What Do You Know About Pulmonology? Trivia Quiz

1.

These are restrictive lung disorders:

A.

ALS
B.

Scoliosis
C.

Guillain-Barre
D.

Alpha-1 antitrypsin deficiency

Correct Answer(s)
A. ALS
B. Scoliosis
C. Guillain-Barre

Explanation
Alpha-1 antitrypsin deficiency is a genetic disorder that causes COPD/emphysema, i.e. obstructive lung disorders, not restrictive.

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2.

These are obstructive lung disorders:

A.

ALS
B.

Anklyosing spondylitis
C.

Chronic bronchitis
D.

Emphysema

Correct Answer(s)
C. Chronic bronchitis
D. Emphysema

Explanation
ALS and ankylosing spondylitis are restrictive lung disorders, not obstructive.

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3.

Obstructive lung disorders have problems with _. Restrictive lung disorders have problems with _.

A.

Exhaling, exhaling
B.

Exhaling, inhaling
C.

Inhaling, exhaling
D.

Inhaling, inhaling

Correct Answer
B. Exhaling, inhaling

Explanation
Obstructive lung disorders refer to conditions that cause difficulty in exhaling air out of the lungs, such as asthma or chronic obstructive pulmonary disease (COPD). These disorders result in narrowed airways, making it harder for air to flow out during exhalation. On the other hand, restrictive lung disorders involve problems with inhaling air into the lungs, such as lung fibrosis or scoliosis. These conditions restrict the expansion of the lungs, making it difficult to take in an adequate amount of air during inhalation.

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4.

Pulsus paradoxus is:

A.

Two heartbeats close together followed by a pause
B.

When the apical heart rate and radial pulse are not the same
C.

An abnormally wide pulse pressure
D.

An abnormally large decrease (20+ mmHg) in arterial pressure on inhalation

Correct Answer
D. An abnormally large decrease (20+ mmHg) in arterial pressure on inhalation

Explanation
Pulmonary causes of pulsus paradoxus include: COPD, asthma, tension pneumothorax, PE

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5.

Stridor is usually heard best on:

A.

Expiration
B.

Inspiration
C.

Biphasic

Correct Answer
B. Inspiration

Explanation
Stridor is a high-pitched, harsh sound that occurs during breathing when there is a blockage or narrowing of the airway. It is usually heard best on inspiration because during this phase, the air is being drawn into the lungs through the narrowed or obstructed airway, causing the sound to be more audible. On the other hand, during expiration, the air is being expelled from the lungs, and the sound of stridor may be less prominent or even absent.

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6.

Your patient has dyspnea and significant lymphadenopathy. You take a lung biopsy and find noncaseating granulomas, and you have ruled out all other granulomatous disorders. It is:

A.

Sarcoidosis
B.

P. carinii infection
C.

Bronciectasis
D.

Tuberculosis

Correct Answer
A. Sarcoidosis

Explanation
The patient's symptoms of dyspnea and significant lymphadenopathy, along with the presence of noncaseating granulomas in the lung biopsy, suggest a diagnosis of sarcoidosis. Sarcoidosis is a systemic inflammatory disease that can affect multiple organs, commonly the lungs and lymph nodes. The characteristic noncaseating granulomas are a hallmark of sarcoidosis. Other granulomatous disorders have been ruled out, making sarcoidosis the most likely diagnosis in this case.

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7.

This unusual radiographic finding strongly suggests silicosis.

A.

Bibasilar consolidation
B.

Reticular opacities
C.

"eggshell" calcification
D.

Diffuse ground glass

Correct Answer
C. "eggshell" calcification

Explanation
The presence of "eggshell" calcification on a radiograph is a characteristic finding in silicosis. Silicosis is a lung disease caused by long-term exposure to silica dust, commonly found in industries such as mining, construction, and sandblasting. The term "eggshell" calcification refers to the thin, calcified nodules that form on the surface of the lungs in advanced stages of silicosis. This finding is distinct and highly suggestive of the disease, as it is not commonly seen in other lung conditions.

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8.

If your patient has contact with live birds, it's:

A.

Histoplasmosis
B.

Stannosis
C.

Asbestosis
D.

Psittacosis

Correct Answer
D. Psittacosis

Explanation
Histoplasmosis is from soil contaminated by bird or bat droppings.

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9.

These are elements of the CURB-65 scoring system for community-acquired pneumonia.

A.

BUN greater than or equal to 19
B.

Age 65+
C.

Respirations greater than or equal to 30
D.

Heart rate above 110
E.

SBP less than 90 or DBP less than 60
F.

Confusion

Correct Answer(s)
A. BUN greater than or equal to 19
B. Age 65+
C. Respirations greater than or equal to 30
E. SBP less than 90 or DBP less than 60
F. Confusion

Explanation
This answer includes the elements of the CURB-65 scoring system for community-acquired pneumonia. BUN greater than or equal to 19 is included because an elevated blood urea nitrogen (BUN) level indicates impaired kidney function, which can be a sign of more severe illness. Age 65+ is included because older age is a risk factor for complications and mortality in pneumonia. Respirations greater than or equal to 30 is included because rapid breathing can indicate respiratory distress. SBP less than 90 or DBP less than 60 is included because low blood pressure can indicate poor perfusion and organ dysfunction. Confusion is included because it can be a sign of severe illness and altered mental status.

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10.

Which is the correct vaccination recommendation for influenza?

A.

All adults working with immunocompromised populations; yearly
B.

All patients over the age of 10; yearly
C.

All patients over the age of 6 months; yearly
D.

All adults over the age of 65; yearly

Correct Answer
C. All patients over the age of 6 months; yearly

Explanation
From Current and CDC

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11.

What is the recommended vaccination schedule for pneumonia?

A.

All adults over 65 (PCV23), all children under 5 (PCV13)
B.

All adults working in healthcare
C.

All patients over the age of 6 months
D.

All at-risk adults

Correct Answer
A. All adults over 65 (PCV23), all children under 5 (PCV13)

Explanation
Current, CDC

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12.

The following are indications for referral for specialty care in an asthma patient.

A.

Patient is not meeting goals of asthma therapy after 3–6 months of treatment.
B.

More than two courses of oral prednisone therapy in the past 12 months.
C.

Any life-threatening asthma exacerbation/exacerbation requiring hospitalization in the past 12 months.
D.

Complicating comorbid problems e.g. rhinosinusitis, tobacco use, multiple environmental allergies, suspected allergic bronchopulmonary mycosis.

Correct Answer(s)
A. Patient is not meeting goals of asthma therapy after 3–6 months of treatment.
B. More than two courses of oral prednisone therapy in the past 12 months.
C. Any life-threatening asthma exacerbation/exacerbation requiring hospitalization in the past 12 months.
D. Complicating comorbid problems e.g. rhinosinusitis, tobacco use, multiple environmental allergies, suspected allergic bronchopulmonary mycosis.

Explanation
Current 2014 p. 250

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13.

The following are indications for referral for specialty care in a COPD patient.

A.

Severe or rapidly progressive COPD.
B.

Smoker.
C.

Need for long-term oxygen therapy.
D.

COPD onset occurs before the age of 40.

Correct Answer(s)
A. Severe or rapidly progressive COPD.
C. Need for long-term oxygen therapy.
D. COPD onset occurs before the age of 40.

Explanation
Current 2014 p. 256

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14.

African-Americans are more likely to die than Caucasians of the following diseases:

A.

Lung cancer
B.

COPD
C.

Sarcoidosis
D.

Asthma

Correct Answer(s)
A. Lung cancer
C. Sarcoidosis
D. Asthma

Explanation
http://www.lung.org/assets/documents/publications/lung-disease-data/solddc_2010.pdf

Caucasians are more likely than any other ethnic group to develop and die from COPD.

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What Do You Know About Pulmonology? Trivia Quiz

These are restrictive lung disorders:

These are obstructive lung disorders:

Obstructive lung disorders have problems with _______. Restrictive lung disorders have problems with _______.

Pulsus paradoxus is:

Stridor is usually heard best on:

Your patient has dyspnea and significant lymphadenopathy. You take a lung biopsy and find noncaseating granulomas, and you have ruled out all other granulomatous disorders. It is:

This unusual radiographic finding strongly suggests silicosis.

If your patient has contact with live birds, it's:

These are elements of the CURB-65 scoring system for community-acquired pneumonia.

Which is the correct vaccination recommendation for influenza?

What is the recommended vaccination schedule for pneumonia?

The following are indications for referral for specialty care in an asthma patient.

The following are indications for referral for specialty care in a COPD patient.

African-Americans are more likely to die than Caucasians of the following diseases:

Obstructive lung disorders have problems with _. Restrictive lung disorders have problems with _.