Your-Doctor Multiple Choice Questions (MCQ)

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Category: Medicine--->Pulmonary Disease
Page: 3

Question 11#Print Question

A 57-year-old man is admitted to the hospital because of acute shortness of breath shortly after a 12-hour automobile ride. Findings on physical examination are normal except for tachypnea and tachycardia. He does not have edema or popliteal tenderness. An electrocardiogram reveals sinus tachycardia but is otherwise normal. Which of the following statements is correct? 

a. . A normal D-dimer level excludes pulmonary embolus
b. If there is no contraindication to anticoagulation, full-dose heparin or enoxaparin should be started pending further testing
c. Normal findings on examination of the lower extremities make pulmonary embolism unlikely
d. Early treatment of pulmonary embolism has little effect on overall mortality
e. A normal lower extremity venous Doppler study will rule out a pulmonary embolus

Question 12#Print Question

A 40-year-old woman has had increasing fatigue and shortness of breath for 6 months. Physical examination reveals normal vital signs and a resting O 2 saturation of 97%. Her lungs are clear without rales or wheezing. Cardiac examination shows a prominent pulmonary component of the second heart sound (P2 ) and a soft systolic murmur at the left sternal border that varies with respiration. Her neck veins show a prominent v wave. Chest x-ray shows right ventricular hypertrophy and enlargement of the central pulmonary arteries. What is the best next step in establishing a diagnosis in this patient?

a. Echocardiogram
b. Spirometry with measurement of diffusing capacity of carbon monoxide
c. Exercise stress test
d. Alpha-1 antitrypsin level
e. Right heart catheterization

Question 13#Print Question

A 65-year-old man with mild congestive heart failure is scheduled to receive total hip replacement. He has no other underlying diseases and no history of hypertension, recent surgery, or bleeding disorder. Which of the following is the best approach to prevention of pulmonary embolus in this patient? 

a. Aspirin 75 mg/d
b. Aspirin 325 mg/d
c. Enoxaparin 30 mg subcutaneously bid
d. Early ambulation
e. Graded compression elastic stockings

Question 14#Print Question

An obese 50-year-old woman complains of insomnia, daytime sleepiness, and fatigue. During a sleep study she is found to have recurrent episodes of arterial desaturation —about 30 events per hour—with evidence of obstructive apnea. Which of the following is the treatment of choice for this patient? 

a. Nasal continuous positive airway pressure
b. Uvulopalatopharyngoplasty
c. Hypocaloric diet
d. Tracheostomy
e. Oxygen via nasal cannula

Question 15#Print Question

A 30-year-old athlete presents to your office complaining of intermittent wheezing. This wheezing begins shortly after running. The patient admits to smoking 1 to 2 packs of cigarettes per day for 5 years. What finding would be consistent with asthma? 

a. Hyperinflation on chest x-ray
b. Improvement in FEV1 after bronchodilator
c. Low oxygen saturation on finger oximetry
d. Decreased FVC on PFT testing
e. Dyspnea on assuming a supine position

Category: Medicine--->Pulmonary Disease
Page: 3 of 7