1. What describes the pathophysiology of bronchiecta- Bronchial wall thickening
sis? & permanent airway dila-
tion due to recurrent in-
flammation
2. A man with COPD presents concerned about getting Influenza & pneumococcal
sick this winter. His friend suffered from the flu & was vaccinations
admitted to the ICU. He is up-to-date on his childhood
vaccinations. Which vaccinations can help reduce his
risk for infections & exacerbations?
3. What treatment is appropriate for a patient with Short-acting inhaled
chronic obstructive pulmonary disease with frequent beta-agonist used P R N
day-to-day symptoms but no history of acute exacer- & a long-acting inhaled
bations? antimuscarinic agent used
daily: SABA & LAMA
4. What is the recommended treatment for non-severe Supportive care
bronchiolitis?
5. What pathophysiologic changes is characteristic of Decreased elastic recoil
chronic obstructive pulmonary disease, COPD? pressure
, Pulmonary: ROSH REVIEW
6. What organ system is involved in the symptom mani- Pulmonary
festation in blastomycosis infection?
7. A patient with a 30 pack-year history presents with Clubbing
gradual onset of dyspnea on exertion & a nonproduc-
tive cough. X ray reveals reticular opacities in the low-
er lung. CT shows sub-pleural honeycombing. Exam
finding present in this patient?
8. A patient complains of shortness of breath, cough, Legionella pneumoniae
fever, nausea, & diarrhea. He's installed a hot tub in his
home. He has bilateral crackles & a pulse ox 91%. Labs:
leukocytosis, hyponatremia, & elevated liver enzymes.
What is his cause of atypical pneumonia?
9. A patient presents with cavitations on chest X ray & TWO months: Isoniazid,
3 positive acid-fast bacillus sputum stains. He was Rifampin, Ethambutol &
recently in prison & his cellmate had active TB. Treat- Pyrazinamide.
ment regimen? FOUR months: Isoniazid &
Rifampin
, Pulmonary: ROSH REVIEW
10. When examining a comatose 87-year-old man, you Cheyne-Stokes respiration
note his breathing steadily increases in depth and
frequency until it reaches a peak, then decreases in
depth & frequency until he has an apneic episode.
What is this pattern of breathing?
11. A patient had open reduction of an ankle fracture. 36 Pulmonary embolism
hours later she presents with chest pain & difficulty
breathing. She is afebrile, blood pressure is 120/80 &
heart rate is 110. Chest X-ray is normal, and an ecg is
normal except for tachycardia. o2 is 90% on room air.
Diagnosis?
12. A smoker with COPD presents with exertional dysp- Pulmonary hypertension
nea, fatigue, & cough. Echo reveals right ventricular
wall thickening with paradoxical motion of the inter-
ventricular septum during systole. Cor pulmonale is
diagnosed. Cause?
13. What is the classic triad of foreign body aspiration in Coughing, wheezing & di-
a young child? minished breath sounds
14. An 85-year-old has inspiratory wheeze & nonproduc- Tracheal foreign body
tive cough. She's a nursing home resident with de-
mentia, aphasia, & right-sided weakness secondary
to stroke. Staff say the wheeze & cough have been
present for 2 weeks with no apparent precipitating
factors. Diagnosis?
15. A teen has a 2-week history of runny nose, sore throat, Chest X ray
& nasal congestion. He has a productive cough, fa-