Answer 35

35.  Choice B is the correct answer.  Singulair is a leukotrine inhibitor and a preventative medication for asthma and allergic rhinitis.  Ipatroprium can be used in asthma but is more helpful with COPD as a rescue medication.  Prednisone is also to be given for asthma attacks not prevention. Salmeterol is one of the medicines in advair.

Question 35

35.  Your patient is a 24 year old being seen in your office with a history of asthma.  He is on albuterol and advair.  He is still having a few times he has to use his rescue inhaler over the course of the week.  Which of the following medications would be appropriate to add to the patients medication as a preventative measure?

A.  Ipatroprium
B.  Singulair
C.  Salmeterol
D.  Prednisone

Answer 34

34.  Choice D is the correct answer.  Wegner's is a vasculitis that can cause lung nodules and hemoptysis as well as nose bleeds.  Superior vena cava syndrome is caused by impingement of the superior vena cava usually by a mass.  Pancoast syndrome is pain caused in the ulnar distribution of the upper extremity due to a tumor in the superior pulmonary sulcus impinging on that nerve.  Pulmonary emboli can be formed because cancer causes a hypercoagulable state and leads to venous thrombi and pulmonary emboli.

Question 34

34.  All of the following are complications of lung cancer except:

A.  Pancoast Syndrome
B.  Superior Vena Cava Syndrome
C.  Pulmonary Emboli
D.  Wegners

Answer 33

33.  Choice B is the correct answer.  Ipatroprium is an anti-cholingeric that is helpful in this instance for acute relief.  Salmeterol is a long acting beta agonist that is more of a maintenance medication.  Flovent is an inhaled glucocorticoid also a maintenance medication.  Cromolyn is an older medication that prevents mast cell degranulation used in prevention of asthma attacks.

Question 33

33.  Your patient is a 45 year old male that has a history of COPD.  He has been treated with albuterol aerosols and prednisone 60 mg PO.  He is still wheezing.  Which of the following medications would be most helpful in this situation?

A.  Salmeterol
B.  Ipatroprium
C.  Cromolyn
D.  Flovent

Answer 32

32.  Choice B is the correct answer.  Cipro provides the best coverage for pseudomonas.  Pseudomonas is typically resistant to augmentin, avelox, and zithromax.

Question 32

32.  Your patient is a 34 year old female that has a history of diabetes and is diagnosed with a right lower lobe pneumonia.  Sputum cultures are positive for pseudomonas.  Which of the following antibiotic regimens would be most appropriate?

A.  Augmentin

B.  Cipro

C.  Avelox

D.  Zithromax

Answer 31

31.  Choice B is the correct answer.  BiPAP has shown to be helpful with COPD exacerbations.  The patient is not exhibiting any respiratory failure.  He is just tachypneic with borderline hypoxemia.  This patient is not appropriate for discharge.  Theophylline drips are not used anymore because of lack of efficacy and potential side effects and toxicity.

Question 31

31.  Your patient is a 84 year old with COPD presents with respiratory distress and diffuse expiratory wheezes.  He has had 2 duoneb aerosols and solumedrol 125 mg IV.  His current vital signs are HR 122, RR 28, BP 136/78, SaO2 of 95%.   His ABG is as follows:  pH 7.35, PaCO2 48, HCO3 31, and PaO2 of 74 and Sat 94%.  Which of the following would be the best intervention in this situation?

A.  Discharge Home
B.  BiPAP
C.  Intubation and place on mechanical ventilation
D.  Start on theophylline drip