RESPI QUIZZES

Question 1

This respiratory sound usually indicates airway closure and secretions

Wheezes
Crackles
Rhonchi
None of the above

Answer 1

Crackles

Question 2

The ABG determines EXCEPT:

Acid-base abnormality
Onset or resolution of cardiopulmonary crises
Appropriateness and effectiveness of the therapy given
None of the above

Answer 2

None of the above

Question 3

Which of the following is the CORRECT step in arterial blood gas determination?

Check the pH→Examine the PaCO2 and HCO3 to determine if it is alkalotic or acidotic→analyze the appropriateness of compensation

Check the pH→Examine the PaCO2 and the standard HCO3 to determine if it is metabolic or respiratory→study the PaO2 in the context of inspired oxygen concentration

Check the pH→Examine the PaCO2 and the standard HCO3 to determine if it is metabolic or respiratory in origin→analyze the appropriateness of compensation→study the PaO2 in the context of inspired oxygen concentration

Check the pH→Examine the PaCO2 and the HCO3 to determine if it is compensated or not→analyze whether it is metabolic or respiratory→study the PaO2 in the context of inspired oxygen concentration

Answer 3

Check the pH→Examine the PaCO2 and the standard HCO3 to determine if it is metabolic or respiratory in origin→analyze the appropriateness of compensation→study the PaO2 in the context of inspired oxygen concentration

Question 4

Baby G is admitted at the NICU who was delivered via normal spontaneous delivery, with APGAR score of 2,2,6, noted to have thickly meconium stained amniotic fluid,
PROM for 20 hours and was eventually intubated and attached to a mechanical ventilator with the following settings: FiO2 100% RR 60 PIP 22 PEEP 6. ABG was taken an hour after the patient was attached to the ventilator with the following results:
pH 7.25 (dec)
PCO2 55 (inc)
P02 80 (dec)
HCO3 16 (dec)
BE -5
O2 sat 99%

This is interpreted as

Respiratory acidosis with moderate hypoxemia
Metabolic acidosis with overly corrected hypoxemia
Mixed respiratory acidosis and metabolic acidosis
Respiratory acidosis with overly corrected hypoxemia

Answer 4

Respiratory acidosis with moderate hypoxemia not sure

Question 5

heresa, 3 years old was admitted with history of cough for 6 days with associated fever and chills. No initial consult was made until 2 days prior to admission was noted to have fast breathing, eventually sought consult the following day and was eventually advised admission. She was managed as a case of Acute Respiratory Failure secondary to CAP D and was eventually intubated, attached to ventilator and admitted at the PICU. The ABG revealed the ff findings:
pH 7.0 (dec)
PCO2 40 (Normal)
PO2 108 (inc)
HCO3 10 (dec)
BE 10 (inc)
O2 sat 98%
This is interpreted as:

Respiratory acidosis with overly corrected hypoxemia
Metabolic acidosis with overly corrected hypoxemia
Respiratory acidosis with moderate hypoxemia
Metabolic acidosis with moderate hypoxemia

Answer 5

Metabolic acidosis with overly corrected hypoxemia

Question 6

Obstructive disease usually manifests with slower, deeper breaths and is seen in cases such as asthma and pneumothorax. Other description of an obstructive disease include:

Expiration that is more prolonged than inspiration and the patient often has to make use of accessory expiratory muscles.

Inspiration that is less prolonged than expiration and an inspiratory stridor can usually be heard.

Results in respiratory excursions that are shallow with associated chest wall retractions and nasal flaring.

Expiration that is less prolonged that inspiration and the patient often has to make use of accessory expiratory muscles

Answer 6

Expiration that is more prolonged than inspiration and the patient often has to make use of accessory expiratory muscles.

Question 7

Stephanie, 7years old patient, 145 cm in height was currently assessed for the possibility of having Bronchial asthma with acute exacerbation. She does not have any maintenance medications for asthma, her baseline PEFR appropriate for
her age and height is:

495
395
345
555

Answer 7

395

Question 8

In performing Thoracentesis, the point of entry is at:

5th ICS and posterior axillary line
5th ICS and anterior axillary line
6th ICS and posterior axillary line
7th ICS and posterior axillary line

Answer 8

7th ICS and posterior axillary line

Question 9

Which of the following fits the Light’s criteria for a Transudative pleural fluid:

Protein 25., LDH 200, WBC 15,000, RBC 4,000, Glucose 35, Hp 71.
Protein 3, LDH 180, WBC 12,000, RBC 3,500, Glucose 50, pH 7.3
Protein 2.3, LDH 150, WBC 6,000, RBC 3,900, Glucose 45, pH 7.5,
Protein 2.9, LDH 198, WBC 11,000, RBC 5,000, Glucose 56, pH 7.4

Answer 9

Protein 2.3, LDH 150, WBC 6,000, RBC 3,900, Glucose 45, pH 7.5,

Question 10

Emily, 6 years old child, manifested for nasal congestion, fever, with associated throat pain, and decreased sense of smell because of the congestion for 4 days already. There was no note of cough, headache, vomiting or abdominal pain. Upon examination she was noted to have swollen and erythematous nasal turbinates. Treatment for the case of Therese includes giving:

Paracetamol and adequate rest will do
Paracetamol, antibiotics and hydration
Antibiotics, Hydration, increased oral fluid intake, and adequate rest
Paracetamol for the fever, Decongestants, Hydration, Encourage increased oral fluid intake and adequate rest

Answer 10

Paracetamol for the fever, Decongestants, Hydration, Encourage increased oral fluid intake and adequate rest

Question 11

Preventive measures for Acute rhinitis are as follow EXCEPT:

Hand hygiene
Pneumococcal vaccine
Good hygienic practices
Proper waste disposal of infected materials

Answer 11

Pneumococcal vaccine

Question 12

The following are TRUE for Acute Pharyngitis EXCEPT

Viral causes includes RSV
Most common cause of sore throat
It is often associated with common cold syndrome
Most common bacterial cause is Streptococcus pneumoniae

Answer 12

Most common bacterial cause is Streptococcus pneumoniae

Question 13

Betty. 5 years old female sought consult for complaints of fever, pain in the throat and cough. By physical examination revealed findings of erythematous tonsils with small vesicles on the soft palate and uvula. Most likely Betty’s condition is caused by?

HSV infection
Influenza infection
Coxsackie virus
Epstein-Barr virus

Answer 13

Coxsackie virus

Question 14

Lester, 6 year old child was brought by his mother for consult due to fever, malaise, pain during swallowing. Mother also mentioned that there was an instance that she noticed of foul smelling cheesy lumps when she checked on time the throat of her son. On physical examination there was note of erythematous enlarged tonsils with multiple exudates, tender maxillary lymph nodes upon palpation and note of halitosis as well. More efficacious medical management for this patient would be to give:

Amoxicillin
Clindamycin
Clarithromycin
Co-amoxiclav

Answer 14

Clindamycin

Question 15

Miya, 5 year old child came in for consult with presentation of 3 days fever associated with pain upon swallowing, no cough or colds. On physical examination, revealed findings for tonsillar exudates with anterior cervical lymphadenopathies. Based on McIsaac Criteria the total score of the patient is:

5
3
4
2

Answer 15

5

Question 16

Tonsillectomy is the most commonly performed procedure for recurrent or chronic pharyngotonsillitis. The minimum frequency of sore throat episodes needed to fulfill the Paradise Criteria is

At least 5 episodes in the previous year, at least 3 episodes in each of the previous 2 years or at least 1 episode in each of the previous 3 years.

At least 7 episodes in the previous year, at least 5 episodes in each of the previous 2 years or at least 3 episodes in each of the previous 3 years.

At least 7 episodes in the previous year, at least 3 episodes in each of the previous 2 years or at least 1 episode in each of the previous 3 years.

At least 5 episodes in the previous year, at least 2 episodes in each of the previous 2 years or at least 1 episode in cach of the previous 3 years.

Answer 16

At least 7 episodes in the previous year, at least 5 episodes in each of the previous 2 years or at least 3 episodes in each of the previous 3 years.

Question 17

Major complication of untreated GABHS infection is/are

Acute rheumatic fever
Post-streptococcal glomerulonephritis
Both
None of the above

Answer 17

Both

Question 18

Peritonsillar infection occur as either cellulitis or a frank abscess in the region superior and lateral to the tonsillar capsule. One of the presenting symptoms include:

Drooling
Bilateral throat pain
Tripod position
One sided dysphagia

Answer 18

Drooling

Question 19

This is true for acute sinusitis

Most common complication is otitis media

It occurs for children who live in developing countries with low immunization rates

Amoxicillin-clavulanate is given to children who previously received antimicrobial therapy in the last three months

Viral cause can trigger inflammatory response by direct mucosal invasion and disruption of nasal epithelium

Answer 19

Amoxicillin-clavulanate is given to children who previously received antimicrobial therapy in the last three months

Question 20

What is the pathogenesis for Acute Otitis Media?

Eustachian tube in children is shorter and more horizontal thus interferes with the gravitational drainage of nasopharyngeal secretions.
Fever is a sole manifestation
It often complicate an acute viral upper respiratory tract infection
All of the above

Answer 20

All of the above

Question 21

Stridor is a harsh high pitch sound associated with upper airway obstruction . If the patient presents with an inspiratory stridor with a muffled voice , most likely the location is at.

Glottic
Infraglottic
Subglottic
Supraglottic

Answer 21

Supraglottic

Question 22

Titus, a 6 year old child, was brought to the hospital for fever of five days associated with hoarseness of voice , pain in swallowing and note of swelling and redness with mark swelling of the soft tissues in the neck area . Further digging up in the history revealed that the patient did not receive any primary immunization . You entertain that patient may have diphtheria laryngitis. One of the treatment modalities for the condition is to give this medication to help reduce the inflammation and obviate the need for tracheostomy.

Intravenous erythromycin
intravenous dexamethasone
antibiotic prophylaxis
intramuscular penicillin G

Answer 22

intravenous dexamethasone

Question 23

Dyno, a 4-year old male child was brought to the emergency room presenting with high grade fever , muffled voice , drooling in respiratory distress , with tongue thrust forward in an attempt to grasp for air . Diagnostic tests revealed cbc revealed leukocytosis with neutrophilia , lateral x-ray of the neck with thumb sign. One of the preventive measures that we need to emphasize is

Hib immunization for infants and children
avoid feeding in a recumbent position
avoid exposure to environmental irritants
none of the above

Answer 23

Hib immunization for infants and children

DX: EPIGLOTTITIS

Question 24

Viral croup is the most common infectious cause of upper airway obstruction in infants and young children caused by influenza virus 1 and 2 . Radiographic imaging for patient with this condition would usually reveal with what sign

Thumb sign
Clover sign
Thumb sign
Bird’s beak sign

Answer 24

STEEPLE SIGN

Question 25

Maya, a 6 months old infant was admitted for fast breathing with a history of cough for three days accompanied by fever and coryza with clear nasal discharge. There was also known as decreased milk intake and fair activity . Progression of symptoms prompted consultation at the emergency room and was subsequently advised admission . Physical examination revealed HR 146, RR 58cpm , O2 SAT 94% positive alar flaring with auscultatory finding of crackles with wheezes , with subcostal and intercostal retractions . Treatment measures needed for this patient are as follows except

Provide supplemental oxygen
admission to intensive care unit for close monitoring frequency
Suctioning of nasal and oral secretions
hydration and antibiotics if with established concomitant bacterial infection

Answer 25

admission to intensive care unit for close monitoring frequency

Question 26

Lido 6 year old child was admitted to the hospital after developing a cough of 4 days with associated fever and whitish nasal discharge , noted to have episodes of posttussive vomiting , fair appetite and activity and fast breathing prior to consultation . At the er his vital signs were as follows: temp 39C, HR 125, RR 48, O2 sat 91%. (May kamay)… flaring, dry lips, slightly sunken eyeballs , with crackles and subcostal and intercostal retraction (kamay)…seconds. Lito would be classified as what risk classification for pneumonia related mortality and what necessary diagnostic measure to request?

Non severe PCAP, request for CBC, chest xray only
Non severe PCAP, request for CBC, chest xray, ABG
PCAP C, request for CBC, chest xray , CRP, ABG
PCAP D, request for CBC, chest xray

Answer 26

PCAP C, request for CBC, chest xray , CRP, ABG

Question 27

The following are ancillary parameters that will determine the need for antibiotic treatment except:

Elevated WBC
Elevated procalcitonin
Bilateral infiltrates on chest x-ray
Blood culture with no growth after 48 hours

Answer 27

Blood culture with no growth after 48 hours

Question 28

Judy, 5 years old child was admitted at JR Borja Hospital-Critical Care Unit and managed as a case of Severe PCAP after being intubated upon admission and subsequently attached to the mechanical ventilator. Chest xray upon admission revealed bilateral infiltrates, initial antimicrobial given was ceftriaxone. However on 3rd hospital stay, a repeat chest xray was done after note of persistent episodes of fever, frequent episodes of desaturations, and tachypnea despite being mechanically ventilated with signs of poor perfusion as well. The repeat chest xray now showed consolidations on both lung fields, blood culture inital result revealed growth for MR + Staphylococcus spp. (Sensitive for meropenem, vancomycin, linezolid. Resistant for cephalosporins, amoxicillin, amikacin). With these recent changes in the signs and symptoms as well as chest xray findings of Judy, what antimicrobial agent should now be given for the patient?

Discontinue ceftriaxone and shift to cefepime
Continue with cetriaxone, disregard blood culture and sensitivity findings
Follow antimicrobials based on blood culture sensitivity. Give meropenem and vancomycin as add on to ceftriaxone.
Follow antimicrobials based on blood culture sensitivity. Give meropenem and vancomycin, discontinue ceftriaxone.

Answer 28

Follow antimicrobials based on blood culture sensitivity. Give meropenem and vancomycin, discontinue ceftriaxone.

Question 29

Which kind of atypical pneumonia would manifest with GI symptoms of abdominal discomfort and diarrhea?

Legionella pneumonia
Chlamydia pneumonia
Staphylococcal pneumonia
Mycoplasma pneumonia

Answer 29

Legionella pneumonia

Question 30

Pathogenesis of progressive Primary TB occurs in this setting:

When the immune system is weakened and fails to control the multiplication of TB
There is reactivation of dormant bacili in the Ghon focus or complexes
There is reinfection with M. tuberculosis and the apices of the lungs are most often affected
When inhalation of organism is not destroyed by the macrophages thus undergoing unrestrained replication

Answer 30

When the immune system is weakened and fails to control the multiplication of TB

Question 31

Belle, 6 years old female was worked up after having been exposed to her grandmother who was recently diagnosed for Pulmonary tuberculosis. She on the other hand showed no manifestations but came out positive for tuberculin skin test, showed normal chest findings, TB Gene Xpert showed no findings for M. tuberculosis. What spectrum of the disease does she belong?

TB exposure
TB infection
TB disease
TB new

Answer 31

TB infection

Question 32

In interpreting the Tuberculin skin test, an induration of 5mm is considered as the positive cut off size in this group if:

Children >/= 24 years old without any risk factors
Children with other medical conditions (Hodgkin disease, lymphoma, malnutrition, chronic renal failure)
Children exposed to adults with HIV infection, users of illicit drugs, residents of nursing homes
Children receiving immunosuppressive therapy or with immunosuppressive conditions such as HIV infection

Answer 32

Children receiving immunosuppressive therapy or with immunosuppressive conditions such as HIV infection

Question 33

One of the most serious complication of tuberculosis in children is TB meningitis. At what stage of TB meningies this presentation of lethargy, nuchal rigidity, seizures, hypertonia, presence of cranial nerve palsies?

3rd stage
2nd stage
3rd stage
4th stage

Answer 33

2nd stage

Question 34

Corticosteroid is a useful adjunct as treatment for this TB complication particularly when the host inflammatory response is contributing to tissue damage or is impairing function. What TB complication is this?

TB meningitis
TB pericarditis
TB pleural effusion
HIV negative patients

Answer 34

HIV negative patients

Question 35

In cases for Drug resistant TB, when there is resistance to Isoniazid and Rifampicin, duration of therapy must be extended for how long?

12 to 18 months
18 to 24 months
12 to 24 months
12 to 36 months

Answer 35

12 to 24 months

Question 36

en, 12 years old female, was admitted for cough of 2 weeks with afternoon fever for a week already. Upon further digging of the patient’s history, you were able to extract that she lives with her grandmother who was currently treated for Pulmonary TB and that she was also treated for Pulmonary TB 6 months ago. According to her mother they were able to give her medications for TB taken with good compliance. Knowing the patient’s history, you worked up the patient for Pulmonary TB, sputum culture revealed growth for M. tuberculosis. With these findings, how would you categorize Jen?

PTB, relapse
PTB, treatment after failure
PTB, treatment after lost to follow-up
PTB. previous treatment outcome unknown

Answer 36

PTB, treatment after failure

Question 37

You received a baby with Apgar score of 4,6,7 in respiratory distress with episodes of cyanosis and apnea, which you eventually intubated. Further digging in the patient’s history, mother was noted to have oligohydramnios prior delivery with decreased fetal movements. Physical examination revealed: breath sounds diminished on both sides, dull to percussion, with desaturations despite being hooked to a mechanical ventilator. Chest ray revealed small lung with mediastinal ipsilateral shift and compensatory hyperinflation. With these findings, what could be your working Impression?

Pulmonary aplasia
Tracheoesophageal fistula
Pulmonary sequestration
Congenital lobar emphysema

Answer 37

Pulmonary aplasia

Question 38

In the Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome, this is considered an Absolute contraindication in performing Adenotonsillectomy:

No adenotonsillar tissue
Submucus cleft palate
Morbid obesity and small tonsils or adenoid
Bleeding disorder refractory to

Answer 38

No adenotonsillar tissue

Question 39

Mark, 5 years old male was admitted beause of difficulty in breathing after having colds for 2 days later accompanied by cough. According to his mother he talks in words in order to communicate and is noted to be agitated. Further examination revealed the following auscultatory findings of wheezing with intercostal,’ subcostal and suprasternal retractions. You diagnosed this patient for Bronchial asthma in severe exacerbation. Management was given accordingly. however on the 2nd hospital stay, he suddenly complained of acute chest pain and shortness of breath with desaturations despite adequate oxygen supplementation. Chest PE findings of chest lagging on the right with diminished breath sounds On the same side. Repeat chest ray revealed findings for Pneumothorax. What initial management must you perform for this patient?

Open thoracotomy
Emergency needle thoracentesis
Closed tube thoracostomy
Supplemental 02 at high concentratio

Answer 39

Emergency needle thoracentesis
????

Question 40

Phillip, 10 months old infant was brought for consult for fever of 2 days, Tmax of 38.6C, no cough or colds, no abdominal pain, no vomiting or LBM. ile was however noted to be irritable and with episodes of banging his head. Pertinent PE revealed non-hyperemic tonsils, hyperemic and bulging tympanic membrane. What preventive measure would you advise to avoid such condition?

Give annual Flu vaccine starting 6 months old
Promote frequent swimming in the pool
Avoid feeding via recumbent position
Advise frequent cleaning of the ears

Answer 40

Avoid feeding via recumbent position

Question 41

Hemoglobin in the red blood cells carrying oxygen is designated as:

O2sat
PaO2
O2CT
PaCO2

Answer 41

O2sat

Question 42

One of the following is a cause of respiratory acidosis except:

Apnea
Pneumonia
Meconium aspiration
Respiratory arrest

Answer 42

Pneumonia

Question 43

One of the following is NOT an infection of the lower respiratory tract;

Viral Bronchitis
Bronchiolitis
Bacterial Pneumonia
Laryngotracheobronchitis

Answer 43

Laryngotracheobronchitis

Question 44

The most common infectious cause of upper airway obstruction in infants and children is

Bacterial tracheitis
Acute epiglottitis
Acute laryngotracheobronchitis
Membranous laryngotracheobronchitis

Answer 44

Acute laryngotracheobronchitis

Question 45

A 13-year old male complained of nasal congestion, headache, facial pain particularly on the forehead. The purulent discharge persisted for more than 2 weeks already. Your most likely diagnosis is

Common colds
Acute rhinitis
Acute sinusitis
Acute epiglottitis

Answer 45

Acute sinusitis

Question 46

. A 3 year old presents with fever, irritability, drooling and poor oral intake He refuses to move his neck. PE showed bulging of the pharyngeal wall. Your most likely diagnosis is.

Acute epiglottitis
Foreign body aspiration
Retropharyngeal abscess
Acute laryngotracheobronchitis

Answer 46

Retropharyngeal abscess

Question 47

The most common etiologic agent of Acute bronchiolitis is:

Influenza virus
Adenovirus
Metapneumovirus
Respiratory syncytial virus

Answer 47

Respiratory syncytial virus

Question 48

One of the following is TRUE about Bronchitis in children:

Majority of cases are viruses
The treatment is antibiotic
Chest xray findings show infiltrates
It is a chronic inflammatory process

Answer 48

Majority of cases are viruses

Question 49

A newborn presents with respiratory distress, choking, cyanosis due to persistent aspiration of pooled oral secretions. Chest xray showed coiling of the nasal catheter at the esophageal pouch. Your most likely diagnosis is:

Choanal atresia
Subglottic stenosis
Tracheoesophageal fistula
Vascular ring anomalies

Answer 49

Tracheoesophageal fistula

Question 50

A Primary Tuberculosis Disease consists of the following EXCEPT:

A. Primary focus
B. Lymphangitis
C. Lymphadenitis
D. Lymphadenopathy

Answer 50

D. Lymphadenopathy