1
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,Which of the following medications should be used cautiously in a patient who has asthma?
(Timolol ophthalmic drops)
Timolol is a beta blocker. This class of medications can precipitate bronchoconstriction in
patients who have asthma. Even though timolol is being administered in the eye, it is absorbed
through mucous membranes and can exert systemic effects. Beta blockers should be avoided in
patients with asthma and used cautiously in patients with COPD. The other medications listed
have no specific contraindications for patients with asthma.
The most common symptom associated with acute bronchitis is: (Cough)
Fever (temp > 101°F) is an unusual symptom associated with acute bronchitis. Cough is the
most common symptom associated with acute bronchitis. Purulent sputum is identified in more
than 50% of patients with acute bronchitis. The color imparted to the sputum is usually due to
sloughing of epithelial cells, not bacterial infection. Concurrent upper respiratory symptoms are
typical of acute bronchitis. Pharyngitis is common.
Mild persistent asthma is characterized by: (symptoms occurring more than twice weekly)
Mild persistent asthma is characterized by symptoms that occur more than twice weekly but
not daily; or 3-4 nocturnal awakenings per month due to asthma. It is treated with an inhaled
steroid daily, and a bronchodilator PRN for exacerbations. If symptoms occur more than twice
weekly, therapy should be stepped up. Generally, a long-acting bronchodilator is added to the
steroid when therapy is stepped up.
The chest circumference of a 12 month-old is: (equal to head circumference)
, The chest circumference is not routinely measured at well-child visits, but is assessed if there is
concern about the circumference of either the head or the chest. An exception to this
observation can occur in premature infants where the head grows very rapidly. Normally, the
head exceeds the chest circumference by 1-2 cm from birth until 6 months. Between 6 and 24
months the head and chest circumference should be about equal and by 2 years of age the
chest should be larger than the head. The chest circumference is measured at the nipple line.
A patient with cough and fever is found to have infiltrates on chest x-ray. What is his likely
diagnosis? (Pneumonia)
The finding of infiltrates on chest x-ray, in conjunction with clinical findings of fever and cough,
should direct the examiner to consider pneumonia as the diagnosis. Other common clinical
findings with pneumonia include chest pain, dyspnea, and sputum production. Though not
common, some patients with pneumonia exhibit gastrointestinal symptoms like nausea,
vomiting, and diarrhea.
An uncommon symptom associated with acute bronchitis is: (temperature > 101°F)
Fever is an unusual symptom associated with acute bronchitis. Cough is the most common
symptom associated with acute bronchitis. Purulent sputum is identified in more than 50% of
patients with acute bronchitis. The color imparted to the sputum is usually due to sloughing of
epithelial cells, not bacterial infection. Concurrent upper respiratory symptoms are typical of
acute bronchitis. Pharyngitis is common within the first 3 days of the illness.
Patients who have cough-variant asthma: (all exhibit cough)
,2
,Which of the following medications should be used cautiously in a patient who has asthma?
(Timolol ophthalmic drops)
Timolol is a beta blocker. This class of medications can precipitate bronchoconstriction in
patients who have asthma. Even though timolol is being administered in the eye, it is absorbed
through mucous membranes and can exert systemic effects. Beta blockers should be avoided in
patients with asthma and used cautiously in patients with COPD. The other medications listed
have no specific contraindications for patients with asthma.
The most common symptom associated with acute bronchitis is: (Cough)
Fever (temp > 101°F) is an unusual symptom associated with acute bronchitis. Cough is the
most common symptom associated with acute bronchitis. Purulent sputum is identified in more
than 50% of patients with acute bronchitis. The color imparted to the sputum is usually due to
sloughing of epithelial cells, not bacterial infection. Concurrent upper respiratory symptoms are
typical of acute bronchitis. Pharyngitis is common.
Mild persistent asthma is characterized by: (symptoms occurring more than twice weekly)
Mild persistent asthma is characterized by symptoms that occur more than twice weekly but
not daily; or 3-4 nocturnal awakenings per month due to asthma. It is treated with an inhaled
steroid daily, and a bronchodilator PRN for exacerbations. If symptoms occur more than twice
weekly, therapy should be stepped up. Generally, a long-acting bronchodilator is added to the
steroid when therapy is stepped up.
The chest circumference of a 12 month-old is: (equal to head circumference)
, The chest circumference is not routinely measured at well-child visits, but is assessed if there is
concern about the circumference of either the head or the chest. An exception to this
observation can occur in premature infants where the head grows very rapidly. Normally, the
head exceeds the chest circumference by 1-2 cm from birth until 6 months. Between 6 and 24
months the head and chest circumference should be about equal and by 2 years of age the
chest should be larger than the head. The chest circumference is measured at the nipple line.
A patient with cough and fever is found to have infiltrates on chest x-ray. What is his likely
diagnosis? (Pneumonia)
The finding of infiltrates on chest x-ray, in conjunction with clinical findings of fever and cough,
should direct the examiner to consider pneumonia as the diagnosis. Other common clinical
findings with pneumonia include chest pain, dyspnea, and sputum production. Though not
common, some patients with pneumonia exhibit gastrointestinal symptoms like nausea,
vomiting, and diarrhea.
An uncommon symptom associated with acute bronchitis is: (temperature > 101°F)
Fever is an unusual symptom associated with acute bronchitis. Cough is the most common
symptom associated with acute bronchitis. Purulent sputum is identified in more than 50% of
patients with acute bronchitis. The color imparted to the sputum is usually due to sloughing of
epithelial cells, not bacterial infection. Concurrent upper respiratory symptoms are typical of
acute bronchitis. Pharyngitis is common within the first 3 days of the illness.
Patients who have cough-variant asthma: (all exhibit cough)
