Pulmonology

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This is a Post-rotation test based on the goals and objectives listed in the residency handbood for the Pulmonology Rotation

Questions and Answers

1.

Which one of the following is most consistent with a diagnosis of asthma?
- A.
  
  Reduced FEV and reduced FEV1 /FVC ratio
- B.
  
  Reduced FEV and normal FEV1 /FVC ratio
- C.
  
  Reduced FEV and increased FEV1 /FVC ratio
- D.
  
  Reduced FVC and normal FEV1 /FVC ratio
- E.
  
  Reduced FVC and increased FEV1 /FVC ratio
Correct Answer
A. Reduced FEV and reduced FEV1 /FVC ratio
2.

A 67-year-old smoker with a history of pulmonary tuberculosis at 22 years of age presents with a 6-month history of increasing shortness of breath. On office spirometry his FVC is 60% of predicted, his FEV1 is 80% of predicted, and his FEV1 /FVC ratio is 0.8. Which one of the following would be the most appropriate next step in his evaluation?
- A.
  
  Refer to a pulmonary laboratory for static lung volume measurement and diffusion studies
- B.
  
  Perform a bronchodilator challenge test
- C.
  
  Investigate for nonpulmonary causes for the patient’s symptoms
- D.
  
  Order a PPD skin test
Correct Answer
B. Perform a bronchodilator challenge test
3.

A 40-year-old nurse presents with a 1-year history of rhinitis, and a more recent onset of episodic wheezing and dyspnea. Her symptoms seem to improve when she is on vacation. She does not smoke, although she says that her husband does. Her FEV1 improves 20% with inhaled B-agonists. Which one of the following is the most likely diagnosis?
- A.
  
  Occupational asthma
- B.
  
  Sarcoidosis
- C.
  
  COPD
- D.
  
  Anxiety
- E.
  
  Vocal cord dysfunction
Correct Answer
A. Occupational asthma
4.

Which one of the following is true concerning the use of short-acting inhaled B-agonists for asthma?
- A.
  
  They should be given before any inhaled corticosteroid to facilitate lung delivery
- B.
  
  They are ineffective in patients taking beta-blockers
- C.
  
  They are less effective than oral B-agonists
- D.
  
  They are less effective than anticholinergic bronchodilators when given with inhaled corticosteroids
- E.
  
  Their effects begin within 5 minutes and last 4–6 hours
Correct Answer
E. Their effects begin within 5 minutes and last 4–6 hours
5.

You see a 9-year-old female for evaluation of her asthma. She and her mother report that she has shortness of breath and wheezing 3–4 times per week, which improves with use of her albuterol inhaler. She does not awaken at night due to symptoms, and as long as she has her albuterol inhaler with her she does not feel her activities are limited by her symptoms. About once per year she requires prednisone for an exacerbation, often triggered by a viral infection. Based on this information you classify her asthma severity as
- A.
  
  Intermittent
- B.
  
  Mild persistent
- C.
  
  Moderate persistent
- D.
  
  Severe persistent
Correct Answer
A. Intermittent
6.

A 14-year-old female with a history of asthma is having daytime symptoms about once a week and symptoms that awaken her at night about once a month. Her asthma does not interfere with 1 normal activity, and her FEV is >80% of predicted. Which one of the following is the most appropriate treatment plan for this patient?
- A.
  
  A short-acting inhaled beta-agonist as needed
- B.
  
  Low-dose inhaled corticosteroids daily
- C.
  
  A leukotriene receptor antagonist daily
- D.
  
  Medium-dose inhaled corticosteroids daily
- E.
  
  Low-dose inhaled corticosteroids plus a long-acting inhaled beta-agonist daily
Correct Answer
A. A short-acting inhaled beta-agonist as needed

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Current Version
Jul 13, 2017

Quiz Edited by
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Oct 30, 2011

Quiz Created by
Richcooke2

Pulmonology

Which one of the following is most consistent with a diagnosis of asthma?

Which one of the following is true concerning the use of short-acting inhaled B-agonists for asthma?