AHA PALS Pulmonary Case Management Final Correct Answers Guaranteed A+

What are the ABCDEs of trauma care? (Identify what each of the letters represents) 5pts - A- Airway B- Breathing C- Circulation D- Disability E- Exposure What are causes of transudative pleural effusions? Choose all that apply. Nephrotic syndrome Bacterial infection Congestive heart failure Rheumatoid arthritis Ascites - Nephrotic syndrome Congestive heart failure Ascites An inhaled anticholinergic agent can be used in the treatment of which of the following? Subglottic stenosis Tracheal tumor Exercise-induced vocal cord dysfunction Laryngomalacia - Exercise-induced vocal cord dysfunction Which area of the larynx is the most common site for laryngeal stenosis? Glottic Subglottic Supraglottic - Subglottic Paradoxical chest movement is associated with which of the following? Flail chest Pleurisy Pleural effusion Pneumothorax - Flail chest A patient with obesity has a pulmonary function testing done. What would the typical results be? Obstructive Restrictive Restrictive and obstructive - Restrictive What is the most likely cause of angioedema? Micronathia Tracheal stenosis Anaphylactic reaction Laryngitis - Anaphylactic reaction A patient has been involved in an accident and experienced blunt chest trauma. A chest radiograph is showing deviation of the trachea to the right and left hemothorax, the mediastinum is widened and the aortic knob is not seen. What injury is seen here? Blunt aortic injury Tension pneumothorax Ruptured diaphragm Flail chest - Blunt aortic injury A patient is admitted with a viral pneumonia. An arterial blood gas is done. What are the expected results? Mild hypoxemia Mild respiratory acidosis Mild respiratory alkalosis Mild metabolic acidosis - Mild hypoxemia Mild respiratory alkalosis What three assessments are part of Beck's triad? Choose all that apply. Increased venous pressure Hyperresonance of chest upon percussion Muffled heart sounds Trachea shift to the right Paradoxical chest movement Decrease in arterial pressure - Increased venous pressure Muffled heart sounds Decrease in arterial pressure What effect do disorders of the pleura have on the lungs? Increase airway resistance. Increase lung compliance. Decrease airway resistance. Decrease lung compliance. - Decrease lung compliance. Inflammatory panel, cardiac enzymes and a metabolic panel should be evaluated when Covid 19 is suspected. False True - True A patient has suspected cervical neck injury. To open the airway, it is best to: use jaw thrust. perform tracheotomy. use chin lift. place patient in sniffing position. - use jaw thrust. The inhaled anticholinergic agent, ipratropium bromide, is helpful in the treatment of: bilateral vocal cord paralysis. exercised induced vocal cord dysfunction. laryngomalacia. subglottic stenosis. - exercised induced vocal cord dysfunction. How is stridor defined? A soft and low-pitched sound with a rustling quality during inspiration and even softer during expiration Discontinuous, brief, popping sounds Continuous, musical sounds, high or low pitched. A loud, high-pitched wheezing sound heard during inspiration but may also occur throughout the respiratory cycle - A loud, high-pitched wheezing sound heard during inspiration but may also occur throughout the respiratory cycle Ground glass opacities are commonly seen with worsening Covid 19 Pneumonia True False - True What is instilled in the pleural space in sclerotherapy? Talc Mineral Oil Lasix Normal Saline - Talc A patient has experienced chest wall trauma and is in the emergency room for evaluation. The chest wall is auscultated and there are decreased breath sounds on the left side. Observation reveals that there is also limited movement of the chest wall on the left. The trachea is shifted to the right chest. What is the probable disorder happening? Right-sided hemothorax Left-sided pneumonia Left-sided pneumothorax Right-sided pneumothorax - Left-sided pneumothorax A muffling of the voice without hoarseness may be a sign of which of the following? Supraglottic process Tracheal tumor Vocal cord dysfunction Tracheal stenosis - Supraglottic process What is the most accurate diagnostic tool for the detection of pulmonary contusion? Chest radiograph Palpation CT chest scan Percussion - CT chest scan A child presents with choking, cough, and wheezing. What is the probable diagnosis? Croup Foreign body aspiration Bronchiolitis Epiglottitis - Foreign body aspiration A patient presents to an ear, nose, and throat specialist with diagnosis of laryngomalacia for further followup. To help determine treatment, the physician wants to further diagnose the laryngomalacia. Following an endoscopic procedure, the airway was observed and found that the patient has short aryepiglottic folds that decrease the dimension of the airway. What type of laryngomalacia is this? Type III Type I Type II Type IV - Type II A neonate has laryngomalacia. This condition: resolves when the child is around 2 years old. usually needs surgery. suppresses the growth of neonate. usually appears right at birth. - resolves when the child is around 2 years old. What is one of the most common triggers of a spontaneous pneumomediastinum? Malignancy Congestive heart failure Severe cough Cystic fibrosis - Severe cough A patient is suspected of having a tension pneumothorax. What should be done next? Obtain a chest radiograph. Placement of chest tube. Perform needle decompression of the chest. Obtain CT of chest. - Perform needle decompression of the chest. A patient has a chest wound and has developed an open pneumothorax. The air in the pleural space is from the: atmosphere. lungs. stomach. - atmosphere What antiviral medication is used for respiratory syncytial virus? Peramivir Palivizumab Zanamivir Ribavirin - Ribavirin What is the most common congenital lesion of the pharynx and cause of congenital stridor? Laryngomalacia Tracheomalacia Laryngeal stenosis Tracheoesophageal fistula - Laryngomalacia Which of the following have been associated with Covid 19 presentation that requires hospital admission? (choose all that apply) Headache malaise SpO2 93% on room air infiltrates on CXR - SpO2 93% on room air infiltrates on CXR Laryngeal stenosis is easy to treat. True False - False Where is a chest tube placed for pneumothorax? Second intercostal space medial line Eighth intercostal space along the superior axillary line Third or fourth intercostal space along the midclavicular line Fourth or fifth intercostal space along the anterior axillary line - Fourth or fifth intercostal space along the anterior axillary line A patient has experienced blunt force trauma and has had to have surgery. What would the healthcare provider expect to see in the patient's laboratory blood work? Increased potassium Increase in white blood cell count Increased hematocrit Increase in red blood cell count - Increase in white blood cell count Cardiac tamponade can cause which of the following? Pulmonary emboli Bradycardia Pulsus alternans Hypotension - Hypotension A patient arrives to the emergency room complaining of chest pain and shortness of breath. Breath sounds reveal absent breath sounds on the right. Percussion is performed and hyperresonance is heard on the right side. What should the healthcare provider suspect? Pneumothorax Correct answer Pneumonia Empyema Pleural effusion - Pneumothorax A patient has been involved in a motor vehicle accident in which his chest hit the steering wheel. The patient has a risk of developing what complication? Choose all that apply. Deep vein thrombosis Decubitus Ulcers ARDS Bradycardia Pulsus alternans - Deep vein thrombosis Decubitus Ulcers ARDS Vocal cord dysfunction episodes of dyspnea is usually relieved by which of the following? Corticosteroids Bronchodilators It goes away on its own. Epinephrine - It goes away on its own. Severe episodes of VCD can be treated with which of the following? Cool aerosol mist Heliox therapy Bronchodilators Botox - Heliox therapy Antibiotics are used to treat all pneumonias. False True - False A patient presents to the emergency room after a motor vehicle accident and blunt trauma to the chest. The patient is experiencing shortness of breath, tachycardia, and tachypnea. Breath sounds are clear but heart sounds are muffled. What should the healthcare professional suspect? Hemothorax Cardiac tamponade Pneumothorax Blunt aortic injury - Cardiac tamponade What are causes of transudative pleural effusions? Choose all that apply. Nephrotic syndrome Bacterial infection Ascites Rheumatoid arthritis Congestive heart failure - Nephrotic syndrome Ascites Congestive heart failure How is tracheomalacia diagnosed? Chest radiograph Dynamic CT Pulmonary function test Lateral neck radiograph - Dynamic CT Pleural fluid pH in a patient measures 7.37. What type of effusion is this? Exudative. Transudative - Transudative What is EBUS useful for when performing a bronchoscopy? Choose all that apply. Guide tumor debridement. Bronchial thermaplasty Argon therapy Select proper airway stent size. Determine degree of tracheal invasion of tumor/cancer. Visualize endobronchial lesions. - Guide tumor debridement. Select proper airway stent size. Determine degree of tracheal invasion of tumor/cancer. What disease process are the symptoms of vocal cord dysfunction similar to? Pulmonic stenosis Asthma Pulmonary emboli Pneumonia - Asthma Disorders of the pleura have what effect on pulmonary function tests? Increase functional residual capacity. Decrease FEV1. Increase total lung capacity. Decrease vital capacity. - Decrease vital capacity. Pulseless electrical activity (PEA) is common with hypovolemic cardiac arrest. True False - True The very young and the elderly are at higher risk of contracting viral pneumonia. True False - True To prevent laryngeal stenosis, endotracheal tube cuff pressures should be kept at: 60-80 cm H2O. 10-20 cm H2O. 20-30 cm H2O. 40-50 cm H2O. - 20-30 cm H2O. What nerve(s) are usually involved in vocal cord paralysis? Choose all that apply. Vagus Phrenic Otic - Vagus The gold standard of diagnosing pneumonia is a chest cat scan. True False - False In the adult, what is the narrowest part of the upper airway? Glottic Subglottic Supraglottic - Glottic A patient has a chest radiograph with interstitial infiltrates. This is indicative of which type of pneumonia? Viral Gram negative Atypical Gram positive - Viral There is no specific treatment for pulmonary contusion. True False - True What can trigger vocal cord dysfunction? Choose all that apply. Gastroesophageal reflux Prone position Heat and humidity Postnasal drip Smoke - Gastroesophageal reflux Postnasal drip Smoke Which of the following is considered a variable extrathoracic upper airway obstruction? Tracheal tumor Angioedema Tracheal malacia Laryngeal stenosis - Laryngeal stenosis A hemothorax is considered to be massive with the immediate drainage of ____________mL after a chest tube is placed. 1,500 500 150 1,000 - 1,500 A patient has a hemopneumothorax on the left side. The left lung is experiencing what disorder? Hyperinflation Pneumonia Empyema Atelectasis - Atelectasis Why is the subglottic region of the larynx prone to injury from an endotracheal tube? It is narrowest and most inflexible. The vocal cords are irritated by the endotracheal tube. Movement of the endotracheal tube stimulates cough. It is where the interarytenoid folds are located and the endotracheal tube rests on them. - It is narrowest and most inflexible. A variable intrathoracic airway obstruction causes which of the following scenarios? Increase in expiratory flow and increase in inspiratory flow Decrease in expiratory flow but normal inspiratory flow Decrease in both inspiratory and expiratory flow Normal expiratory flow and decrease inspiratory flow - Decrease in expiratory flow but normal inspiratory flow Prevention of hypoxemia is of vital importance when managing a patient with blunt chest trauma. True False - True How does vocal cord dysfunction usually present? Exercise intolerance Nocturnal awakenings Orthopnea Episodic attacks of dyspnea - Episodic attacks of dyspnea A patient is intubated and on mechanical ventilation. What is a complication of extubation of this patient? Laryngomalacia Tracheoesophageal fistula Laryngeal stenosis Tracheomalacia - Laryngeal stenosis A fatiguing diaphragm can be suspected when which of the following is observed? Paradoxical abdomen Unilateral breath sounds Jugular venous distention Hypotension - Paradoxical abdomen WBC count can be normal or indicate leukopenia in Covid 19 Pneumonia. True False - True Name the parameters used to identify an Exudative Pleural Effusion. (Hint this was a table in the book and on the slides that we discussed in class) - Associated with inflammation high specific gravity high protein content and cell count or you could have listed any of lights criteria for exudative effusion. Protein 0.5 Pleural Fluid LDH/serum LDH 0.6 Pleural fluid LDH 2/3 serum LDH upper limits of normal What is the definition of vocal cord dysfunction? - Vocal cord disfunction is when there is possible inflammation around the vocal cords causing coughing, dyspnea and or trouble breathing due to them not working right. The larynx has three separate areas; these are the ________, the glottis, and the subglottic region - supraglottic region Compare and contrast the parietal and visceral pleura - The inner layer covers the lungs and parietal would be outer layer it covers the chest wall What is pleurodesis? - The fusing or obliteration of the pleural space usually with talc to prevent reoccurring fluid from collecting Explain why Racemic Epinephrine is used to treat post extubation airway edema? What other treatments can be done for post extubation airway edema? - Racemic Epinephrine is used for patients post extubation who are experiencing high pitched wheezing. This is known as stridor and can be heard by listening over the patients upper airway. This will help calm down any inflammation post extubating and then the physician/team can decide what is needed to happen farther for the patient. Heliox, cool mist aerosols, steroids are other treatments In chronic aortic insufficiency, the left ventricle eventually adjusts to extra volume. In this scenario, a patient presents with symptoms similar to which cardiomyopathy? Hypertropic Dilated Correct answer Restrictive - Dilated Fluid accumulation in the sac around the heart is called which of the following? Pleural effusion Pericarditis Pericardial effusion Pneumocystitis - Pericardial effusion What symptom is present in up to 90% of all lung cancer patients? Fatigue Pain Cough Breathlessness - Breathlessness The most common presenting physical manifestation of non-small cell lung cancer is: Dyspnea Cough Hemoptysis Chest pain - Cough __________is the most commonly used modality for diagnosis and staging of nonsmall cell lung cancer. VATS Bronchoscopy with EBUS Mediastinoscopy CT - Bronchoscopy with EBUS Which of the following are the most useful test(s) for patients suspected of having CHF? EKG Echo Echo combined with ECG Echo combined with CXR - Echo combined with ECG Cardiac output is decreased in anaphylactic shock due to which of the following? Systemic vasodilation Systemic vasoconstriction Pulmonic vasodilation Pulmonic vasoconstriction - Systemic vasodilation Benign neoplasms: Are just as aggressive as malignant neoplasms Typically originate in the lung periphery Are usually non-metastasizing Are staged like malignant neoplasms - Are usually non-metastasizing Squamous cell lung carcinoma is most commonly located in the : Pharynx Lymph nodes Alveoli Subsegmental level of the lung - Subsegmental level of the lung Which of the following are treatments that may be indicated for dilated cardiomyopathy? Choose all that apply. ICD RVAD or LVAD Beta-blockers Valvuloplasty - ICD RVAD or LVAD Beta-blockers In cardiogenic shock, which of the following is the result of left ventricular systolic dysfunction? increased stroke volume increased organ perfusion decreased stroke volume lower left ventricular end-diastolic volume - decreased stroke volume A patient is in a state of shock. Laboratory tests are being drawn. What should the healthcare provider expect the lactate levels to be? Increased Decreased Unable to determine; the type of shock needs to be known. - Increased Which of the following symptoms is indicative of severe hypovolemia? Diaphoresis Mild tachycardia More than 40% blood loss Anxiety - More than 40% blood loss Tests used to diagnose heart failure include which of the following? (Choose all that apply) Heart catheterization Electrocardiogram Blood tests CT scan Echocardiogram - Heart catheterization Electrocardiogram Blood tests Echocardiogram What is the mortality rate for heart failure? Hide answer choices 1 in 15 1 in 20 1 in 9 1 in 5 - 1 in 9 Heart Failure can affect________ Only the left side of the heart Only the right side of the heart Both sides of the heart The cardiac valves only - Both sides of the heart During aortic insufficiency: the aortic valve is not allowing blood to flow out of ventricle. afterload of the heart increases. preload of the heart increases. oxygen supply to heart increases - preload of the heart increases. You are looking at a patient's BNP results of 500. These results indicate which of the following: Acute HF is likely Acute HF is unlikely Uncertain diagnosis - Acute HF is likely Mediastinoscopy is a non-invasive procedure used to evaluate lymph nodes of the mediastinum. True False - False Aortic stenosis will have what effect on the heart? Increased afterload. Decreased contractility. Decreased preload. Increased oxygen demand. - Increased afterload. Which of the following medications are commonly used to treat heart failure? Choose all that apply. Diuretics Ace inhibitors Beta blockers Morphine Epinephrine - Diuretics Ace inhibitors Beta blockers In patients over 55, the most common anaphylaxis reaction is due to: latex medications food environmental - medications Heart failure occurs when : The heart is unable to meet the body's metabolic needs The heart stops working The heart has a congenital problem The left ventricle becomes hypertrophied - The heart is unable to meet the body's metabolic needs Never smokers most commonly develop: SCLC (small cell) LCLC (large cell) SQCLC (squamous cell) AdenoCA - AdenoCA What type of cancer is the most common type of lung cancer in the US? Small cell Adenocarcinoma Squamous cell Large cell - Adenocarcinoma Which of the following is true of a valve replacement using a mechanical valve (vs. bioprosthetic)? Choose all that apply it requires use of long-term anti-coagulants it is indicated for older patients it is the more durable (longer-lasting) of the valve types it has better success than the other valve type - it requires use of long-term anti-coagulants it is the more durable (longer-lasting) of the valve types To reduce afterload of the heart and increase coronary perfusion for a patient in cardiogenic shock, what device or procedure should be used? Left ventricular assist device Coronary artery bypass graft Intra-aortic balloon pump IV administration of vasopressor - Intra-aortic balloon pump Prophylatic (preventative) cranial radiation is a common practice when treating which type of cancer? AdenoCA Large cell Small Cell Squamous cell - Small Cell What is the preferred approach for the treatment of non-small lung cancer? Radiation only Chemotherapy Radiation followed by chemotherapy Surgical resection - Surgical resection Valvuloplasty is a treatment that is indicated for which of the following? Choose all that apply. pulmonary stenosis pericardial effusion mitral insufficiency mitral stenosis VSD - pulmonary stenosis mitral stenosis Which of the following are NOT clinical manifestations of left-sided heart failure? Choose all that apply. Crackles on auscultation JVD Pulmonary edema Hepatomegaly - JVD Hepatomegaly Which of the valve disorders will show left atrial enlargement on CXR? aortic insufficiency mitral regurgitation tricuspid regurgitation pulmonary insufficiency - mitral regurgitation