Multiple Choice Questions (MCQ)

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

Question 31# Print Question

A 62-year-old man seeks your advice for management of his COPD. He is a former 60-pack-year smoker, but stopped smoking 3 years ago. He uses inhaled albuterol when he feels particularly short of breath. He has noticed mild peripheral edema. He has diabetes mellitus, hypertension, and peripheral vascular disease. For these conditions he takes metformin, HCTZ, lisinopril, and cilostazol. Physical examination reveals a thin man who appears older than his stated age. His BP is 136/78, HR is 88, and RR 18. Room air O2 saturation is 85%. He has distant breath sounds, but no rales, rhonchi, or wheezes. What treatment is most important in his overall health status?

A. Long acting bronchodilator such as tiotropium or salmeterol
B. Inhaled corticosteroids
C. Oxygen to keep O2 saturation 90% or above
D. Pulmonary rehabilitation
E. Antibiotics promptly at time of purulent exacerbation

Question 32# Print Question

A 57-year-old man presents with gradually worsening dyspnea on exertion for the past 6 months. He has a 40-pack-year history of tobacco use. He has noted a minimally productive cough, worse in the mornings, for the past 2 years. He is otherwise healthy, without hypertension, hyper-cholesterolemia, or diabetes mellitus. On physical examination, he is comfortable at rest. His room air oximeter reading is 93%. His neck veins are flat and his cardiac examination is normal. He has no basilar crackles, but breath sounds are distant bilaterally. Chest x-ray shows hyperexpansion without evidence of cardiomegaly or pulmonary congestion. What is the most important next step in staging this patient’s illness?

A. Arterial blood gas
B. CT scan of chest
C. Exercise tolerance test with measurement of maximum oxygen consumption
D. Echocardiogram with estimation of RV pressures
E. Spirometry

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