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Pulmonology Flashcards Master EL Husseiny’s Essentials of Pulmonology in just 2 hour

[qwiz style=”width: auto !important; min-height: auto !important; border-width: 4px !important; border-color: #0099cc !important; ” align=”center”]

[h] Pulmonology Flashcards

[i] Master EL Husseiny’s Essentials of Pulmonology in just 2 hour

[q] The main difference between Asthma and chronic obstructive pulmonary disease (COPD) is …..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFJldmVyc2liaWxpdHku[Qq]

[q] …. are the most common stimuli to cause asthma exacerbation?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFJlc3BpcmF0b3J5IGluZmVjdGlvbnMuIFN0dWRpZXMgaGF2ZSBkb2N1bWVudGVkIHRoYXQgdmlydXNlcyAocmVzcGlyYXRvcnkgc3luY3l0aWFsIHZpcnVzIGluIHlvdW5nIGNoaWxkcmVuLCByaGlub3ZpcnVzZXMgaW4gYWR1bHRzKSBhcmUgdGhlIG1ham9yIGNhdXNlcy4=[Qq]

[q] What is the best initial treatment?

Patient with history of asthma who experience acute exacerbation in response to exercise?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNob3J0LWFjdGluZyBiZXRhLWFkcmVuZXJnaWMgYWdvbmlzdHMgc3VjaCBhcyBhbGJ1dGVyb2wsIHVzZWQgMTAtMjAgbWludXRlcyBwcmlvciB0byBleGVyY2lzZSwgYXJlIHR5cGljYWxseSBzdWZmaWNpZW50IHRvIHByZXZlbnQgc3ltcHRvbXMuIFRoZXkgYXJlIGNvbnNpZGVyZWQgZmlyc3QtbGluZSB0aGVyYXB5IGlmIHVzZWQgb25seSBpbnRlcm1pdHRlbnRseSAobGVzcyB0aGFuIGRhaWx5KS4=

Cg==

QSBjb21iaW5hdGlvbiBvZiBiZXRhIGFnb25pc3RzIGFuZCBhbnRpbGV1a290cmllbmUgYWdlbnRzIG1heSBhbHNvIGJlIHVzZWQgaW4gaGlnaC1wZXJmb3JtYW5jZSBhdGhsZXRlcy4=[Qq]

[q] What is the best initial treatment?

Patient with history of asthma who experience acute exacerbation after having GERD?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFByb3Rvbi1wdW1wIGluaGliaXRvciAoUFBJKSB0aGVyYXB5IGhhcyBiZWVuIHNob3duIHRvIGltcHJvdmUgYm90aCBhc3RobWEgc3ltcHRvbXMgYW5kIHBlYWsgZXhwaXJhdG9yeSBmbG93IHJhdGUgaW4gYXN0aG1hIHBhdGllbnRzIHdpdGggZXZpZGVuY2Ugb2YgY29tb3JiaWQgR0VSRCwgYW5kIGEgUFBJIHRyaWFsIChlc29tZXByYXpvbGUpIHNob3VsZCBiZSBpbml0aWF0ZWQgaW4gdGhpcyBwYXRpZW50Lg==[Qq]

[q] Pathogenesis of Aspirin intolerant Asthma involves …….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFyYWNoaWRvbmljIGFjaWQgaXMgZGl2ZXJ0ZWQgdG8gdGhlIHByb2R1Y3Rpb24gb2YgcHJvaW5mbGFtbWF0b3J5IGxldWtvdHJpZW5lcyB2aWEgdGhlIDUtbGlwb3h5Z2VuYXNlIHBhdGh3YXku

Cg==

Cg==[Qq]

[q] What is the most accurate diagnostic test?

Patient presenting with dyspnea, tachypnea, prolonged expirations, respiratory wheezing?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFB1bG1vbmFyeSBmdW5jdGlvbiB0ZXN0aW5nIChQRlRzKS4gU3Bpcm9tZXRyeSB3aWxsIHNob3cgYSBkZWNyZWFzZSBpbiB0aGUgcmF0aW8gb2YgZm9yY2VkIGV4cGlyYXRvcnkgdm9sdW1lIGluIDEgc2Vjb25kIChGRVYxKSB0byBmb3JjZWQgdml0YWwgY2FwYWNpdHkgKEZWQykuIFRoZSBGRVYxIGRlY3JlYXNlcyBtb3JlIHRoYW4gdGhlIEZWQy4=[Qq]

[q] The best initial diagnostic test in an acute exacerbation of Asthma is …..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBlYWsgZXhwaXJhdG9yeSBmbG93IChQRUYpIG9yIGFydGVyaWFsIGJsb29kIGdhcyAoQUJHKQ==[Qq]

[q] ABG in patient with acute exacerbation of asthma will show ….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFJlc3BpcmF0b3J5IEFsa2Fsb3Npcy4=

Cg==

QWN1dGUgYXN0aG1hIGV4YWNlcmJhdGlvbiBjYXVzZXMgaW5jcmVhc2VkIHJlc3BpcmF0b3J5IGRyaXZlIGFuZCBoeXBlcnZlbnRpbGF0aW9uLCBsZWFkaW5nIHRvIGRlY3JlYXNlZCBwYXJ0aWFsIHByZXNzdXJlIG9mIGNhcmJvbiBkaW94aWRlIChQYUNPMiku

Cg==

SHlwZXJ2ZW50aWxhdGlvbiByZXN1bHRzIGluIGEgZGVjcmVhc2UgaW4gdGhlIFBhQ08yIGFuZCBhIHByaW1hcnkgcmVzcGlyYXRvcnkgYWxrYWxvc2lzLCB3aGljaCBpcyB0aGUgdHlwaWNhbCBwcmVzZW50YXRpb24gaW4gYW4gYWN1dGUgYXN0aG1hIGV4YWNlcmJhdGlvbi4=[Qq]

[q] Pulmonary Function Testing in Asthma patient will show ….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBGVHMgc2hvdyBhbiBvYnN0cnVjdGl2ZSBwYXR0ZXJuIHRoYXQgdHlwaWNhbGx5IHJldmVyc2VzIHdpdGggYnJvbmNob2RpbGF0aW9uOg==

Cg==

JiM4MjExOyBEZWNyZWFzZWQgRkVWMSBhbmQgZGVjcmVhc2VkIEZWQyB3aXRoIGEgZGVjcmVhc2VkIHJhdGlvIG9mIEZFVjEvRlZDLg==

Cg==

JiM4MjExOyBJbmNyZWFzZSBpbiBGRVYxIG9mIG1vcmUgdGhhbiAxMiUgYW5kIDIwMCBtTCB3aXRoIHRoZSB1c2Ugb2YgYWxidXRlcm9sLg==

[Qq]

– When the patient is asymptomatic, the most accurate test of reactive airway disease is a 20% decrease in FEV1 with the use of methacholine (provocative challenge test).

[q] The best initial treatment for patients with newly diagnosed asthma or intermittent asthma is ……?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFuIGFzLSBuZWVkZWQgc2hvcnQtYWN0aW5nIGJldGEtMiBhZ29uaXN0IChhbGJ1dGVyb2wpLg==

Cg==

Cg==[Qq]

[q] What is the best next step in management?

Asthmatic patient complaining in follow-up visit that his symptoms is not controlled with albuterol?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFkZCBhIGxvbmctdGVybSBjb250cm9sIGFnZW50IHRvIGEgU0FCQS4gTG93LWRvc2UgaW5oYWxlZCBjb3J0aWNvc3Rlcm9pZHMgKElDUykgYXJlIHRoZSBiZXN0IGluaXRpYWwgbG9uZy10ZXJtIGNvbnRyb2wgYWdlbnQu

Cg==

Cg==[Qq]

[q] The best initial therapy for acute asthma exacerbation is …..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE94eWdlbiBjb21iaW5lZCB3aXRoIGluaGFsZWQgc2hvcnQtYWN0aW5nIGJldGEgYWdvbmlzdHMgc3VjaCBhcyBhbGJ1dGVyb2wgYW5kIGEgYm9sdXMgb2Ygc3Rlcm9pZHMu

Cg==

SWYgdGhlIHBhdGllbnQgZG9lcyBub3QgcmVzcG9uZCB0byBveHlnZW4sIGFsYnV0ZXJvbCwgYW5kIHN0ZXJvaWRzIG9yIGRldmVsb3BzIHJlc3BpcmF0b3J5IGFjaWRvc2lzIChpbmNyZWFzZWQgcENPMiksIHRoZSBwYXRpZW50IG1heSBoYXZlIHRvIHVuZGVyZ28gZW5kb3RyYWNoZWFsIGludHViYXRpb24gZm9yIG1lY2hhbmljYWwgdmVudGlsYXRpb24uIFRoZXNlIHBhdGllbnRzIHNob3VsZCBiZSBwbGFjZWQgaW4gdGhlIGludGVuc2l2ZSBjYXJlIHVuaXQu[Qq]

[q] What is the best next step in management?

Asthmatic patient who use short-acting beta agonists inhaler for years complaining of muscle weakness, tremor, headache, palpitations, arrhythmias, and EKG changes?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE9idGFpbmluZyBhIHNlcnVtIGVsZWN0cm9seXRlIHBhbmVsIHdvdWxkIGJlIGhlbHBmdWwgdG8gY29uZmlybSBhbmQgYXNzZXNzIHRoZSBzZXZlcml0eSBvZiBwYXRpZW50JiM4MjE3O3MgaHlwb2thbGVtaWEu[Qq]

[q] An elevated or even normal PaCO2 in asthmatic patient with acute exacerbation suggests ……?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEluYWJpbGl0eSB0byBtZWV0IGluY3JlYXNlZCByZXNwaXJhdG9yeSBkZW1hbmRzIChsaWtlbHkgZHVlIHRvIHJlc3BpcmF0b3J5IG11c2NsZSBmYXRpZ3VlKSBhbmQgaW1wZW5kaW5nIHJlc3BpcmF0b3J5IGZhaWx1cmUuIEVuZG90cmFjaGVhbCBpbnR1YmF0aW9uIGFuZCBtZWNoYW5pY2FsIHZlbnRpbGF0aW9uIGFyZSBpbmRpY2F0ZWQgaW4gcGF0aWVudHMgd2l0aCBzZXZlcmUgYXN0aG1hIHVucmVzcG9uc2l2ZSB0byBtYXhpbWFsIG1lZGljYWwgdGhlcmFweSBhbmQgd2hvIGhhdmUgc2lnbnMgb2YgaW1wZW5kaW5nIHJlc3BpcmF0b3J5IGFycmVzdC4=[Qq]

[q] Theophylline has a narrow therapeutic index, and toxicity can occur from accumulation by reduced clearance or decreased metabolism. The most feared complication of theophylline toxicity are …..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENlbnRyYWwgbmVydm91cyBzeXN0ZW0gc3RpbXVsYXRpb24gKGhlYWRhY2hlLCBpbnNvbW5pYSwgc2VpenVyZXMpLCBhbmQgY2FyZGlhYyB0b3hpY2l0eSAoYXJyaHl0aG1pYSku[Qq]

[q] What is the most likely diagnosis?

Patient with history of heavy smocking presenting with shortness of breath worsened by exertion + Productive cough + expiratory wheezing + x-ray shows hyperinflated lung with flattened diaphragm + pulmonary function test shows o Decreased FEV1, decreased FVC, decreased FEV1/FVC ratio (˃ 70%).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENocm9uaWMgT2JzdHJ1Y3RpdmUgUHVsbW9uYXJ5IERpc2Vhc2Uu

Cg==

Cg==[Qq]

[q] Mention 3 findings can help distinguish between chronic bronchitis and emphysema:

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IDEuIFRoZSBkaWZmdXNpb24gY2FwYWNpdHkgb2YgdGhlIGx1bmcgZm9yIGNhcmJvbiBtb25veGlkZSAoRExDTykgd2hpY2ggbWVhc3VyZXMgZ2FzIGV4Y2hhbmdlIGJldHdlZW4gdGhlIGFsdmVvbGkgYW5kIHB1bG1vbmFyeSBjYXBpbGxhcnkgYmxvb2QsIHJlbWFpbnMgbm9ybWFsIGluIGNocm9uaWMgYnJvbmNoaXRpcyAoaW50YWN0IGFsdmVvbGFyIGFuZCBjYXBpbGxhcnkgc3RydWN0dXJlcyksIGJ1dCB0aGUgYWx2ZW9sYXIgZGVzdHJ1Y3Rpb24gdGhhdCBvY2N1cnMgaW4gZW1waHlzZW1hIHJlc3VsdHMgaW4gZGVjcmVhc2VkIERMQ08u

Cg==

Mi4gVGhlIGNoZXN0IHgtcmF5IGluIGNocm9uaWMgYnJvbmNoaXRpcyByZXZlYWxzIHByb21pbmVudCBicm9uY2hvdmFzY3VsYXIgbWFya2luZ3MgYW5kIGEgbWlsZGx5IGZsYXR0ZW5lZCBkaWFwaHJhZ20uIEluIGNvbnRyYXN0LCB0aGUgY2hlc3QgeC1yYXkgaW4gZW1waHlzZW1hIHJldmVhbHMgZGVjcmVhc2VkIHZhc2N1bGFyIG1hcmtpbmdzIGFuZCBoeXBlcmluZmxhdGVkIGx1bmdzLg==

Cg==

My4gUGF0aWVudHMgd2l0aCBwcmVkb21pbmFudCBjaHJvbmljIGJyb25jaGl0aXMgbWF5IGRlbW9uc3RyYXRlIG1vcmUgcHJvbm91bmNlZCBoeXBveGVtaWEgdGhhbiBwYXRpZW50cyB3aXRoIGVtcGh5c2VtYS4=[Qq]

[q] The only interventions which have been shown to decrease mortality in patients with COPD are …….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEhvbWUgb3h5Z2VuIGFuZCBzbW9raW5nIGNlc3NhdGlvbi4=[Qq]

[q] The criteria for initiating Long-term supplemental oxygen therapy (LTOT) in COPD patients include ……?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]

Cg==

UmVzdGluZyBhcnRlcmlhbCBveHlnZW4gdGVuc2lvbiAoUGFPMikg4omkNTUgbW0gSGcgb3IgcHVsc2Ugb3h5Z2VuIHNhdHVyYXRpb24gKFNhTzIpIOKJpDg4JSBvbiByb29tIGFpci4=

Cg==

UGFPMiAmbHQ7NjAgbW0gSGcgb3IgU2FPMiAmbHQ7OTAlIGluIHBhdGllbnRzIHdpdGggY29yIHB1bG1vbmFsZSwgZXZpZGVuY2Ugb2YgcmlnaHQgaGVhcnQgZmFpbHVyZSwgb3IgaGVtYXRvY3JpdCAmZ3Q7NTUlLg==[Qq]

[q] The management of acute episodes of increased shortness of breath in COPD patients is similar to the treatment of acute asthma exacerbations + ….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFudGliaW90aWNzIGJlY2F1c2UgYmFjdGVyaWFsIGluZmVjdGlvbiBpcyBieSBmYXIgdGhlIG1vc3QgY29tbW9ubHkgaWRlbnRpZmllZCBjYXVzZS4=

Cg==

QWxsIHBhdGllbnRzIHdpdGggYWN1dGUgZXhhY2VyYmF0aW9uIG9mIGNocm9uaWMgb2JzdHJ1Y3RpdmUgcHVsbW9uYXJ5IGRpc2Vhc2Ugc2hvdWxkIHJlY2VpdmUgaW5oYWxlZCBicm9uY2hvZGlsYXRvcnMgQjIgYWdvbmlzdHMgYW5kIGFudGljaG9saW5lcmdpY3MgYW5kIHN5c3RlbWljIGdsdWNvY29ydGljb2lkcy4gSW4gYWRkaXRpb24sIHN1cHBsZW1lbnRhbCBveHlnZW4sIGFudGliaW90aWNzLCBhbmQgdmVudGlsYXRvcnkgc3VwcG9ydCBzaG91bGQgYmUgYWRtaW5pc3RlcmVkIHdoZW4gaW5kaWNhdGVkLg==

Cg==

[Qq]

[q] In COPD, the diaphragmatic flattening and muscular shortening caused by hyperinflation result in ……?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IG1vcmUgZGlmZmljdWx0eSBpbiBkZWNyZWFzaW5nIGludHJhdGhvcmFjaWMgcHJlc3N1cmUgZHVyaW5nIGluc3BpcmF0aW9uIGFuZCB0aGVyZWZvcmUgaW5jcmVhc2UgdGhlIHdvcmsgb2YgYnJlYXRoaW5nLg==[Qq]

[q] What is the most likely diagnosis?

40 years old patient (not smoker) presenting with basilar predominate emphysema + unexplained elevated liver enzymes?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFscGhhLTEgYW50aXRyeXBzaW4gKEExQVQpIGRlZmljaWVuY3ku

Cg==

Cg==[Qq]

[q] What is the most likely diagnosis?

Patient who work in insulation presenting with dyspnea that worsen with exertion + digital clubbing + pulmonary function test shows  FEV1, FVC, TLC, and residual volume are decreased, FEV1/FVC ratio is normal + reduced diffusion capacity of carbon monoxide (DLCO) + CT shows honeycombing pattern?

P[c]IFNob3cgbWUgdG hlIGFuc3dlcg==

Cg==[Qq]

[f]IFBuZXVtb2Nvbmlvc2VzIChBc2Jlc3Rvc2lzKS4=

Cg==

Cg==[Qq]

[q] Obstructive lung disease can be due to intermittent cause like asthma or chronic cause like COPD. How to differentiate between both through DLCO?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IERMQ08gaXMgbm9ybWFsIGluIGFzdGhtYSwgYnV0IGRlY3JlYXNlZCBpbiBDT1BEIGR1ZSB0byBkZWNyZWFzZSBvZiB0aGUgc3VyZmFjZSBhcmVhLg==

Cg==

Cg==[Qq]

[q] Restrictive lung disease may be due to ILD or due to chest wall thickness. How to differentiate between them through DLCO?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IERMQ08gaXMgbm9ybWFsIGluIENoZXN0IHdhbGwgdGhpY2tuZXNzIGFuZCBkZWNyZWFzZWQgaW4gSUxELg==

Cg==

Cg==[Qq]

[q] What is the most likely diagnosis?

Farmer who is (Bird fancier, bird breeder) presenting with cough, dyspnea, fever and malaise?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEh5cGVyc2Vuc2l0aXZpdHkgcG5ldW1vbml0aXMgKEhQKS4=

Cg==

U3R1ZGllcyBoYXZlIHNob3duIHRoYXQgdGhlIGJlc3QgdHJlYXRtZW50IGZvciBIUCBpcyBhdm9pZGFuY2Ugb2YgYW50aWdlbiBleHBvc3VyZS4gSW4gbWFueSBwYXRpZW50cywgdGhpcyBwcm9kdWNlcyBjb21wbGV0ZSByZW1pc3Npb24u

Cg==

V2l0aCBjaHJvbmljIGV4cG9zdXJlLCBwYXRpZW50cyBtYXkgZGV2ZWxvcCBwdWxtb25hcnkgZmlicm9zaXMgYW5kIGEgcmVzdHJpY3RpdmUgcGF0dGVybiBvbiBsdW5nIHNwaXJvbWV0cnku[Qq]

[q] Asbestosis is associated with increase cancer risk like …..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]

Cg==

VGhlIG1vc3QgY29tbW9uIGNhbmNlciBhc3NvY2lhdGVkIHdpdGggYXNiZXN0b3NpcyBpcyBicm9uY2hvZ2VuaWMgY2FyY2lub21hIChhZGVub2NhcmNpbm9tYSBvciBzcXVhbW91cyBjZWxsIGNhcmNpbm9tYSku

Cg==

UGxldXJhbCBvciBwZXJpdG9uZWFsIG1lc290aGVsaW9tYXMgYXJlIGFsc28gYXNzb2NpYXRlZCB3aXRoIGFzYmVzdG9zIGV4cG9zdXJlIGJ1dCBhcmUgbm90IGEgY29tbW9uIGFzIGJyb25jaG9nZW5pYyBjYW5jZXIu[Qq]

[q] It is thought that silica may disrupt phagolysosomes and impair macrophages, increasing susceptibility to ….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRCLg==[Qq]

[q] What is the most likely diagnosis?

African American female with shortness of breath on exertion and occasional fine rales on lung exam + bilateral hilar adenopathy in chest X-ray + Bronchoalveolar lavage shows high CD4:CD8 ratio?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNhcmNvaWRvc2lzLg==[Qq]

[q] Cystic fibrosis patient presenting with Dyspnea and wheezing + Recurrent episodes of very high-volume purulent sputum production + high resolution CT shows abnormally dilated airways with tram track appearance?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEJyb25jaGllY3Rhc2lzLg==[Qq]

[q] The most common cause mortality in cystic fibrosis patient is …..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENocm9uaWMgbHVuZyBkaXNlYXNlLg==[Qq]

[q] The most common cause of pancreatic insufficiency in children is ….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEN5c3RpYyBmaWJyb3Npcy4=[Qq]

[q] The cause of infertility in cystic fibrosis male patient is …?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE9ic3RydWN0aXZlIGF6b29zcGVybWlhIGZyb20gY29uZ2VuaXRhbCBiaWxhdGVyYWwgYWJzZW5jZSBvZiB0aGUgdmFzIGRlZmVyZW5zLg==[Qq]

[q] The cause of infertility in cystic fibrosis female patient is …?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFdvbWVuIGFyZSBpbmZlcnRpbGUgYmVjYXVzZSBjaHJvbmljIGx1bmcgZGlzZWFzZSBhbHRlcnMgdGhlIG1lbnN0cnVhbCBjeWNsZSBhbmQgdGhpY2sgY2VydmljYWwgbXVjdXMgYmxvY2tzIHNwZXJtIGVudHJ5Lg==[Qq]

[q] The most accurate diagnostic test in cystic fibrosis patient is ….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFN3ZWF0IGNobG9yaWRlIHRlc3QuIFBpbG9jYXJwaW5lIGluY3JlYXNlcyBhY2V0eWxjaG9saW5lIGxldmVscyB3aGljaCBpbmNyZWFzZXMgc3dlYXQgcHJvZHVjdGlvbi4gQ2hsb3JpZGUgbGV2ZWxzIGluIHN3ZWF0IGFib3ZlIDYwIG1lcS9MIG9uIHJlcGVhdGVkIHRlc3RpbmcgZXN0YWJsaXNoZXMgdGhlIGRpYWdub3Npcy4=[Qq]

[q] The most common pathogen isolated from sputum cultures in infants and young children is ……?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFN0YXBoeWxvY29jY3VzIGF1cmV1cy4=

Cg==

Cg==[Qq]

[q] ….. is the most common cause of CF-related pneumonia in adults and contributes to life-threatening decline of pulmonary function?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBzZXVkb21vbmFzIGFlcnVnaW5vc2Eu

Cg==

Cg==[Qq]

[q] Symptomatic relief of polyps in cystic fibrosis patient with recurrent rhinosinusitis includes ……?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEludHJhbmFzYWwgZ2x1Y29jb3J0aWNvaWRzIGFuZCwgaW4gc29tZSBjYXNlcywgc3VyZ2ljYWwgcmVzZWN0aW9uLg==[Qq]

[q] What is the most likely diagnosis?

Patient presenting with dyspnea that worsen with exertion + sometimes he experiences syncope and chest pain + no history of cardiac and lung diseases + physical examination shows wide splitting of the second heart sound + chest X-ray shows widening of the proximal part of the pulmonary artery + Echocardiography shows systolic pulmonary hypertension 29 mmHg

?[c]IFNob3cgbWUgdG hlIGFuc3dlcg==

Cg==[Qq]

[f]IElkaW9wYXRoaWMgUHVsbW9uYXJ5IEh5cGVydGVuc2lvbi4=[Qq]

[q] Drugs available for treatment of pulmonary hypertension are:

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]

Cg==

UHJvc3RhY3ljbGluIGFuYWxvZ3VlcyAoUEEgdmFzb2RpbGF0b3JzKTogZXBvcHJvc3Rlbm9sLCB0cmVwcm9zdGluaWwsIGlsb3Byb3N0LCBiZXJhcHJvc3QsIG9yIHNlbGV4aXBhZy4=

Cg==

RW5kb3RoZWxpbiBhbnRhZ29uaXN0czogYm9zZW50YW4sIGFtYnJpc2VudGFuLg==

[Qq]

Phosphodiesterase inhibitors: sildenafil, tadalafil.

cGMP stimulators: riociguat.

[q] What is the most likely diagnosis?

40 years old male come with his sleep partner complaining from loud snoring during sleep + he wakes up alot from sleep due to difficulty in breathing + excessive daytime sleeping + chronic headache + loss of concentration and impaired memory?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE9ic3RydWN0aXZlIFNsZWVwIEFwbmVhLg==

Cg==

Cg==[Qq]

[q] The gold standard diagnostic test for Obstructive sleep apnea is ….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFdoZW4gT1NBIGlzIHN1c3BlY3RlZCwgbm9jdHVybmFsIHBvbHlzb21ub2dyYXBoeSBpcyB0aGUgZ29sZCBzdGFuZGFyZCBmb3IgZGlhZ25vc2lzLg==

Cg==

RXhwZXJpZW5jaW5nICZndDsxNSBvYnN0cnVjdGl2ZSByZXNwaXJhdG9yeSBldmVudHMgKGFwbmVhcyBvciBoeXBvcG5lYXMpIHBlciBob3VyIGlzIGRpYWdub3N0aWMgb2YgT1NBLg==

Cg==

VGhlcmUgYXJlIDIgdHlwZXMgb2YgYWJub3JtYWwgdmVudGlsYXRpb24gZHVyaW5nIHNsZWVwOg==
[Qq] Apnea (cessation of breathing for >10 seconds).
Hypopnea (reduced airflow causing SaO2 to decrease by > 4%).

[q] What is the most likely diagnosis?

Patient with history of acute pancreatitis 3 days ago presenting with severe respiratory distress with hypoxemia + chest x ray shows bilateral lung infiltrate + Swan Ganz catheter shows normal PCWP + PO2/FiO2 ratio 150?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFjdXRlIFJlc3BpcmF0b3J5IERpc3RyZXNzIFN5bmRyb21lLg==[Qq]

[q] Why mechanical ventilation setting in patient with ARDS include low tidal volume ventilation (LTVV) (6 mL/kg of ideal body weight)?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRvIGRlY3JlYXNlcyB0aGUgbGlrZWxpaG9vZCBvZiBvdmVyLWRpc3RlbmRpbmcgYWx2ZW9saSBhbmQgcHJvdm9raW5nIGJhcm90cmF1bWEgZHVlIHRvIGhpZ2ggcGxhdGVhdSBwcmVzc3VyZXMgKHByZXNzdXJlIGFwcGxpZWQgdG8gc21hbGwgYWlyd2F5cyBhbmQgYWx2ZW9saSku[Qq]

[q] Increasing positive end-expiratory pressure (PEEP) also improves oxygenation in ARDS patient by …..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBFRVAgcHJldmVudHMgYWx2ZW9sYXIgY29sbGFwc2UgZHVyaW5nIHJlc3BpcmF0b3J5IGN5Y2xlcyBhbmQgbWF5IGFsc28gcmVvcGVuIHNvbWUgYWx2ZW9saSB0aGF0IGhhdmUgYWxyZWFkeSBjb2xsYXBzZWQsIHJlZHVjaW5nIHNodW50aW5nLiBUaGVyZWZvcmUsIGluY3JlYXNpbmcgUEVFUCB3b3VsZCBub3Qgb25seSBpbXByb3ZlIG94eWdlbmF0aW9uIGJ1dCBhbHNvIGRpcmVjdGx5IGNvdW50ZXJhY3Qgb25lIG9mIHRoZSBtZWNoYW5pc21zIGJ5IHdoaWNoIEFSRFMgY2F1c2VzIGh5cG94ZW1pYS4=[Qq]

[q] The most important complication of mechanical ventilation are ….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBuZXVtb3Rob3JheCBhbmQgYWN1dGUgY2lyY3VsYXRvcnkgZmFpbHVyZSBhbmQgc3VkZGVuIGNhcmRpYWMgZGVhdGggKFNDRCkgaW4gaHlwb3RlbnNpdmUgb3IgaHlwb3ZvbGVtaWMgcGF0aWVudHMu

Cg==

RGVsaXZlcnkgb2YgcG9zaXRpdmUgcHJlc3N1cmUgdmVudGlsYXRpb24gdG8gc3VjaCBwYXRpZW50cyBjYW4gcnVwdHVyZSB0aGUgZnJhZ2lsZSBsdW5nIHBhcmVuY2h5bWEsIHJlc3VsdGluZyBpbiBhaXIgbGVha2FnZSBpbnRvIHRoZSBwbGV1cmFsIHNwYWNlLiBQbmV1bW90aG9yYXggbWF5IHJlc3VsdCwgd2hpY2ggY2FuIGNhdXNlIGFic2VudCBicmVhdGggc291bmRzIG9uIHRoZSBhZmZlY3RlZCBzaWRlIGFuZCBsZWFkIHRvIGNvbXByZXNzaW9uIG9mIHN0cnVjdHVyZXMgaW4gdGhlIG1lZGlhc3RpbnVtIGFuZCBpbXBhaXJlZCByaWdodCB2ZW50cmljdWxhciBmaWxsaW5nLCByZXN1bHRpbmcgaW4gaHlwb3RlbnNpb24gYW5kIHRhY2h5Y2FyZGlhLg==

Cg==

UG9zaXRpdmUgcHJlc3N1cmUgbWVjaGFuaWNhbCB2ZW50aWxhdGlvbiBjYXVzZXMgYW4gYWN1dGUgaW5jcmVhc2UgaW4gaW50cmF0aG9yYWNpYyBwcmVzc3VyZSwgd2hpY2gsIGluIGEgc2V2ZXJlbHkgaHlwb3ZvbGVtaWMgcGF0aWVudCB3aXRoIGxvdyBjZW50cmFsIHZlbm91cyBwcmVzc3VyZSwgY2FuIGNvbGxhcHNlIHZlbm91cyBjYXBhY2l0YW5jZSB2ZXNzZWxzIChpbmZlcmlvciB2ZW5hIGNhdmEpIGFuZCBjdXQgb2ZmIHZlbm91cyByZXR1cm4uIFRoaXMgc3VkZGVuIGxvc3Mgb2YgcmlnaHQgdmVudHJpY3VsYXIgcHJlbG9hZCBjYW4gY2F1c2UgYWN1dGUgY2lyY3VsYXRvcnkgZmFpbHVyZSBhbmQgc3VkZGVuIGNhcmRpYWMgZGVhdGggKFNDRCku[Qq]

[q] What is the most likely diagnosis?

Patient presenting with acute-onset dyspnea, pleuritic chest pain, Tachypnea and tachycardia + chest x-ray is normal + ABG shows hypoxia and respiratory alkalosis + ECG shows sinus tachycardia + history of DVT?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFB1bG1vbmFyeSBlbWJvbGlzbSAoUEUpLg==[Qq]

[q] What is the best next step if the patient is likely to have pulmonary embolism?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoZSBzcGlyYWwgQ1QgaGFzIGJlY29tZSB0aGUgc3RhbmRhcmQgb2YgY2FyZSBpbiB0ZXJtcyBvZiBkaWFnbm9zdGljIHRlc3RpbmcgdG8gY29uZmlybSB0aGUgcHJlc2VuY2Ugb2YgYSBQRS4=

Cg==

Cg==

[Qq]

[q] What is the best next step if the patient is unlikely to have pulmonary embolism?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEQtZGltZXIgaXMgdGhlIGFuc3dlciB3aGVuIHRoZSBwcmV0ZXN0IHByb2JhYmlsaXR5IG9mIFBFIGlzIGxvdyBhbmQgeW91IG5lZWQgYSBzaW1wbGUsIG5vbmludmFzaXZlIHRlc3QgdG8gZXhjbHVkZSB0aHJvbWJvZW1ib2xpYyBkaXNlYXNlLg==[Qq]

[q] What is the best next step in treatment of the patient who is likely to have pulmonary embolism?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEdpdmUgb3h5Z2VuIGFuZCBzdGFydCBMTVdIIGltbWVkaWF0ZWx5IGJlZm9yZSB0aGUgZGlhZ25vc2lzIGlzIGNvbmZpcm1lZCBhbmQgd2hpbGUgdGhlIGRpYWdub3N0aWMgd29ya3VwIGlzIGJlaW5nIGNvbXBsZXRlZC4gT25jZSB0aGUgZGlhZ25vc2lzIGlzIGNvbmZpcm1lZCAmIzgyMTE7Jmd0OyBXYXJmYXJpbjogc2hvdWxkIGJlIHN0YXJ0ZWQgd2l0aCBoZXBhcmluIGFuZCBjb250aW51ZWQgZm9yIDYgbW9udGhzIGZvciBib3RoIHB1bG1vbmFyeSBlbWJvbGkgYW5kIERWVC4=[Qq]

[q] Antidote of heparin in case of toxicity is …..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFByb3RhbWluZSBzdWxmYXRlICYjODIxMTsmZ3Q7IGNoZW1pY2FsIGluYWN0aXZhdGlvbi4=[Qq]

[q] What is the best next step in management?

Patient presenting with thrombocytopenia 5 days after using heparin as anticoagulant for DVT?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFN0b3AgYW55IHR5cGUgb2YgaGVwYXJpbiBhbmQgZ2l2ZSBkaXJlY3QgdGhyb21iaW4gaW5oaWJpdG9yIChBcmdhdHJvYmFuKS4=

Cg==

SGVwYXJpbi1pbmR1Y2VkIHRocm9tYm9jeXRvcGVuaWEgKEhJVCk6IGRldmVsb3BtZW50IG9mIElnRyBhbnRpYm9kaWVzIGFnYWluc3QgaGVwYXJpbi1ib3VuZCBwbGF0ZWxldCBmYWN0b3IgNCAoUEY0KS4gQW50aWJvZHktaGVwYXJpbi1QRjQgY29tcGxleCBhY3RpdmF0ZXMgcGxhdGVsZXRzICYjODIxMTsmZ3Q7IHRocm9tYm9zaXMgYW5kIHRocm9tYm9jeXRvcGVuaWEu

Cg==

[Qq]

[q] What is the most likely diagnosis?

Patient presenting with diffuse skin necrosis after using warfarin as anticoagulant for DVT?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]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[Qq]

[q] In case of renal failure, which type of heparin you will use?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFVuZnJhY3Rpb25hdGVkIGhlcGFyaW4gaXMgcmVjb21tZW5kZWQgaW4gcGF0aWVudHMgd2l0aCBkZWNyZWFzZWQgZXN0aW1hdGVkIGdsb21lcnVsYXIgZmlsdHJhdGlvbiByYXRlIGFzIGl0IGlzIG1vcmUgY29udmVuaWVudCB0byBtb25pdG9yIGl0cyB0aGVyYXBldXRpYyBsZXZlbCB2aWEgYWN0aXZhdGVkIHBhcnRpYWwgdGhyb21ib3BsYXN0aW4gdGltZSAoYVBUVCkuIE9uY2UgdGhlIGhlcGFyaW4gcHJvZHVjZXMgdGhlcmFwZXV0aWMgYW50aWNvYWd1bGF0aW9uIChnb2FsIFBUVCAmZ3Q7MS41LTIgdGltZXMgbm9ybWFsKSwgd2FyZmFyaW4gaXMgaW5pdGlhdGVkLg==[Qq]

[q] When are thrombolytic is the right answer in case of pulmonary embolism?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRocm9tYm9seXRpY3MgKHRQQSwgc3RyZXB0b2tpbmFzZSkgYXJlIG5vdCB1c2VkIHJvdXRpbmVseSBpbiBwdWxtb25hcnkgZW1ib2xpc20gYW5kIHNob3VsZCBiZSByZXNlcnZlZCBmb3I6

Cg==

MS4gUGF0aWVudHMgdGhhdCBiZWNvbWUgaGVtb2R5bmFtaWNhbGx5IHVuc3RhYmxlIChoeXBvdGVuc2lvbiBbc3lzdG9saWMgQlAgJmx0OzkwXSBhbmQgdGFjaHljYXJkaWEpLg==

Cg==

Mi4gQWN1dGUgUlYgZHlzZnVuY3Rpb24u[Qq]

[q] When is an inferior vena cava (IVC) filter the right answer in pulmonary embolism?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]

Cg==

Q29udHJhaW5kaWNhdGlvbiB0byB0aGUgdXNlIG9mIGFudGljb2FndWxhbnRzIChtZWxlbmEsIENOUyBibGVlZGluZyku

Cg==

UmVjdXJyZW50IGVtYm9saSB3aGlsZSBvbiBhIE5PQUMgb3IgZnVsbHkgdGhlcmFwZXV0aWMgd2FyZmFyaW4gKElOUiBvZiAyLTMpLg==

[Qq]

Right ventricular (RV) dysfunction with an enlarged RV on echo. In this case, disease is so severe that an IVC filter is placed because the next embolus, even if seemingly small, could be potentially fatal.

[q] When are direct-acting thrombin inhibitors (argatroban) the answer?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEluIGhlcGFyaW4taW5kdWNlZCB0aHJvbWJvY3l0b3BlbmlhIChISVQpLg==[Qq]

[q] Causes of hypoxemia with normal A-a gradient are ……?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEhpZ2ggYWx0aXR1ZGUgYW5kIGh5cG92ZW50aWxhdGlvbiBhcmUgdGhlIHR3byBjYXVzZXMgb2YgaHlwb3hlbWlhIHRoYXQgb3JpZ2luYXRlIGZyb20gYSBsb3cgYWx2ZW9sYXIgUE8yIGFuZCBib3RoIG9mIHRoZW0gaGF2ZSBhIG5vcm1hbCBBLWEgZ3JhZGllbnQu

Cg==

[Qq]

[q] Pneumonia causes hypoxemia with high A-a gradient due to …..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBuZXVtb25pYSBjYXVzZXMgaHlwb3hlbWlhIGR1ZSB0byByaWdodC10by1sZWZ0IGludHJhcHVsbW9uYXJ5IHNodW50aW5nIGFuZCBhbiBleHRyZW1lIHZlbnRpbGF0aW9uL3BlcmZ1c2lvbiBtaXNtYXRjaC4gSW5jcmVhc2VkIGNvbmNlbnRyYXRpb24gb2YgaW5zcGlyZWQgb3h5Z2VuIGRvZXMgbm90IGNvcnJlY3QgaHlwb3hlbWlhIGNhdXNlZCBieSBpbnRyYXB1bG1vbmFyeSBzaHVudGluZy4=

Cg==

[Qq]

[q] Pulmonary embolism causes hypoxemia with high A-a gradient due to …..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEEgc2lnbmlmaWNhbnQgcHVsbW9uYXJ5IGVtYm9saXNtIGNhdXNlcyBhbiBhY3V0ZSBwdWxtb25hcnkgVi9RIGltYmFsYW5jZSwgd2hpY2ggcmVzdWx0cyBpbiBoeXBveGVtaWEuIFRoZSBoeXBveGVtaWEgbGVhZHMgdG8gaHlwZXJ2ZW50aWxhdGlvbiBhbmQgcmVzcGlyYXRvcnkgYWxrYWxvc2lzLiBBbiBlbGV2YXRlZCBhbHZlb2xhci0gYXJ0ZXJpYWwgb3h5Z2VuIGdyYWRpZW50IGlzIGNvbW1vbmx5IHNlZW4gaW4gcGF0aWVudHMgd2l0aCBQRS4=

Cg==

Cg==[Qq]

[q] What is the most likely diagnosis?

Patient with chronic cough (lasting >8 weeks) tell you that he experiences elimination of nasal discharge and cough with the use of H1 histamine receptor antagonists?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFVwcGVyIGFpcndheSBjb3VnaCBzeW5kcm9tZS4=[Qq]

[q] What is the most likely diagnosis?

Patient with chronic cough (lasting >8 weeks) that relieve with the use of PPI?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEdFUkQu

Cg==

Cg==[Qq]

[q] The initial criteria for extubation readiness include?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]

Cg==

cEggJmd0OzcuMjUu

Cg==

QWRlcXVhdGUgb3h5Z2VuYXRpb24gb24gbWluaW1hbCBzdXBwb3J0IChmcmFjdGlvbiBvZiBpbnNwaXJlZCBveHlnZW4gW0ZpTzIgJmx0OzQwJSBhbmQgcG9zaXRpdmUgZW5kLSBleHBpcmF0b3J5IHByZXNzdXJlIFtQRUVQXSAmbHQ7NSBtbSBIZyku

[Qq]

Intact inspiratory effort and sufficient mental alertness to protect the airway.

[q] Because there is short-term risk of recurrent respiratory failure requiring reintubation, most patients who meet the above criteria should undergo ….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNwb250YW5lb3VzIGJyZWF0aGluZyB0cmlhbCAoU0JUKSB0byBoZWxwIGNvbmZpcm0gcmVhZGluZXNzIGZvciBleHR1YmF0aW9uLg==[Qq]

[q] What is the most likely diagnosis?

Patient presenting with cough lasting >5 days after upper respiratory viral infection with mild dyspnea and chest wall discomfort + normal chest x-ray?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFjdXRlIEJyb25jaGl0aXMuIFRoZSBpbGxuZXNzIGlzIHNlbGYtbGltaXRpbmcgKGFsdGhvdWdoIGNvdWdoIGFuZCBhaXJ3YXkgaHlwZXJzZW5zaXRpdml0eSBtYXkgcGVyc2lzdCBmb3Igd2Vla3MpLCBhbmQgb25seSBzeW1wdG9tYXRpYyB0cmVhdG1lbnQgKG5vbnByZXNjcmlwdGlvbiBwYWluIHJlbGlldmVycykgaXMgaW5kaWNhdGVkLg==[Qq]

[q] What is the most likely diagnosis?

Patient presenting with fever, cough, chest pain, and foul-smelling sputum + Chest x-ray show a thick-walled cavitary lesion with air fluid level?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEx1bmcgQWJzY2Vzcy4gSW4gdGhlIGFic2VuY2Ugb2Ygc3BlY2lmaWMgbWljcm9iaW9sb2dpYyBkaWFnbm9zaXMsIGNsaW5kYW15Y2luIGlzIGdvb2QgZW1waXJpYyBjb3ZlcmFnZSBmb3IgdGhlIOKAnGFib3ZlIHRoZSBkaWFwaHJhZ23igJ0gYW5hZXJvYmVzIG1vc3Qgb2Z0ZW4gZm91bmQu[Qq]

[q] What is the most likely diagnosis?

Patient presenting with fever, productive cough with rusty sputum production, dyspnea, pleuritic chest pain + chest x-ray shows lobar pneumonia with parapneumonic pleural effusion?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IExvYmFyIHBuZXVtb25pYS4=[Qq]

[q] What is the most likely diagnosis?

Patient presenting with high-grade fever (>39), gastrointestinal symptoms (diarrhea), and neurologic symptoms (confusion) + Hyponatremia + chest x-ray shows bilateral interstitial infiltrate + sputum Gram stain showing many neutrophils but no organisms?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IExlZ2lvbmVsbGEgcG5ldW1vbmlhLiBVcmluZSBhbnRpZ2VuIHRlc3RpbmcgaXMgcmFwaWRseSBhdmFpbGFibGUsIGhpZ2hseSBzcGVjaWZpYywgYW5kIHRoZSBtb3N0IGNvbW1vbiBtZXRob2QgdG8gY29uZmlybSB0aGUgZGlhZ25vc2lzLg==[Qq]

[q] What is the most likely diagnosis?

Patient presenting with low grade fever, nonproductive cough, mild dyspnea, chest x-ray shows bilateral interstitial infiltrate?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEF0eXBpY2FsIHBuZXVtb25pYS4=[Qq]

[q] – The most common cause of community-acquired pneumonia in all groups is ……., while Hospital- acquired or ventilator-associated pneumonia shows a predominance of …….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoZSBtb3N0IGNvbW1vbiBjYXVzZSBvZiBjb21tdW5pdHktYWNxdWlyZWQgcG5ldW1vbmlhIGluIGFsbCBncm91cHMgaXMgUy4gcG5ldW1vbmlhZSAoaG93ZXZlciwgdmlydXNlcyBhcmUgdGhlIG1vc3QgY29tbW9uIGNhdXNlIGluIGNoaWxkcmVuIGFnZSAmbHQ7NSku

Cg==

VGhvc2UgcGF0aWVudHMgd2hvIGRldmVsb3AgcG5ldW1vbmlhIGFmdGVyIDUtNyBkYXlzIGluIHRoZSBob3NwaXRhbCBhcmUgYXQgaW5jcmVhc2VkIHJpc2sgb2YgaW5mZWN0aW9uIGZyb20gZHJ1Zy1yZXNpc3RhbnQsIEdyYW0tbmVnYXRpdmUgYmFjaWxsaSAoUHNldWRvbW9uYXMsIEtsZWJzaWVsbGEsIEUuIGNvbGksIGV0Yy4pIG9yIGdyYW0tcG9zaXRpdmUgY29jY2kgc3VjaCBhcyBtZXRoaWNpbGxpbi1yZXNpc3RhbnQgU3RhcGh5bG9jb2NjdXMgYXVyZXVzIChNUlNBKS4=[Qq]

[q] Patients with CAP are often risk stratified using …… to help guide treatment and treatment location (home, medical floor, intensive care unit) decisions?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoZSBwbmV1bW9uaWEgc2V2ZXJpdHkgaW5kZXggb3IgQ1VSQi02NSBjcml0ZXJpYS4=

Cg==

Cg==

[Qq]

[q] Empiric therapy of hospital-acquired pneumonia is with ……?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoaXJkIGdlbmVyYXRpb24gY2VwaGFsb3Nwb3JpbnMgd2l0aCBhbnRpcHNldWRvbW9uYWwgYWN0aXZpdHkgKHN1Y2ggYXMgY2VmdGF6aWRpbWUpIG9yIGNhcmJhcGVuZW1zIChzdWNoIGFzIGltaXBlbmVtKSBvciB3aXRoIGJldGEtbGFjdGFtL2JldGEtbGFjdGFtYXNlIGluaGliaXRvciBjb21iaW5hdGlvbnMgKHN1Y2ggYXMgcGlwZXJhY2lsbGluL3Rhem9iYWN0YW0pIGFuZCBjb3ZlcmFnZSBmb3IgTVJTQSB3aXRoIHZhbmNvbXljaW4gb3IgbGluZXpvbGlkLg==[Qq]

[q] Positional changes that make the consolidation more gravity dependent ……… ventilation/perfusion mismatch?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFBvc2l0aW9uYWwgY2hhbmdlcyB0aGF0IG1ha2UgdGhlIGNvbnNvbGlkYXRpb24gbW9yZSBncmF2aXR5IGRlcGVuZGVudCB3b3JzZW4gdmVudGlsYXRpb24vcGVyZnVzaW9uIG1pc21hdGNoLCBpbmNyZWFzZSBpbnRyYXB1bG1vbmFyeSBzaHVudGluZywgYW5kIGxlYWQgdG8gd29yc2VuZWQgaHlwb3hlbWlhLg==

Cg==

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

Cg==

[Qq]

[q] In case of aspiration pneumonia, the most dependent area of the lung to be involved in the supine position is …….., and in erect position is …..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEluIHRoZSBzdXBpbmUgcG9zaXRpb24gdGhlIHBvc3RlcmlvciBzZWdtZW50cyBvZiB0aGUgdXBwZXIgbG9iZXMgYW5kIHN1cGVyaW9yIHNlZ21lbnRzIG9mIHRoZSBsb3dlciBsb2JlcyBhcmUgbW9zdCBhZmZlY3RlZCwgd2hlcmVhcyBpbiBlcmVjdCBwYXRpZW50cyB0aGUgYmFzZXMgb2YgdGhlIGxvd2VyIGxvYmVzIGFyZSBtb3N0IGFmZmVjdGVkLiBBc3BpcmF0aW9uIG9mIHRoZSBhYnNjZXNzIGZsdWlkIGlzIG5lY2Vzc2FyeSBmb3IgYSBzcGVjaWZpYyBiYWN0ZXJpb2xvZ2ljIGRpYWdub3Npcy4=

Cg==

Cg==[Qq]

[q] What is the most likely diagnosis?

45 years old immigrant presenting with fever, cough, productive sputum, weight loss and night sweats + chest x-ray shows apical cavitation and calcified nodules + Sputum examination is positive for  acid-fast bacilli (AFB) + patient started tumor necrosis alpha inhibitor and corticosteroid for rheumatoid arthritis 2 months ago?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFB1bG1vbmFyeSBUdWJlcmN1bG9zaXMu[Qq]

[q] Initial therapy of TB before the results of sensitivity testing are known consists of ……?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]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[Qq]

[q] The only forms of TB that definitely must be treated for longer than 6 months are ……?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRCIG1lbmluZ2l0aXMgKDEyIG1vbnRocykgYW5kIFRCIGluIHByZWduYW5jeSAoOSBtb250aHMpLg==[Qq]

[q]  ……. should generally be combined with vitamin B6 (pyridoxine) to prevent peripheral neuropathy?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IElOSC1pbmR1Y2VkIHBlcmlwaGVyYWwgbmV1cm9wYXRoeSBpcyBjYXVzZWQgYnkgcHlyaWRveGluZSAodml0YW1pbiBCNikgZGVmaWNpZW5jeS4gSU5IIGJpbmRzIHRoZSBhY3RpdmUgZm9ybSBvZiBweXJpZG94aW5lLCByZXN1bHRpbmcgaW4gcmVuYWwgZXhjcmV0aW9uLiBNb3N0IHBhdGllbnRzIGhhdmUgbGFyZ2UgZW5vdWdoIHN0b3JlcyBvZiBweXJpZG94aW5lIHRvIHRvbGVyYXRlIGluY3JlYXNlZCBleGNyZXRpb247IGhvd2V2ZXIsIHRob3NlIHdpdGggbWFsbm91cmlzaG1lbnQsIHByZWduYW5jeSwgb3IgY2VydGFpbiBjb21vcmJpZCBpbGxuZXNzZXMgKGRpYWJldGVzIG1lbGxpdHVzKSBtYXkgZGV2ZWxvcCBhIGRlZmljaWVuY3ku[Qq]

[q] …… is associated with causing a benign change in the color of all bodily fluids to orange/red (Rifampin → Red/orange body fluids)?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFJpZmFtcGluLg==[Qq]

[q] ….. is associated with optic neuritis, which can cause color blindness and other visual disturbances?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEV0aGFtYnV0b2wg4oCcRXlldGhhbWJ1dG9s4oCdLg==[Qq]

[q] The first step in evaluation of solitary pulmonary nodules is to …..?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE9idGFpbiBhbnkgcHJldmlvdXMgcmFkaW9ncmFwaGljIGx1bmcgaW1hZ2VzIHRvIGNvbXBhcmUgdGhlIHNpemUgd2l0aCBvbGQgeC0gcmF5cy4gQWJzZW5jZSBvZiBncm93dGggb3ZlciAyLTMgeWVhcnMgcnVsZXMgb3V0IG1hbGlnbmFuY3ku[Qq]

[q] If previous films are not available, …. should be performed to further characterize the lesion?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENULiBDVCBzY2FuIGlzIG1vcmUgc2Vuc2l0aXZlIHRoYW4gY2hlc3QgeC1yYXkgdG8gaWRlbnRpZnkgdGhlc2UgZmVhdHVyZXMgYW5kIGFsc28gY2FuIGRldGVjdCBvdGhlciBzbWFsbCBub2R1bGVzIHRoYXQgbWF5IHJlcHJlc2VudCBtZXRhc3Rhc2lzLg==[Qq]

[q] Lesions with high malignancy risk require …… ; lesions with low risk can be monitored with …… Lesions with intermediate risk for malignancy should undergo ……?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHN1cmdpY2FsIGV4Y2lzaW9uLCBzZXJpYWwgQ1Qgc2NhbnMsIGZ1cnRoZXIgaW1hZ2luZyBhbmQgYmlvcHN5IGRlcGVuZGluZyBvbiByYWRpb2dyYXBoaWMgZmluZGluZ3Mu

Cg==

Cg==[Qq]

[q] Which type of lung cancer?

60 years old Patient with history of heavy smoking presenting with centrally located lung mass + cough, dyspnea, weight loss + Cushing syndrome + SIADH + muscles weakness?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNtYWxsIGNlbGwgbHVuZyBjYW5jZXIu

Cg==

Cg==[Qq]

[q] Which type of lung cancer?

60 years old female without history of heavy smoking presenting with peripherally located cancer + cough, dyspnea, weight loss + digital clubbing + joint pain?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFkZW5vY2FyY2lub21hIG9mIHRoZSBsdW5nLg==

Cg==

Cg==[Qq]

[q] Which type of lung cancer?

60 years old Patient with history of heavy smoking presenting with centrally located lung mass + cough, dyspnea, weight loss + hypercalcemia?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNxdWFtb3VzIGNlbGwgY2FyY2lub21hLg==

Cg==

Cg==[Qq]

[q] Which type of lung cancer?

60 years old patient with history of heavy smoking presenting with peripherally located cancer + cough, dyspnea, weight loss + gynecomastia and galactorrhea?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IExhcmdlIGNlbGwgY2FyY2lub21hLg==

Cg==

Cg==[Qq]

[q] What is the most likely diagnosis?

60 years old patient with history of heavy smoking presenting with cough, dyspnea, weight loss + radiating arm pain and paresthesias, weakness of the arm and hand + Hoarseness +  swelling of the head, neck and arms?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFN1cGVyaW9yIHB1bG1vbmFyeSBzdWxjdXMgKFNQUykgdHVtb3IgKFBhbmNvYXN0IHR1bW9yKS4=

Cg==

Cg==[Qq]

[q] What is the best next step in management?

40 years old patient presenting with dyspnea, decreased breath sounds, decreased tactile fremitus, and dullness to percussion over the effusion + x-ray was done and showed accumulation of fluid in pleural space with obliteration of the costophrenic angel?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IERpYWdub3N0aWMgdGhvcmFjZW50ZXNpcyBpcyB0aGUgcHJlbGltaW5hcnkgaW52ZXN0aWdhdGlvbiBvZiBjaG9pY2UgaW4gdGhlIG1hbmFnZW1lbnQgb2YgcGxldXJhbCBlZmZ1c2lvbiwgZXhjZXB0IGluIHBhdGllbnRzIHdpdGggY2xhc3NpYyBzaWducyBhbmQgc3ltcHRvbXMgb2YgY29uZ2VzdGl2ZSBoZWFydCBmYWlsdXJlLCB3aGVyZSBhIHRyaWFsIG9mIGEgZGl1cmV0aWMgaXMgd2FycmFudGVkLg==

Cg==

Jm5ic3A7

Cg==

[Qq]

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