You are using the CURB 65 clinical tool, for determining which patient dx with CAP
should be hospitalized or treated at home. Mabel's score is 2- what should we do? -
ANSWER- Short inpatient stay; if she is relatively healthy, she could be closely
supervised outpatient
which of the following is the drug of choice for a African American pt with HTN and DM?
- ANSWER- HCTZ (diuretic)
Which of the following is in the heart and rapidly rises in the blood stream in heart
failure? - ANSWER- BNP
Which obstructive lung disease is reversible - ANSWER- asthma
Which diagnostic test would be used for dx of a venous embolism (gold standard)? -
ANSWER- Ascending venogram
When should cholesterol screening begin for low risk? - ANSWER- males 35, females
45, every 5 yrs
When should cholesterol screening begin for high risk? - ANSWER- 25 for women, 35
for men, every 3 yrs
When should a rescue course of prednisolone be issued for a asthma attack -
ANSWER- anytime its needed for symptoms
When is combo therapy of LABA + ICS indicated - ANSWER- for moderate or severe
persistent asthma
When is a cough considered chronic? - ANSWER- last longer than 8 weeks
What would you see on EKG with ischemia? - ANSWER- T-wave inversion
What would be considered Severe Persistent Asthma? - ANSWER- Symptoms
throughout day, Awakening 7x/WK, use of SABA several x/D, extreme limited daily life,
FEV1 <60%
What would be considered Moderate Persistent Asthma? - ANSWER- Symptoms daily,
Awakening >1x weekly but not nightly, some limitation in daily life, FEV1 >60%
What would be considered Mild-Persistent asthma - ANSWER- Symptoms >2 D/Wk but
not daily, Awakening 3-4x/MTH, minor interference with daily life, FEV1 ≥ 80%
What would be considered Intermittent asthma - ANSWER- symptoms <2 D/WK,
Awakening <2x/MTH, no interference with daily life, Nml FEV1 between episodes,
predicted FEV >80%
What would a diagnosis of HTN w/o further confirmation be based on? - ANSWER-
Initial screening BP of ≥180/110 mmHg or who presents with hypertensive emergency
What tests and labs are use to dx PVD? - ANSWER- Ankle-Brachial Index (ABI) & lipid
panel
What should be used instead of ACEIs and ARBs in patients over age 75 with impaired
kidney function - ANSWER- CCBs and thiazides
what physical finding may be seen with severe-persistent asthma? - ANSWER-
hyperinflation of the chest with an increase in the AP diameter
What medication are used to manage CAD? - ANSWER- Beta blocker, aspirin, statin,
nitrates
What level of BUN will increase the CURB 65 score by 1? - ANSWER- greater than 19
what is usually the earliest sign of coronary artery disease (CAD) - ANSWER-
intermittent claudication
What is the most important measurement in a pulmonary function in a patient with
asthma? - ANSWER- FEV forced expiratory volume
, What is the most important goal of treating HTN - ANSWER- Avoiding disease targeted
organ damage
What is the most common bacterial pathogen in CAP? - ANSWER- Streptococcus PNA
What is the main trigger to asthma? - ANSWER- exposure to agent pt is sensitized to.
What is the goal of oxygen therapy in COPD? - ANSWER- Maintain O2 sat of 90% or
better
What is the goal of asthma education - ANSWER- encourage self-managment
What is the first lifestyle modification to address for someone diagnosed with HTN -
ANSWER- Weight reduction
What is the desired therapeutic action of inhaled corticosteroids? - ANSWER- reduction
in airway inflammation
What is the cause of CAD and PAD/PVD? - ANSWER- atherosclerosis (hardening of
the arteries)
What is the cardinal symptom of COPD and primary symptom for seeking medical care?
- ANSWER- Dyspnea (progressive and persistent labored breathing and/or Air hunger)
What is the appropriate tx for a pt dx with chronic venous insufficiency - ANSWER- use
of elastic stockings
What is represented on the ECG strip? - ANSWER- V Tach
What is represented on the ECG strip? - ANSWER- ST elevation (Acute MI)
What is represented on the ECG strip? - ANSWER- Atrial Flutter
What is represented on the ECG strip? - ANSWER- AFIB
What is represented on the ECG strip? - ANSWER- 3rd degree AV block (complete
heart block)
What is Baylor's Rules of Two with asthma? - ANSWER- More than 2 uses of rescue
inhaler/wk, more than 2 night awakenings/month, more than 2 rescue canisters/ year
What is a common technique to elicit pain associated with DVT - ANSWER- Homan's
sign (dorsiflexion of foot)
What intervention would indicate a patient needs more education for her asthma? -
ANSWER- opening a window at night
What HDL level is considered cardioprotective? - ANSWER- >60
What factors are considered to calculate CURB 65 score? - ANSWER- age ≥65, BUN
>19, Systolic <90/Diastolic ≤ 60, RR >30, confusion
What does this CXR Show? - ANSWER- infiltrates; pneumonia
what characteristic is a risk factor for PVD? - ANSWER- male gender
What are the steps in the "Stepwise Approach" to asthma? - ANSWER- Step 1 -
Intermittent: SABA PRN
what are Cozaar (losartan), Benicar (olmesartan), Micardis (telmisartan), and Avapro
(Irbesartan) examples of? - ANSWER- angiotensin receptor blockers (ARBs)
What are considered 'quick relievers' of asthma? - ANSWER- SABA (albuterol-
Ventolin), SAMA (ipratropium-Atrovent), systemic CS
What are considered 'controllers' of asthma? - ANSWER- ICS (fluticasone-Flovent,
budesonide-Pulmocort), LABA (salmeterol-Servent), Cromolyn inhaler (Intal),
Leukotrienes (montelukast-Singulair), Methylxanthines (Theophylline) Anti-IgE therapy
(Xolair)
what 2 classes of HTN medication should not be used together? - ANSWER- ACEIs
and ARBs
should be hospitalized or treated at home. Mabel's score is 2- what should we do? -
ANSWER- Short inpatient stay; if she is relatively healthy, she could be closely
supervised outpatient
which of the following is the drug of choice for a African American pt with HTN and DM?
- ANSWER- HCTZ (diuretic)
Which of the following is in the heart and rapidly rises in the blood stream in heart
failure? - ANSWER- BNP
Which obstructive lung disease is reversible - ANSWER- asthma
Which diagnostic test would be used for dx of a venous embolism (gold standard)? -
ANSWER- Ascending venogram
When should cholesterol screening begin for low risk? - ANSWER- males 35, females
45, every 5 yrs
When should cholesterol screening begin for high risk? - ANSWER- 25 for women, 35
for men, every 3 yrs
When should a rescue course of prednisolone be issued for a asthma attack -
ANSWER- anytime its needed for symptoms
When is combo therapy of LABA + ICS indicated - ANSWER- for moderate or severe
persistent asthma
When is a cough considered chronic? - ANSWER- last longer than 8 weeks
What would you see on EKG with ischemia? - ANSWER- T-wave inversion
What would be considered Severe Persistent Asthma? - ANSWER- Symptoms
throughout day, Awakening 7x/WK, use of SABA several x/D, extreme limited daily life,
FEV1 <60%
What would be considered Moderate Persistent Asthma? - ANSWER- Symptoms daily,
Awakening >1x weekly but not nightly, some limitation in daily life, FEV1 >60%
What would be considered Mild-Persistent asthma - ANSWER- Symptoms >2 D/Wk but
not daily, Awakening 3-4x/MTH, minor interference with daily life, FEV1 ≥ 80%
What would be considered Intermittent asthma - ANSWER- symptoms <2 D/WK,
Awakening <2x/MTH, no interference with daily life, Nml FEV1 between episodes,
predicted FEV >80%
What would a diagnosis of HTN w/o further confirmation be based on? - ANSWER-
Initial screening BP of ≥180/110 mmHg or who presents with hypertensive emergency
What tests and labs are use to dx PVD? - ANSWER- Ankle-Brachial Index (ABI) & lipid
panel
What should be used instead of ACEIs and ARBs in patients over age 75 with impaired
kidney function - ANSWER- CCBs and thiazides
what physical finding may be seen with severe-persistent asthma? - ANSWER-
hyperinflation of the chest with an increase in the AP diameter
What medication are used to manage CAD? - ANSWER- Beta blocker, aspirin, statin,
nitrates
What level of BUN will increase the CURB 65 score by 1? - ANSWER- greater than 19
what is usually the earliest sign of coronary artery disease (CAD) - ANSWER-
intermittent claudication
What is the most important measurement in a pulmonary function in a patient with
asthma? - ANSWER- FEV forced expiratory volume
, What is the most important goal of treating HTN - ANSWER- Avoiding disease targeted
organ damage
What is the most common bacterial pathogen in CAP? - ANSWER- Streptococcus PNA
What is the main trigger to asthma? - ANSWER- exposure to agent pt is sensitized to.
What is the goal of oxygen therapy in COPD? - ANSWER- Maintain O2 sat of 90% or
better
What is the goal of asthma education - ANSWER- encourage self-managment
What is the first lifestyle modification to address for someone diagnosed with HTN -
ANSWER- Weight reduction
What is the desired therapeutic action of inhaled corticosteroids? - ANSWER- reduction
in airway inflammation
What is the cause of CAD and PAD/PVD? - ANSWER- atherosclerosis (hardening of
the arteries)
What is the cardinal symptom of COPD and primary symptom for seeking medical care?
- ANSWER- Dyspnea (progressive and persistent labored breathing and/or Air hunger)
What is the appropriate tx for a pt dx with chronic venous insufficiency - ANSWER- use
of elastic stockings
What is represented on the ECG strip? - ANSWER- V Tach
What is represented on the ECG strip? - ANSWER- ST elevation (Acute MI)
What is represented on the ECG strip? - ANSWER- Atrial Flutter
What is represented on the ECG strip? - ANSWER- AFIB
What is represented on the ECG strip? - ANSWER- 3rd degree AV block (complete
heart block)
What is Baylor's Rules of Two with asthma? - ANSWER- More than 2 uses of rescue
inhaler/wk, more than 2 night awakenings/month, more than 2 rescue canisters/ year
What is a common technique to elicit pain associated with DVT - ANSWER- Homan's
sign (dorsiflexion of foot)
What intervention would indicate a patient needs more education for her asthma? -
ANSWER- opening a window at night
What HDL level is considered cardioprotective? - ANSWER- >60
What factors are considered to calculate CURB 65 score? - ANSWER- age ≥65, BUN
>19, Systolic <90/Diastolic ≤ 60, RR >30, confusion
What does this CXR Show? - ANSWER- infiltrates; pneumonia
what characteristic is a risk factor for PVD? - ANSWER- male gender
What are the steps in the "Stepwise Approach" to asthma? - ANSWER- Step 1 -
Intermittent: SABA PRN
what are Cozaar (losartan), Benicar (olmesartan), Micardis (telmisartan), and Avapro
(Irbesartan) examples of? - ANSWER- angiotensin receptor blockers (ARBs)
What are considered 'quick relievers' of asthma? - ANSWER- SABA (albuterol-
Ventolin), SAMA (ipratropium-Atrovent), systemic CS
What are considered 'controllers' of asthma? - ANSWER- ICS (fluticasone-Flovent,
budesonide-Pulmocort), LABA (salmeterol-Servent), Cromolyn inhaler (Intal),
Leukotrienes (montelukast-Singulair), Methylxanthines (Theophylline) Anti-IgE therapy
(Xolair)
what 2 classes of HTN medication should not be used together? - ANSWER- ACEIs
and ARBs
