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[OS 213] Respiratory E2 > Samplex 2017 > Flashcards

Flashcards in Samplex 2017 Deck (165)
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Function of respiratory system which is most reflected by PaO2 values:

a. ventilation
b. perfusion
c. body metabolism
d. gas exchange
e lung defense



Function of respiratory system most reflected by paCo2 values

a ventilation
b. perfusion
c. body metabolism
d. gas exchange
e. lung defense



what is the most common cause of hypoxemia?

a hypoventilation
b. shunt
c. v/q mismatch
d. diffusion defect
e. decrease inspired oxygen



the use of non invasive ventilation in respiratory failure associated with what disease entity has led to a decrease in mortality and length of hospital stay amongst patients with this disease process?

a. severe pneumonia
b. status asthmaticus
c. COPD in exacerbation
d. post operative respiratory failure



Which of the following is not a consideration to non-invasive ventilation

A. Acute respiratory failure
B. Hemodynamic instability
C. Severe agitation or uncooperability
D. obtunded or unresponsive patient
E. facial trauma



Which is not part of the berlin definition of acute respiratory distress syndrome?

A. respiratory failure within 1 week of a known clinical insult
B. Bilateral parenchymal opacities on chest radiographs that are not fully explained by effusion, lung collapse or nodules
C. Respiratory failure not fully explained by cardiac failure of fluid overload
D. paO2/FaO2 ratio of less than 300mmHg
E. Need for oxygen support of at least 51/min to maintain an O2 sat of 95%



According to the berline definition of Acute respiratory distress syndrome, which is severe ARDS?

A. PaO2/FI O2 of 200mmhg to 300mmhg
B. PaO2/FI O2 of 100 mmhg to 150 mmhg
C. PaO2/Fi O2 of 300 mmhg to 200 mmhg
D. PaO2/FI O2 of 100 mmhg or less
E. PaO2/FI O2 of 50 mmhg or less



Low tidal volume as a ventilatory strategy has been found to decrease mortality in ARDS by preventing inflammation in the lungs. This means the ventilator’s tidal volume should be set at?

A. 3 ml/kg
B. 4 ml/kg
C. 5ml/kg
D. 6ml/kg
E 7ml/kg



Respiratory strategies employed by infants who are hypoxemic?

a. decreasing tidal volume by the use of accessory muscles
b. slowing expiration through laryngeal narrowing during expiration or grunting
c. decreasing respiratory rate



True of persistent pulmonary hypertension

a. more of a cardiovascular rather than a pulmonary disease
b. characterized by elevated systemic hypertension
c. characterized by shunting of blood from the systemic circulation to pulmonary circulation through the foramen ovale or ductus arteriosus



True of meconium aspiration syndrome?

A. the pathophysiology includes pulmonary obstruction, surfactant inactivation and chemical pneumonitis
B. affects infants more often than term infacts
C. Is self-limiting and resolves within 24-48 hours
D. None of the above



True of cardiac causes of respiratory distress

A. Characterized by cyanosis
B. Characterized by left to right shunt causing pulmonary congestion
C. Hypoxia is reversed by the administration of oxygen
D. None of the above



True of Hyaline Membrane Disease

A. A disease of primary surfactant deficiency
B. Involves only preterm infants
C. Treated only by surfactant replacement therapy
D. None of the above



True of transient tachypnea of the newborn

A. A disease of primary surfactant deficiency
B. Involves only term infants
C. Self-limiting and resolves within 24-48 hours
D. None of the above



True of apnea

A. Defined as cessation of respiration for 10 seconds with or without desaturations or
B. Occurs more often among term infants compared to preterm infants
C. Is a manifestation among infants who may be hypoxemic as a result of a lung
D. None of the above



True of neonatal pneumonia

A. May be caused by bacteria, virus, protozoan or fungal agents
B. Affects both term and preterm infants with the same frequency
C. The x-ray may resemble HMD, TTN or meconium aspiration syndrome
D. None of the above



What is the most common way for microorganisms to gain access to the lower respiratory tract?

A. Inhalation of contaminated droplets
B. Aspiration from the oropharynx
C. Contiguous extension from an infected pleural or mediastinal space
D. Hematogenous spread
E. All of the above



Which of the following is NOT TRUE of lung defense?

A. The turbinates and nares form the first mechanical defense by filtering the inhaled air.
B. The mucociliary apparatus exists from the trachea to the lobar bronchus.
C. Normal flora are nonpathogenic bacteria that bind the mucosal cells.
D. Alveolar macrophages protect at the alveolar level.
E. Surfactant proteins A and B/D (not clear enough in pic) have antibacterial activity.



Which of the following medical illnesses affect host defenses?

A. diabetes mellitus
B. congestive heart failure
C. renal failure
D. A and B
E. All of the above



Which of the following is NOT TRUE of nonspecific URIs?

A. Has a median duration of 1 week
B. Common reason for physician consults
C. Majority are bacterial in origin
D. Diagnosis is made mostly on clinical grounds.
E. Antibiotics do not play a prominent role during treatment.



Which is TRUE of acute rhinosinusitis?

A. Most commonly involves the frontal sinuses
B. Most common bacterial causes (50-60%) are Haemophilus influenzae andStreptococcus pyogenes.
C. Characterized by pain over the sinus involved
D. Nasal steroids are indicated for treatment.
E. Antibiotics are indicated when there is no improvement after 3 days.



Which of the following is FALSE of etiologies of acute pharyngitis?

A. Majority of causes (30%) have an identifiable cause.
B. Rhinoviruses are the most common viral etiology.
C. Streptococcus pneumoniae is the most common bacterial etiology.
D. Formation of exudates, vesicles and ulcers are characteristic of rhinoviruses.
E. Exudative pharyngitis with generalized lymphadenopathy is characteristic of HSV.



Which of the following is FALSE of lung abscesses?

A. Aspiration from alcoholism is a common cause of lung abscesses.
B. Anaerobic bacteria are common organisms in immunocompromised hosts.
C. Pulmonary sequestration and infected bullae are differential diagnoses.
D. Clindamycin for 4-6 weeks is an effective treatment regimen.
E. Surgery is an option if there is refractory hemoptysis.



What is the most common cause of lung abscess?

A. Alcoholism
B. Bulbar dysfunction
C. Esophageal dysmotility
D. Aspiration
E. Seizure disorders



The major human receptor of Rhinovirus is

A. polymorphonuclear cells
B. intracellular adhesion molecules
C. macrophages
D. epithelial cells



The most common type of influenza circulating in the community and responsible for the occurrence of pandemic is

a. Type A
b. Type B
c. Type C
d. Type D



A 70 y/o male was admitted for fever, shaking chills, pleuritic chest pain, and productive cough of rusty sputum for six days. He was diagnosed to have pneumonia. Microscopic examination of the sputum showed numerous PMN’s with extracellular Gram-positive cocci in pairs. Further test showed catalase (-), alpha hemolytic colonies. What other test result will confirm the etiologic agents?

a. Coagulase positive
b. Lactase fermenter
c. Susceptibility to optochin
d. Novobiocin resistant



A 5y/o male was brought to the ER due to cyanosis. Hx revealed he had chronic cough of 3 weeks with characteristic paroxysmal attacks that terminates in a high pitched sound. This condition is clinically consistent with whooping cough. The most probable agent is best cultured in which media

a. Blood agar plate
b. Loeffer’s slant
c. Chocolate agar
d. Bordet Gengou agar



A3 y/o consulted the OPD due to cough and fever of 5 days. On PE, there was note of fast breathing and “noisy” lung fields. She was diagnosed to have community-acquired pneumonia. Immunization of this child was all done at the local health center. Lab work-up included demonstration of satellite phenomenon to observe the growth of Hemophilus influenzae. This test needs a organism streaked on blood agar plate to provide the V growth factor:

a. Streptococcus pneumoniae
b. Mycoplasma pneumoniae
c. Staphylococcus aureus
d. Bordetella pertussis



A 4 y/o child came in due to cough and throat pain associated with fever. She was given cough syrup by the mother with no relief. On PE, it was noted that her neck was slightly enlarged and the tonsillar wall had adherent whitish plaque. The child did not receive any immunization. If you suspect that lesion to be a pseudomembrane caused by diphtheria and decide to do further lab workup, what medium will you use to culture your throat swab?

a. Bordet Gengou agar
b. Blood agar plate
c. Lowenstein Jensen agar
d. Loeffler’s agar slant