, green, foul odored sputum which has become blood streaked. She reports frequent lung infections her whole life, but no other significant medical history. On examination, she appears to be in mild distress and crackles are heard at the bases of the lungs. Chest x-ray shows dilation of the large airways. Which of the following organisms is most likely the cause of her current symptoms?
A 23-year-old male presents to the emergency room with a complaint of severe left sided pleuritic chest pain and dyspnea. He is a 1 pack per day smoker. He has no significant past medical history. On exam he is a tall thin man, who appears to be in mild discomfort, has a respiratory rate of 22 breaths per minute, and a heart rate of 110 beats per minute. His trachea is midline, and there is no jugular venous distention. There are slightly decreased breath sounds on the left side of his chest. A chest x-ray shows a small pneumothorax, involving approximately 10% of his lung volume. Which of the following is the most appropriate management strategy for this patient?
A 19-year-old female presents for a college physical. She has no complaints, and no significant medical history. She has never travelled outside of the United States and lives in a single family home with her parents and brother. She has a normal physical examination. A ppd is performed on her and she is instructed to return for the reading. Which of the following is the minimum criteria for a positive reaction in this patient?
A 28-year-old female nurse presents to the occupational medicine clinic to have her ppd read. On examination of the test site there is 11 mm of induration. She does not report any symptoms of tuberculosis and has a normal chest x-ray. She has a past medical history of type one diabetes since age 6 and is not pregnant. Which of the following would be the most appropriate management of this patient?
A 54-year-old female presents to the emergency room with a complaint of hemoptysis. She reports that for the past 3 weeks she has had productive cough, fevers, chills, night sweats and an unintentional 15 pound weight loss. On examination she appears unwell, and has a temperature of 101.0o. Rales are heard in the upper right lung fields. A chest x-ray reveals consolidation in the right apex of the lung. Sputum examination is positive for acid fast bacilli. Which of the following medications is the most appropriate regimen to start her on pending results of culture and sensitivity?
A 21-year-old female with a history of asthma is presently taking salmeterol and a medium dose inhaled corticosteroid. She has persistent symptoms almost daily and is awakening from sleep with symptoms 2-3 times per night. She was previously well controlled with her current management, so the decision is made to step up to a high dose inhaled corticosteroid and continue the salmeterol. Which of the following is a known adverse systemic affect of inhaled high dose corticosteroids?
A 6-month-old female is brought in for a well baby check. She was diagnosed with cystic fibrosis via newborn screening; but is thriving with treatment. Which of the following vitamins should she be receiving supplementation of?
A 7-year-old male with a history of asthma is being seen for follow up of his asthma. He was last seen one month ago. At this last visit he was found to have poor control, so a long acting bronchodilator was added to his regimen, which already included low dose inhaled corticosteroids. His mother reports that since the medication change, he has been having symptoms less than once weekly. Which of the following statements regarding his management is the most appropriate strategy?
A 48-year-old smoker presents with a complaint of arthralgias, malaise and for several weeks, and has now developed hemoptysis and hematuria over the past few days. There are bibasilar rales on physical examination. Chest x-ray reveals alveolar shadowing. Renal function is severely impaired. Which of the following is the most likely diagnosis?
A 78-year-old male with a history of COPD comes in for a routine review of his medications. He has a 60 pack year history of cigarette smoking. Which of the following findings should prompt an evaluation for malignancy because it is not associated with COPD ?
A 38-year-old female presents to the emergency department with a complaint of mild shortness of breath. A portable chest x-ray is performed and shows slight blunting of the costophrenic angle. Which of the following x-ray views would be more sensitive in detecting a small pulmonary effusion?
A 23-year-old female college student presents to the emergency room with acute shortness of breath. She also reports numbness and tingling in her hands, feet and mouth. On examination she is breathing at 64 breaths per minute and carpopedal spasm is noted. Which of the following acid base abnormalities is most likely present in this patient?
A 21-year-old college student presents with a 4 week history of paroxysms of nonproductive cough. She reports repeated episodes of severe hacking coughing which are sometimes followed by emesis. On examination she is afebrile and her lungs are clear to auscultation. Which of the following is the most likely diagnosis?
A 57-year-old male is admitted for complications due to squamous cell carcinoma of the lungs. Which of the following electrolyte abnormalities is most likely to be seen in this patient?
A 3-year-old male is brought to the emergency room for acute onset of a severe barky cough that started in the middle of the night. He has had mild coryzal symptoms for the past three days. On examination there is inspiratory stridor and mild intercostal retractions, along with a barky, seal-like cough. Which of the following is the most likely causative organism?