Answer 20

20.  Choice B is the correct answer.  Small Cell Lung Cancer tends to be the most aggressive lung cancer.  Adenocarcinoma is the most common of all lung cancers.  

Question 20

20.  Which of the following is the most aggressive type of lung cancer?

A.  Adenocarcinoma Lung Cancer
B.  Small Cell Lung Cancer
C.  Carcinoid Lung Cancer
D.  Large Cell Lung Cancer

Answer 19

19.  Choice B is the correct answer.  Community acquired pneumonia means that the patient has not been in the hospital or nursing home in the last 48 hours.  HCAP means that the patients has been in a nursing home within 90 days of discharge or chronic care facility.  Ventilator assisted pneumonia develops 48-72 hours after intubation.

Question 19

19.  Your patient is an 84 year old male that has been in a nursing home for the last 4 months.  He comes in with fever, cough and a RML infiltrate.  Which type of the following pneumonias is his classified as?

A.  Community acquired pneumonia (CAP)
B.  Healthcare acquired pneumonia (HCAP)
C.  Hospital acquired pneumonia (Nosocomial)
D.  Ventilator Associated Pneumonia (VAP)

Answer 18

18.  Choice C is the correct answer.  Usually in patients with active TB four drugs are used in initial treatment INH, rifampin, ethambutol, and pyrazinamide.  The culture is repeated after 8 weeks and if culture is sensitive to one of the four agents, usually ethambutol can be discontinued.

Question 18

18.  Your patient is a 34 year old that has been having hemoptysis, night sweats and weight loss.  Sputum culture is positive for acid fast bacillus.  Chest x ray reveals a cavitary lesion in the right upper lobe.  All of the following are appropriate for treatment except:

A.  INH
B.  Rifampin
C.  Erythromycin
D.  Pyrazinamide

Answer 17

17.  Choice C is the correct answer.  Macrolides are considered first line for pertussis.  Bactrim is considered alternative therapy.  Pertussis is usually not sensitive to augmentin.   Levaquin should not be used in patients under 18 years of age and may not be effective against pertussis.

Question 17

17.  Your patient is a 8 year old female that presents with intense coughing episodes and low grade fever that was present earlier in the week.  Her vital signs are normal.   Her lungs are clear.  Her chest x ray is normal.   You order swabs for PCR testing that was positive for Bordetella Pertussis.  Which of the following is the best course of treatment?

A.  Symptomatic treatment with Tylenol and Motrin.  Pertussis is a viral infection

B.  Levaquin 

C.  Zithromax

D.  Augmentin

Answer 16

16.  Choice C is the correct answer.   The patients respiratory rate is too high to send home.  Admission to the hospital should be considered in patients with bronchiolitis with the following exists:  signs of respiratory distress such as nasal flaring, retractions, and grunting, respiratory rate greater than 70, cyanosis, toxic appearance, apnea, hypoxemia, and parents unable to care for child at home.  Rocephin is really not shown to be beneficial in patients with bronchiolitis.  Racemic epinephrine aerosols should not be given at home due to rebound effect seen in some patients.

Question 16

16.  Your patient is a 3 month old female that present with cough, wheezing and nasal congestion.  She was a full term infant born of a group B strep negative mother.  Immunizations are up to date.  The patient has had 2 albuterol aerosols and 2 mg/kg of prelone.  RSV negative and Chest X Ray shows bronchiolitis without infiltrate.  Her breath sounds are now clear.  Her repeat vital signs are as follows:  BP 86/38, HR 156, RR 80, SpO2 95%, Temp 99.3 Rectal.  Based upon this information which of the following choices would be the appropriate disposition.

A.  Discharge home with home albuterol aerosols and prelone 2 mg/kg PO daily for 5 days
B.  Given the paint Rocephin 50 mg/kg IV and discharge home with follow up with PCP in AM
C.  Admit to hospital
D.  Send home with Racemic Epinephrine Aerosols