Respiratory

Question 1

Common Cold/Upper Respiratory Tract Infection

Answer 1

Diagnosis: Based on patient symptoms, nasal discharge/sputum cultures, blood count
Treatment: Antibiotics, no cure, reset and drink plenty of fluids, vaporizer, OTC medications(decongestants, cough suppressants, analgesics)

Question 2

Sinusitis

Answer 2

Diagnosis: Physical exam, sinus radiography, CT scans, endoscopic sinuscopy, nasal secretion culture
Treatment: Saline nasal spray, corticosteroid nasal spray, antibiotics, oral corticosteroids, antihistamines, decongestants, sinustomy, analgesics

Question 3

Pharyngitis(Sore throat)

Answer 3

Diagnosis: Physical exam, located primary source of infection, sinus radiography, blood count
Treatment: Viral(home treatment using lozenges, mouthwashes, salt water, ice collar, anti-inflammatory medications), Acute Bacterial(Antibiotics), surgical excision, bed rest and fluids

Question 4

Nasopharygeal Carcinoma

Answer 4

Diagnosis: Full clinical examination of head and neck, endoscopic examinations of nasopharynx, biopsy of lesions, staging according to tnm, MRI, bone scan, CT, PET, scan
Treatment: Radiation therapy, chemotherapy, chemoradiotherapy, follow up

Question 5

Laryngitis

Answer 5

Diagnosis: Laryngoscopic examination for inflammation, further tests
Treatment: Palliative measures(voice rest, bed rest, humidity, fluid intake, no tobacco or alcohol, lozenges, antibiotics, corticosteroids, eliminate causative factors(chronic)

Question 6

Deviated Septum

Answer 6

Diagnosis: Examination with nasal speculum
Treatment: Surgical straightening, none is needed if it doesn’t compress air passages

Question 7

Nasal Polyps

Answer 7

Diagnosis: Visual exam using nasal speculum
Treatment: Surgery with local anesthetic, steroids

Question 8

Anosmia

Answer 8

Diagnosis: Physical exam, neurological diagnostic tests
Treatment: Aimed at cause of condition, injections of allergens for allergic rhinitus patients, nerve damage is not treatable

Question 9

Epistaxis(Nosebleed)

Answer 9

Diagnosis: Patient history, injury, or systemic disease
Treatment: Constant pressure on nose bridge for mild nosebleed, persistent(Epinephrine, cauterization, posterior nasal packing), mild sclerosis agents, surgical ligation

Question 10

Laryngeal Tumors

Answer 10

Diagnosis: Physical exam, biopsy
Treatment: Benign(Correction of vocal strain, reflux management, smoking cessation, excision with local anesthetic), Malignant(Radiation), Metastasis(Laryngectomy, Speech therapy)

Question 11

Laryngeal Cancer

Answer 11

Diagnosis: Flexible fiber optic endoscopy, biopsy, staging via TNM, CT, PET, MRI, Panendoscopy
Treatment: Radiation, surgery(partial/total laryngectomy, scopic laser resection), surgery, chemoradiotherapy, speech and swallowing therapy

Question 12

Hemoptysis

Answer 12

Diagnosis: Visual exam radiography to determine source of bleeding, coagulation studies, PPD skin test(for tuberculosis), lung scan, CT scan, pulmonary angiogram
Treatment: Treat source of bleeding, ligation/surgical removal or repair of vessel(severe), antibiotics and cough suppressant therapy(minor)

Question 13

Atelectasis

Answer 13

Diagnosis: Radiography, physical exam, CT scans, auscultation, bronchoscopy
Treatment: Ambulate soon as possible after surgery, breathe deeply and cough periodically, suction airway., antiobiotics, analgesics, surgical drainage

Question 14

Pulmonary Embolism

Answer 14

Diagnosis: Lung scan, CT angiography, pulmonary angiography, auscultation, arterial blood gas levels(reduced partial pressure of oxygen and carbon dioxide), residual thrombin in lower veins
Treatment: Maintain cardio pulmonary integrity, adequate ventilation and perfusion, oxygen therapy, anticoagulants(heparin, warfarin), thrombolytic drugs

Question 15

Pneumonia

Answer 15

Diagnosis: Physical exam, patient history, chest radiography, arterial blood gas tests, bronchoscopy, sputum and blood cultures
Treatment: Antibiotics, antifungals, antivirals, analgesics, oxygen therapy, bed rest, fluids, high calorie diet

Question 16

Pulmonary Abscesses

Answer 16

Diagnosis: Chest auscultation(decreased chest sounds), patient history(recent aspiration), radiography, blood an sputum cultures
Treatment: Antibiotics, surgical resection of abscess and portion of affected lung

Question 17

Legionellosis(Legionnaire’s Disease/Pontiac Fever)

Answer 17

Diagnosis: Physical exam, radiography, blood tests(elevated WBC, liver enzymes, erythrocytes, sedimentation rate), sputum and urine culture
Treatment: Antibiotic therapy started early, oxygen, antipyretics, antiemetics, analgesics

Question 18

Respiratory Syncytial Virus Pneumonia

Answer 18

Diagnosis: Physical exam, lavage of nasopharynx, examination of secretions for ESV, RSV produces giant syncytial cells in cultures
Treatment: Upper Respiratory(Self-limiting, antipyretics, antibiotics for otitis media), Lower Respiratory(Inhalation and oxygen therapy, hydration)

Question 19

Histoplasmosis

Answer 19

Diagnosis: Positive skin test result, blood serology (for specific bacteria), identification of fungus in pus, sputum and tissue, radiography
Treatment: Anti-fungal therapy, antifungal drugs, corticosteroids(severe)

Question 20

Influenza

Answer 20

Diagnosis: Throat culture(to isolate virus), sputum culture(for secondary and bacterial infections), leukopenia with relative leukocytosis
Treatment: Symptomatic, bed rest, fluids, light diet, antipyretics, analgesics, antiviral agents within 48 hours, Less Severe(Warm salt water, steam inhalation, cough syrups), antibiotics

Question 21

Bronchitis

Answer 21

Diagnosis: History, symptoms, radiography, pulmonary function tests, arterial blood gases, blood and sputum analysis
Treatment: Acute(Symptomatic, increased fluid, humidifier, bronchodilators, antibiotic), Chronic(Low flow oxygen therapy, postural drainage, percussion, aerosolized corticosteroids, giving up smoking, avoid colds

Question 22

Bronchiectasis

Answer 22

Diagnosis: Physical exam, history, radiography, CT, bronchoscopy, sputum culture, pulmonary function tests
Treatment: Antibiotics, bronchodilators, postural drainage, avoid environmental irritants, surgery

Question 23

Asthma

Answer 23

Treatment: Pharmacologic therapy with anti inflammatory drugs and bronchodilators, quick relief medications, long term medications, patient education

Question 24

Pulmonary Emphysema

Answer 24

Diagnosis: Clinical exam, patient history, pulmonary function tests(increased tidal volume and residual volume, decreased vital capacity, expert torimaneuver volumes), radiography(translucent appearing lungs,depressed or flattened diagram), blood gas(Decreased arterial oxygen, increased carbon dioxide)
Treatment: Supplemental oxygen(low concentrations), beta adrenergic sympathetomimetic drugs, inhaled corticosteroids, pulmonary rehabilitation, progressive exercise training, surgery

Question 25

Pneumoconiosis

Answer 25

Diagnosis: Physical exam, patient history, radiography, pulmonary function tests, arterial blood tests
Treatment: Symptomatic, bronchodilators, oxygen therapy, chest physical therapy to remove secretions, short term corticosteroids, lung transplantations, treat complications aggressively, cessation of smoking

Question 26

Pleurisy(Pleuritis)

Answer 26

Diagnosis: Physical exam, patient history, radiography, CT scans, thoracostomy
Treatment: Antibiotic therapy, analgesics, splinting of chest, deep breathing exercises, therapeutic thoracostomy

Question 27

Pneumothorax

Answer 27

Diagnosis: Radiography(air in pleural cavity), diminished breath sounds, sucking air sounds around wound site
Treatment: Place patient in Fowler’s or Semi-Fowler’s position, oxygen, occlusive dressings over sucking wound, thoracostomy, closed drainage system

Question 28

Hemothorax

Answer 28

Diagnosis: Diminished/absent breath sounds, chest wall movement unaffected side, radiography(blood in pleural space), blood tests(hemorrhage), arterial blood tests
Treatment: Similar to pneumothorax, thoracostomy, closed drainage, surgical intervention, monitor vital signs, blood loss replaced

Question 29

Pulmonary Tuberculosis

Answer 29

Diagnosis: Mantoux test, intradermal tests, radiography(waldorff lesions), bronchoscopy, sputum cultures, atypical pulmonary infiltrates with cavities
Treatment: Quarantined, latent(isoniazid for six to nine months), active(drug therapy with multiple anti-tuberculosis agents), drug resistant(treated more aggressively with various combinations of different medications

Question 30

Infectious Mononucleosis(Glandular Fever)

Answer 30

Diagnosis: Physical exam, patient history, blood smear, blood tests(bilirubin, EBV serology)
Treatment: Symptomatic, acute(bed rest, fluid intake, intravenous fluids for high fever, antipyretics

Question 31

Adult Respiratory Distress Syndrome(ARDS)

Answer 31

Diagnosis: Radiography(shows diffuse bilateral alveolar infiltration with normal cardiac silhouette), depending on cause
Treatment: Interventions are supportive, oxygenation with humidified oxygen, mechanical ventilation, nutritional status, hydration, monitor arterial blood gas, blood pressure, urine output

Question 32

Sarcoidosis

Answer 32

Diagnosis: Difficult to detect, physical exam, patient history, radiography of chest, lab tests, pulmonary function studies, biopsy of tissue
Treatments: Corticosteroids, immunosuppressive drugs to treat widespread diseases(disfiguring skin lesions, cardiac or central nervous system involvement), treatment not necessary when there are no symptoms or mild symptoms

Question 33

Lung Cancer

Answer 33

Diagnosis: Abnormal chest radiography, sputum serologic analysis(positive for malignant cells), tissue biopsy, bronchoscopy, mediastinoscopy, CT guided fine needled aspiration, CT scans, lab tests, staged using two staged systems
Treatment: Surgical resection, radiation, chemotherapy, lobectomy, pneumonectomy, palliative symptom control