Clin Med Practice Exam 1: Pulmonary

20 Questions | Total Attempts: 866

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Clin Med Practice Exam 1: Pulmonary

Pulmonary - URI-interstitial, including IMHM


Questions and Answers
  • 1. 
    After quitting smoking, how much time does it take to reduce the risk of lung cancer to half that of a smoker?
    • A. 

      1 year

    • B. 

      5 years

    • C. 

      10 years

    • D. 

      15 years

  • 2. 
    A patient comes to the office in November with a headache, sore throat, earache and urticaria.  Upon examination, he's found to have rhonchi, rales and lymphadenopathy, but the chest x-ray doesn't show any consolidation of the lower lung zones.  Which is suspect?
    • A. 

      Upper respiratory infection

    • B. 

      Lung abscess

    • C. 

      Mycoplasma (primary atypical) pnemonia

    • D. 

      Pulmonary embolism

  • 3. 
    Which the following is not associated with acute bronchitis?
    • A. 

      Mycoplasma pneumoniae

    • B. 

      Strep. pneumoniae

    • C. 

      Chlamydia pneumoniae

    • D. 

      Bordetella pertussis

  • 4. 
    A 36 year old woman has been in the hospital for 30 hours.  Unrelated to her original diagnosis, you find she has a low-grade fever, bronchial breath sounds, lungs dull to percussion and rales.  Her chest X-ray shows consolidation.  Pending results of cultures, which would be an appropriate treatment?
    • A. 

      If there are other patients in the hospital who have been successfully treated for pneumonia, use the same antibiotic

    • B. 

      Direct treatment at virulent organisms, especially pseudomonas and enterobacter species

    • C. 

      Suspect she is a candidate for bronchial lavage

    • D. 

      Immediately give her a nasal CPAP

  • 5. 
    Which of the following appears on a chest X ray as a thick walled solitary cavity surrounded by consolidation?
    • A. 

      Lung cancer

    • B. 

      Epyema

    • C. 

      Lung abscess

    • D. 

      Epyema

  • 6. 
    A pre-op patient is a smoker.  How long before the operation should he be told to stop smoking in order to decrease the risk of myocardial infarction?
    • A. 

      20 minutes

    • B. 

      8 hours

    • C. 

      24 hours

    • D. 

      48 hours

  • 7. 
    Which of the following conditions is not responsive to corticosteroids?
    • A. 

      Asthma

    • B. 

      Constrictive bronchiolitis

    • C. 

      Proliferative bronchiolitis

    • D. 

      Bronchiolitis obliterans with organizing pneumonia (BOOP)

  • 8. 
    In which dyspnea patient would diffuse panbronchiolitis be on the differential diagnosis?
    • A. 

      65 year old Caucasian woman with rheumatoid arthritis

    • B. 

      35 year old African American man with type 2 diabetes

    • C. 

      22 year old Korean man who is 6'4" and 140 pounds

    • D. 

      A 40 year old Japanese man with a history of pansinusitis

  • 9. 
    Which  of the following could produce 200 cc hemoptysis at a time or over 600 cc over 24 hours?
    • A. 

      Bronchiectasis

    • B. 

      Pulmonary embolism

    • C. 

      Cystic fibrosis

    • D. 

      Atelectasis

  • 10. 
    A thin, barrel-chested 32 year old male of European descent complains of dyspnea and wet cough.  PFTs reveal an obstructive pattern that is unaffected by a bronchodilator.  Chest X ray shows hyperinflation of the lungs and a flattened diaphragm with arterial depletion at the lung bases.  Which is a logical step?
    • A. 

      Order a pilocarpine sweat test

    • B. 

      Test the serum level of alpha-1-antitrypsin

    • C. 

      Recommend postural drainage

    • D. 

      Order an ECG

  • 11. 
    The same patient comes back a year later and admits noncompliance to treatment for his alpha-1-antitrypsin deficiency. This time his chest X-ray shows scattered irregular opacities and honeycombing.  You then order a helical CT, which shows an area with a signet ring appearance.  Which would probably not be a detail of the treatment?
    • A. 

      Daily inhaled corticosteroids for maintenance

    • B. 

      Antibiotics for acute exacerbations

    • C. 

      Use of a flutter-valve device

    • D. 

      Beta blockers

  • 12. 
    A patient presents with anorexia, weight loss, fatigue, bone pain, hoarseness and anemia.  Upon examination, you also find ptosis and a constricted pupil in her left eye and diaphoresis only on the right side of her face.  What is suspect?
    • A. 

      Superior vena cava syndrome

    • B. 

      Small cell carcinoma

    • C. 

      Pancoast tumor

    • D. 

      Atelectasis

  • 13. 
    In which cancer stage of non-small cell lung cancer is there involvement of lung tissue and lymph nodes in the lung?
    • A. 

      I

    • B. 

      II

    • C. 

      III

    • D. 

      IV

  • 14. 
    What does the Karnofski scale measure?
    • A. 

      Risk for development of paraneoplastic syndrome

    • B. 

      Quality of life

    • C. 

      Risk for development of cor pulmonale

    • D. 

      Apneic index

  • 15. 
    Where in the lungs is surfactant produced?
    • A. 

      Type I cells

    • B. 

      Cuboidal cells

    • C. 

      Type II cells

    • D. 

      Both B and C

  • 16. 
    Equalization between the pressure of the pleura and the lungs would cause which of the following?
    • A. 

      Pleural effusion

    • B. 

      Pulmonary edema

    • C. 

      Pneumothorax

    • D. 

      Atelectasis

  • 17. 
    Which of the following could cause pulmonary hypertension by increasing pulmonary venous pressure?
    • A. 

      Acidosis

    • B. 

      Congenital left to right intracardia shunts

    • C. 

      Polycythemia

    • D. 

      Mitral stenosis

  • 18. 
    Which of the following is not a cause of an exudative pleural effusion?
    • A. 

      Congestive heart failure

    • B. 

      Epyema

    • C. 

      SLE

    • D. 

      TB

  • 19. 
    An otherwise healthy 32 year old woman has a positive routine Matoux, and her chest X-ray shows a caseous granuloma.  She freaks out.  You reassure her by telling her:
    • A. 

      The infection is self-limiting and has little chance of reactivation

    • B. 

      Prophylaxis in patients her age will decrease the risk of cirrhosis and lower her chance of reactivation to less than 5%

    • C. 

      The treatment for primary tuberculosis is an easy-to-follow regimen with few side effects

    • D. 

      Most solitary lung nodules in patients her age and health status are benign

  • 20. 
    Which is false of tuberculosis treatment?
    • A. 

      It lasts 6-9 months

    • B. 

      It includes ethambutol and pyrazinamide for the entire course of treatment

    • C. 

      Ethambutol has a side affect of optic neuritis

    • D. 

      DOT should be used in HIV+ patients due to possible interactions with their existing treatment regimen