Deck 8: Respiratory System

Question 1

During physical examination of a patient,you note resonance on percussion in the upper lung fields.This is consistent with:

A) COPD
B) Pneumothorax
C) A normal finding
D) Pleural effusion

Answer 1

A normal finding

Question 2

A 66-year-old patient presents to the clinic complaining of dyspnea and wheezing.The patient reports a smoking history of 2 packs of cigarettes per day since age 16.This would be recorded in the chart as:

A) 50 x 2-pack years
B) 100-pack years
C) 50-year,2-pack history
D) 100 pack history

Answer 2

100-pack years

Question 3

The following criterion is considered a positive finding when determining whether a patient with asthma can be safely monitored and treated at home:

A) Age over 40
B) Fever greater than 101
C) Tachypnea greater than 30 breaths/minute
D) Productive cough

Answer 3

Tachypnea greater than 30 breaths/minute

Question 4

During auscultation of the chest,your exam reveals a loud grating sound at the lower anterolateral lung fields,at full inspiration and early expiration.This finding is consistent with:

A) Pneumonia
B) Pleuritis
C) Pneumothorax
D) A and B

Question 5

Alpha-1 antitrypsin deficiency should be considered in patients diagnosed with:

A) Exercise-induced cough
B) Bronciectasis
C) COPD
D) Pericarditis

Question 6

The most common etiologic organism for community-acquired pneumonia is:

A) Streptococcus pneumoniae
B) Beta hemolytic streptococcus
C) Mycoplasma
D) Methicillin resistant staphylococcus

Question 7

Which of the following medications are commonly associated with the side effect of cough?

A) Beta blocker
B) Diuretic
C) ACE inhibitor
D) Calcium antagonist

Question 8

Which of the following details are NOT considered while staging asthma?

A) Nighttime awakenings
B) Long-acting beta agonist usage
C) Frequency of symptoms
D) Spirometry findings

Question 9

When asthma is suspected,which of the following is NOT useful in making a diagnosis?

A) Decreased FEV1/FVC ratio
B) Decreased FEV1
C) Some reversibility with administration of bronchodilator
D) Peak flow meter reading

Question 10

A cough is described as chronic if it has been present for:

A) 2 weeks or more
B) 8 weeks or more
C) 3 months or more
D) 6 months or more

Question 11

When palpating the posterior chest,the clinician notes increased tactile fremitus over the left lower lobe.This can be indicative of:

A) Pneumonia
B) Emphysema
C) Pneumothorax
D) Asthma

Question 12

Which of the following imaging studies should be considered if a pulmonary malignancy is suspected?

A) Computed tomography (CT)scan
B) Chest xray with PA,lateral,and lordotic views
C) Ultrasound
D) Positron emission tomography (PET)scan

Question 13

If on physical examination the clinician auscultates rhonchi,the clinician should ask the patient to take a deep breath and cough in order to:

A) Mobilize secretions
B) Diagnose pleural effusion
C) Accurately distinguish lung sounds
D) A & C

Question 14

Which of the following is considered a "red flag" when diagnosing a patient with pneumonia?

A) Fever of 102
B) Infiltrates on chest x-ray
C) Pleural effusion on chest x-ray
D) Elevated white blood cell count

Question 15

Upon assessment of respiratory excursion,the clinician notes asymmetric expansion of the chest.One side expands greater than the other.This could be due to:

A) Pneumothorax
B) Pleural effusion
C) Pneumonia
D) Pulmonary embolism

Question 16

A 23-year-old patient who has had bronchiectasis since childhood is likely to have which of the following:

A) Barrel-shaped chest
B) Clubbing
C) Pectus excavatum
D) Prolonged capillary refill

Question 17

Your patient with community-acquired pneumonia shows a pleural effusion on chest x-ray,indicating the need for:

A) Immediate endotracheal intubation
B) Broad spectrum intravenous antibiotics
C) Thoracentesis to rule out empyema
D) Gram stain and culture of sputum

Question 18

A 75-year-old patient with community-acquired pneumonia presents with temperature of 102.1,chills,productive cough,BP 90/5062,WBC 12,000,and blood urea nitrogen (BUN)20 mg/dl.He has a history of mild dementia and his mental status is unchanged from his last visit.These findings indicate that the patient:

A) Can be treated as an outpatient
B) Requires hospitalization for treatment
C) Requires a high dose of parenteral antibiotic
D) Can be treated with oral antibiotics

Question 19

Which of the following is characteristic of COPD?

A) Asymmetric chest expansion
B) Increased lateral diameter
C) Increased anterior-posterior diameter
D) Pectus excavatum

Question 20

While assessing auscultated spoken sounds,the ausculated sound is heard as "a-a-a" when he is asked to repeat "e-e-e." This is indicative of:

A) Asthma
B) Tumor
C) Pneumonia
D) Pleural effusion

Question 21

A 76-year-old patient with a 200-pack year smoking history presents with complaints of chronic cough,dyspnea,fatigue,hemoptysis,and weight loss over the past 2 months.The physical exam reveals decreased breath sounds and dullness to percussion over the left lower lung field.The chest x-ray demonstrates shift of the mediastinum and trachea to the left.These are classic signs of:

A) Lung cancer
B) Tuberculosis
C) Pneumonia
D) COPD

Question 22

Causes of pleural effusions include:

A) Malignancy
B) Pneumonia
C) Cardiomegaly
D) All of the above

Question 23

Patients with pulmonary fibrosis show decreased lung tissue compliance and diminished forced vital capacity (FVC).Pulmonary fibrosis is a type of:

A) Obstructive disease
B) Restrictive disease
C) Hyperreactive airway disease
D) None of the above

Question 24

Your patient has just returned from a 6-month missionary trip to Southeast Asia.He reports unremitting cough,hemoptysis,and an unintentional weight loss of 10 pounds over the last month.These symptoms should prompt the clinician to suspect:

A) Legionaire's disease
B) Malaria
C) Tuberculosis
D) Pneumonia

Question 25

A 24-year-old patient presents to the emergency department after sustaining multiple traumatic injuries after a motorcycle accident.Upon examination,you note tachypnea,use of intercostal muscles to breathe,asymmetric chest expansion,and no breath sounds over the left lower lobe.It is most important to suspect:

A) Pulmonary embolism
B) Pleural effusion
C) Pneumothorax
D) Fracture of ribs