Egan's Fundamentails of Respiratory Care Part 3

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What clinical finding should raise your suspicion that a patient has developed hospital acquired pneumonia?

a new fever

What classification of drug would the leukotriene inhibitors fall under?

antiinflammatory

Indicate the typical chest radiographic findings of a patient with silicosis.

apical nodules

The presence of pleural calcification on the chest film is consistent with what type of interstitial lung disease (ILD)?

asbestosis

What etiologic factor is associated with the onset of nocturnal asthma?

aspiration of gastric acid at night

A patient presents with pneumonia accompanied by foul-smelling breath, an absent gag reflex, or recent loss of consciousness. What should be suspected?

aspiration pneumonia

Which of the following is NOT a pulmonary complication frequently associated with flail chest?

aspiration pneumonia

What is a common complication of pleurodynia (pleural pain)?

atelectasis

What term is used to describe CPAP units that use a computer to adjust CPAP levels as needed by the patient during sleep?

auto-CPAP

Which of the following behavioral interventions is least useful for the treatment of sleep apnea?

avoidance of daytime naps

What is the most common radiographic finding in the chest film of a patient with sarcoidosis?

bilateral hilar lymphadenopathy

Screening of patients at high risk for bronchogenic carcinoma with a chest radiograph has been found to increase survival.

false

Spontaneous remission rarely occurs with sarcoidosis.

false

The presence of previous chronic obstructive pulmonary disease (COPD) reduces the diagnostic usefulness of mc155-1.jpg scans in acute pulmonary embolism.

false

Which of the following is NOT associated with local tumor growth in the central airways?

fine crackles

Squamous cell carcinoma is composed of which of the following?

flattened stratified epithelial cells

Peripheral nerve disorders that cause respiratory muscle dysfunction can be caused by all of the following except:

fluid imbalances

What is the fastest way to achieve therapeutic levels of heparin in the treatment of acute deep venous thrombi?

follow established nomogram

What term is used to describe objects capable of transmitting infection through physical contact with them?

fomites

Where does COPD rank among the leading causes of death in the United States?

fourth

The rapid, shallow breathing pattern seen in patients with neuromuscular disease is generally due to which of the following mechanisms?

frequent respiratory infections

If an HIV-infected patient has an adverse reaction to the treatment of choice for Pneumocystis jiroveci pneumonia, what treatment should be instituted?

pentamidine

What type of histopathologic cells is associated with large-cell carcinoma?

pleomorphic cells

Which of the following radiographic findings is NOT typical for patients with primary pulmonary hypertension?

pleural effusion

Which of the following symptoms is typical for pneumococcal pneumonia?

pleuritic chest pain

How does CPAP improve breathing in the patient with OSA?

pneumatic splinting of the upper airway

What treatment is recommended by the Centers for Disease Control and Prevention (CDC) guidelines for patients with interstitial lung disease (ILD)?

pneumococcal vaccine

Describe a secondary spontaneous pneumothorax.

pneumothorax that results from underlying lung disease

Which of the following risk factors is NOT associated with an increase in the incidence of pulmonary embolism?

positive smoking history

What is the most common treatment for patients with idiopathic pulmonary fibrosis (IPF)?

prednisone

Which of the interstitial lung diseases is directly tied to exposure to first- and second-hand tobacco smoke?

pulmonary Langerhans cell histiocytosis (PLCH)

What type of drug is Bosentan?

Endothelin antagonists

What IV infusion has been found to improve exercise capacity, hemodynamic variables, and survival in patients with severe IPAH?

Epoprostenol

A patient comes into the emergency department presenting with signs and symptoms of pneumonia. While taking the patient's history, it is determined that 2mc002-1.jpg months ago the patient spent 3 days in the hospital for acute angina. Since then the patient has been stable on medication. What type of pneumonia is this patient most likely to have?

HCAP

A 35-year-old man is admitted to the hospital and has been confirmed to have pneumococcal pneumonia. What test would be wise to order at this time?

HIV

Which of the following organisms have been found to colonize the oropharynx of healthy individuals?

Haemophilus influenzae

Which of the following organisms that cause pneumonia is most likely to result in a positive blood culture?

Haemophilus influenzae

A patient presents with high fever, teeth-chattering chills, pleuritic pain, and a cough producing rust-colored sputum. What pathogen should be suspected?

Pneumococcal pneumoniae

Which of the following is true concerning pneumonia?

Pneumonia is the sixth leading cause of death in the United States.

In patients suspected of having pulmonary emboli in whom noninvasive studies do not give a definite diagnosis, what diagnostic procedure is the test of choice?

pulmonary angiography

What complication often occurs following rapid lung reexpansion due to the evacuation of air or fluid from the pleural space?

pulmonary edema

Respiratory muscle weakness is associated with all of the following abnormalities except:

pulmonary embolism

How is diaphragmatic paralysis most often diagnosed?

pulmonary function testing

Which of the following physical exam findings could be considered a late manifestation of interstitial lung disease (ILD)?

pulmonary hypertension

Which of the following complications has been associated with the use of PEEP in patients with ARDS?

reduced cardiac output

Which of the following clinical findings is NOT associated with an increased risk of death in the patient with pneumonia?

respiratory alkalosis

Which of the following is NOT a typical complication of thoracentesis?

rib fracture

What ECG finding is most often associated with right-sided heart failure and pulmonary hypertension?

right-axis deviation

What b2-agonist is associated with 12 to 24 hours of bronchodilation?

salmeterol

A patient with which of the following diseases will have the longest life expectancy?

sarcoidosis

What disease process is the most common cause of interstitial lung disease (ILD) in the United States?

sarcoidosis

What is the most common cause of interstitial lung disease (ILD)?

sarcoidosis

Cobb angles are used to measure the severity in which disorder of the thoracic cage?

scoliosis

Which of the following risk factors for ARDS is considered a secondary risk factor?

sepsis

A patient is admitted to the emergency department with an acute asthma exacerbation. Based on the following blood gas results, how severe is the asthma attack? pH 7.35, PaO2 58 mm Hg, PaCO2 46 mm Hg, HCO3- 18 mEq/L, SaO2 89%

severe

What alteration in respiration is typically associated with stroke involving the cerebral cortex?

sleep apnea

What respiratory dysfunction is commonly seen in myotonic dystrophy?

sleep-related disorders

Which airways are most susceptible to airway obstruction in patients with COPD?

small

Which bronchogenic carcinoma is staged as limited or extensive?

small cell

What is the primary cause of obstructive sleep apnea?

small or unstable pharyngeal airway

What is the most effective way to prevent lung cancer?

smoking prevention

Which of the following tests is recommended as part of the initial assessment of asthma?

spirometry

What type of lung cancer usually is seen as a central lesion that may obstruct airways and lead to atelectasis?

squamous cell

Which of the following treatments is least useful in the treatment of the patient with idiopathic pulmonary artery hypertension?

steroids

Which of the following organs is not commonly compromised in metastatic lung cancer?

stomach

A patient with pulmonary emboli has severe hypoxemia, acute right-sided heart failure, and shock. What treatment should be given at this time?

streptokinase

Of the following common causes of asthma, which is the least likely to cause exercise-induced asthma?

swimming indoors

What are the two most common findings on the electrocardiogram (ECG) in the patient with pulmonary embolism?

tachycardia and depressed ST segment

Which of the following mechanisms is an uncommon route for the spread of pneumonia?

through the bloodstream

Which of the following has been identified as the most common cause of occupational asthma?

toluene diisocyanate

What is the drug of choice for the patient with Pneumocystis jiroveci pneumonia?

trimethoprim-sulfamethoxazole

Death from massive pulmonary embolism is the result of cardiovascular collapse rather than respiratory failure.

true

Expiratory muscle weakness is accompanied by a poor cough and secretion clearance.

true

Idiopathic pulmonary artery hypertension (IPAH) is often a fatal disease.

true

Most hospitalized patients who are immobile need prophylaxis for venous thromboembolism.

true

Most patients with asbestosis have considerable asbestos exposure for many years before manifestation of the disease

true

Most patients with cryptogenic organizing pneumonia (COP) will improve if given corticosteroid therapy.

true

Patients with poor inspiratory muscle function might show significant orthopnea and prefer to sleep in a prone position.

true

Patients with simple pneumoconiosis of coal workers are often asymptomatic.

true

Sarcoidosis is more common among young adults than is idiopathic pulmonary fibrosis (IPF).

true

The development of interstitial lung disease (ILD) in a patient with emphysema can result in normal compliance measurements

true

The first line of treatment for patients with hypersensitivity pneumonitis is to avoid the offending agent.

true

The lungs of a patient with ARDS are effectively reduced to 20% to 30% of their normal size.

true

The presence of headaches, vision changes, and neurologic symptoms is highly suggestive of metastasis.

true

The routine use of extracorporeal membrane oxygenation (ECMO) in the treatment of patients with ARDS is not recommended at this time.

true

Uvulopalatopharyngoplasty has a success rate of less than 50%.

true

Which of the following conditions is most closely associated with exudative pleural effusion?

tuberculosis

What does the acronym TNM mean?

tumor, lymph node, metastases

On a chest radiograph, large-cell carcinoma is commonly seen as what type of lesion?

unilateral nodules

In what percentage of patients with pneumonia has NO microbial agent been isolated?

up to 50%

What time does the exudative phase of ARDS typically presents?

between days 1 and 3

What is recommended in terms of fluid management of patients with ARDS?

conservative

Most pleural effusions are transudative.

false

Most pulmonary infarctions occur in the lung apexes.

false

In what age group is a primary spontaneous pneumothorax most commonly seen?

18 to 25 years

What lung disease is the most common current indication for lung transplantation?

COPD

What is the approximate cost of COPD to the U.S. health system?

$32 billion

The definition of sleep apnea uses what criteria for defining an episode of apnea?

10 seconds

Approximately how many individuals died of COPD in the United States in 2000?

120,000

What percentage of all cases of COPD is caused by an a1-antitrypsin deficiency?

2% to 3%

How much improvement is needed in the FEV1 after bronchodilator therapy before reversibility can be considered present in the patient with obstructive lung disease?

200 ml

What is the maximal inspiratory pressure that should be targeted when using pressure control ventilation in patients with ARDS?

30 to 35 cm H2O

What are the criteria to define hypopnea?

30% decrease in airflow and 4% oxygen desaturation

What percent of patients with community-acquired pneumonia have a parapneumonic pleural effusion?

30% to 50%

What is the 5-year survival rate for patients with untreated idiopathic pulmonary artery hypertension (IPAH)?

33%

What timeline has been established to initiate antibiotic treatment in patients with pneumonia who are admitted to the hospital that will result in improved survival?

4 hours or less

What is the critical value for mean pulmonary arterial pressure, above which the right ventricle fails and death may ensue?

40 mm Hg

What percentage of the pulmonary vascular bed must be occluded by emboli before pulmonary hypertension occurs?

50%

What is the approximate mean age of onset for amyotrophic lateral sclerosis?

56 years

Approximately what percentage of patients who die from pulmonary embolism are NOT suspected before death?

70%

What is the critical a1-antitrypsin level below which lung elastin is attacked and broken down?

80 mg/dl

What percentage of amyotrophic lateral sclerosis patients die within 5 years of diagnosis?

80%

Approximately what percentage of all lung cancer is linked to smoking?

85%

Why is the D-dimer test not routinely performed on hospital inpatients suspected of having pulmonary emboli?

A high D-dimer only suggests the presence of comorbidities.

Why should the patient with obstructive sleep apnea not use alcohol?

Alcohol decreases the arousal threshold.

When using a small-bore catheter with a one-way valve such as a Heimlich valve, how can you determine definitively that there is or is not a small air leak?

Connect to an underwater seal.

Which of the following parameters is important in determining the optimal level of positive end-expiratory pressure (PEEP) in a patient with ARDS?

DO2

Which of the following could be early warning signs that a pneumothorax is enlarging?; I. decreased pulse oximetryt reading II. development of a fever III. increased respiratory rate IV. mental confusion

I and III

Which of the following factors are associated with a higher risk for ARDS?; I. gastric aspiration II. multiple transfusions III. septic shock IV. burn injury

I and III

Which of the following pulmonary function tests are frequently used to determine tolerance to resectional surgery?; I. FEV1 II. FEF25-75 III. FVC IV. DLCO

I and IV

What are the functions of a chest tube in a patient with chest trauma that causes bleeding and pneumothorax?; I. to measure the rate of bleeding II. to improve ventilation III. to allow lung reexpansion

I, II, and III

Which of the following individuals should be immunized against influenza?; I. 65-year-old individual II. respiratory therapist III. individual with chronic heart disease IV. individual with glaucoma

I, II, and III

Which of the following would interfere with the collection of a good sputum sample for Gram stain?; I. contamination of the sample with oral secretions II. lack of productive cough III. prior antibiotic therapy IV. rinsing with mouthwash prior to sputum collection

I, II, and III

Which of the following clinical conditions are often associated with a normal chest radiograph in the patient with pneumonia?; I. dehydration II. early infection III. Klebsiella pneumonia IV. Pneumocystis jiroveci infection

I, II, and IV

Which of the following conditions contribute to the development of hypoxemia in a patient with pulmonary emboli?; I. cardiogenic shock II. destruction of lung parenchyma III. intrapulmonary shunt IV. mc145-1.jpg mismatch

I, III, and IV

Which of the following conditions predispose a patient to venous thromboembolic disease?; I. carcinoma II. COPD III. trauma IV. thrombocytosis

I, III, and IV

Which of the following pulmonary function improvements have been associated with lung volume-reduction surgery (LVRS) in patients with emphysema?; I. improved exercise endurance II. improved FEV1 III. improved quality of life IV. improved survival

I, III, and IV

Which of the following strategies is useful in the mechanical ventilation of a patient in status asthmaticus?; I. allow peak inspiratory pressures to go as high as required II. permissive hypercapnia III. prolonged inspiratory time IV. small tidal volumes

II and IV

An intubated, mechanically ventilated patient is suspected of developing nosocomial pneumonia. The pulmonologist decides to perform a bronchoscopy. Which bronchoscopy findings would be consistent with pneumonia?; I. alveolar collapse II. distal purulent secretions III. persistent secretions surging from distal bronchi during exhalation IV. P/F ratio less than 50

II, III, and IV

Which of the following physical examination findings are consistent with the diagnosis of pulmonary embolism?; I. congestive heart failure II. inspiratory crackles on auscultation III. loud P2 IV. tachypnea

II, III, and IV

Which of the following statements is true about prone-positioning of patients with ARDS?

It produces a transient improvement in gas exchange.

Rapidly spreading multilobar consolidation is typical for what type of pneumonia?

Legionella

Which of the following represents an example of atypical community-acquired pneumonia?

Legionella pneumophila

Why are calcium channel blockers NOT used in all patients with idiopathic pulmonary artery hypertension?

Only a small percentage of IPAH patients respond

What therapy has been proven to improve survival in patients with COPD and pulmonary hypertension?

Oxygen

In myasthenia gravis, which two pulmonary function values are the most sensitive in detecting respiratory muscle weakness?

PImax and PEmax

Apical growth may be associated with which of the following syndromes?

Pancoast

An asthma patient's best effort produces a PEFR of 55% of personal best. What is indicated at this time?

Patient should probably seek medical attention now.

What would be important to perform in order to obtain a good sputum sample that is to be used to detect the pathogen causing community-acquired pneumonia?

Patient should rinse mouth prior to sample collection.

In what type of IPAH patient is lung transplantation indicated?

Patients not responding to vasodilators with significant cardiac dysfunction

What organism is associated with the highest mortality rate for patients with pneumonia?

Pseudomonas aeruginosa

What type of severe lung infection may result in the development of small lung cavities called pneumatoceles?

Staphylococcus aureus

A patient with nephritic syndrome is noted to have a large right-sided pleural effusion and a small to medium-sized left-sided pleural effusion. What would explain this finding?

The nephrosis is complicated by pulmonary emboli.

Which of the following assessment tools is most useful in distinguishing ARDS from CHF?

Swan-Ganz catheter

Lung transplantation is an option in the management of idiopathic pulmonary artery hypertension.

True

What is the hallmark finding of diaphragm paralysis?

abdominal paradox

What percentage of all cancer deaths are related to lung cancer?

about 30%

Which of the following signs associated with COPD is considered a late manifestation?

accessory muscle usage

A patient is exposed a second time to an antigen and subsequently seeks medical attention with sudden shortness of breath, chest pain, fever, chills, malaise, and a cough that may be productive of purulent sputum. What is the most likely cause of this pathology?

acute hypersensitivity pneumonitis

Which of the following is the most common type of lung cancer?

adenocarcinoma

Which group of patients is most likely to develop pneumonia subsequent to large volume aspiration?

alcohol toxicity

What is the primary pathologic change that occurs in interstitial lung disease?

alveolar-capillary membrane structures replaced by fibrotic tissue

What causes the degranulation of mast cells in asthma patients?

antigens attaching to IgE molecules on the mast cell surface

Nephrotic syndrome causes pleural effusion by increasing oncotic pressure in the blood as a result of a protein leak into the urine.

false

Which of the following is true regarding the use of CT with contrast for diagnosing pulmonary embolism (PE)?

can only identify the medium to large PE

What is the most common cause of pleural effusion that occurs due to lymphatic obstruction within the mediastinum?

cancer that has metastasized to the mediastinum

Which of the following signs and symptoms is most closely associated with respiratory failure in a COPD patient?

changes in mental status

What is the treatment of choice for limited-stage small-cell lung cancer?

chemoradiotherapy

Which of the following symptoms is NOT a classic symptom of asthma?

chest pain

What diagnostic procedure or technique is most commonly used to diagnosis the presence of a pleural effusion?

chest radiography

What is the primary tool used to diagnosis a pneumothorax?

chest radiography

What is the most common cause of hemothorax?

chest trauma

Which form of COPD is most common?

chronic bronchitis

What underlying lung disease is most often present in a patient with secondary spontaneous pneumothorax?

chronic obstructive pulmonary disease (COPD)

Which complaint is most closely associated with the diagnosis of chronic bronchitis?

chronic productive cough

What type of pleural problem is most likely to develop from rupture of the thoracic duct?

chylothorax

What is the leading risk factor for the development of COPD?

cigarette smoking

Which of the following is NOT a major histopathologic type of lung cancer?

ciliated cell carcinoma

An elderly patient presents with failure to thrive, shortness of breath, confusion, and worsening congestive heart failure. What is most likely the patient's primary problem?

community-acquired pneumonia

If accurate sizing on a pneumothorax is desired, what diagnostic technique would be most appropriate?

computed tomography

Which of the following medical therapies is considered first-line treatment for obstructive sleep apnea (OSA)?

continuous positive airway pressure (CPAP)

Which of the following findings on a radiologic report would indicate the presence of a tension pneumothorax?

contralateral mediastinal shift, diaphragmatic depression, flattening of ribs

What medication is currently the most effective for the treatment of asthma?

corticosteroids

What may be the drug of choice for managing atopic asthma in children?

cromolyn

Which of the following types of pneumonia suggests that the patient acquired it because of the reactivation of a latent infection, often in the setting of immunosuppression?

cytomegalovirus

Patients with more severe levels of OSA usually need higher levels of CPAP to eliminate the apnea episodes.

false

Primary pulmonary hypertension is more common in males than in females.

false

In interstitial lung disease, which of the following mechanisms does NOT contribute to impaired gas exchange?

depression of respiratory drive

Which of the following best describes the cell characteristics in small cell carcinoma?

develops from a common pulmonary stem cell

A decrease in forced expiratory volume in 1 second (FEV1) and vital capacity (VC) of greater than 20% when a patient moves from the seated to the supine position is suggestive of which of the following?

diaphragmatic muscle weakness

Pulmonary function testing in patients with neuromuscular weakness would show normal values for which of the following?

diffusing capacity of the lungs (DLCO)

Which of the following physical examination findings is NOT found in patients with primary pulmonary hypertension?

digital clubbing

Which of the following mechanisms ultimately leads to ARDS regardless of the etiology?

disruption of the endothelial and epithelial barriers

What is a common clinical finding even with small pleural effusions?

dyspnea

What is the most common symptom in patients with pulmonary embolism?

dyspnea

What is the most frequent symptom found in patients with confirmed pulmonary emboli?

dyspnea

What step must be taken to gain control of asthma in a patient that is experiencing frequent emergency department visits?

environmental control

What use, other than prognostic value, can serial pulmonary function tests provide for the management of interstitial lung disease patients?

establish the need for lung transplantation

Which of the following complaints is frequently seen in a patient with obstructive sleep apnea?

excessive daytime sleepiness

What is the benefit of pulmonary rehabilitation in patients with moderate to severe COPD?

exercise tolerance

What symptoms are most common in the patient with interstitial lung disease?

exertional dyspnea and nonproductive cough

Which of the following problems is associated with intravenous augmentation of synthetic a1-antitrypsin for the patient with genetic emphysema?

expense

Chest pain occurs in only a small percentage of patients with a pneumothorax.

false

Chest radiographs will show hilar lymphadenopathy in most cases of asbestosis

false

Chest tubes should be directed toward the base of the lung to evacuate a pneumothorax.

false

What composition of adenocarcinoma best describes its histopathology?

glandular structures

What is an often-neglected but very important component of preventing transmission of pathogens between patients, particularly those who are ventilated?

hand washing

A patient is exposed a second time to an antigen and subsequently seeks medical attention with sudden shortness of breath, chest pain, fever, chills, malaise, and a cough that may be productive of purulent sputum. Which of the following is the most likely source of for the antigen?

hay field

Which of the following is NOT a common side effect of positive-pressure therapy?

headache

Which of the following medications should be used for in hospital prophylactic deep venous thrombosis therapy?

heparin

Which of the following medications would be standard therapy to treat acute deep venous thrombi?

heparin

What mode of mechanical ventilation is designed to optimize ventilation by reducing alveolar collapse while using small tidal volumes in patients with ARDS?

high-frequency ventilation (HFV)

What radiographic technique has the ability to better define the specific parenchymal characteristics associated with specific types of interstitial lung disease?

high-resolution CT

Which of the following types of pneumonia suggests that the patient acquired it through inhalation of infectious particles?

histoplasmosis

What term is used to describe a significant decrease in airflow during sleep but not a complete cessation of breathing?

hypopnea

Which of the following characteristics is not typically associated with sleep apnea?

hypotensive

Which of the following arterial blood gas findings is seen in most patients with pulmonary embolism?

hypoxemia

The classic chest radiographic findings in interstitial lung disease (ILD) are considered to be those caused by which of its component diseases?

idiopathic pulmonary fibrosis (IPF)

What treatment strategy is most controversial for a patient with asthma?

immunotherapy

Which of the following benefits has not been associated with the use of PEEP in a patient with ARDS?

improved venous return

What is the main hemodynamic consequence of pulmonary emboli?

increased pulmonary vascular resistance

What is believed to be the cause of systemic hypertension in patients with sleep apnea?

increased sympathetic tone

What pathophysiologic characteristic of asthma has been most recently emphasized in the description and subsequent treatment of this disease?

inflammation of the airways

At what point is intrapleural pressure most negative?

inspiration

What finding on the chest radiograph is typical for a viral pneumonia?

interstitial infiltrates

Which group of disorders is categorized together because of similarities in their clinical presentations, plain chest radiographic appearance, and physiologic features?

interstitial lung diseases

For a patient with pneumonia with coexisting cardiopulmonary disease, according to the ATS guidelines, what single antibiotic could be given as empiric treatment?

intravenous fluoroquinolone

Which bronchodilator is commonly used in the hospital management of acute asthma exacerbation but is not the first-line bronchodilator?

ipratropium bromide

Which medication is an anticholinergic bronchodilator?

ipratropium bromide

Which of the following asthma medications is not usually administered during pregnancy?

ipratropium bromide

At what anatomic position should an 18-gauge IV catheter be placed to relieve a tension pneumothorax?

just superior to the second rib

Which of the following physical exam findings is associated with obstructive sleep apnea?

large tonsils

What percentage of patients with pulmonary embolism have pulmonary infarction as a complication?

less than 10%

Which of the following organs plays a major role in induction and modulation of the systemic inflammatory response?

liver

What is the mortality rate for Guillain-Barré syndrome?

low, less than 10%

What is the only therapy shown to prolong life in patients with end-stage, particularly fibrotic interstitial lung disease (ILD)?

lung transplantation

Which of the interstitial lung diseases will in one third of patients cause a chylothorax?

lymphangioleiomyomatosis

Pleural effusions that occur secondarily to _____ are most often treated with pleurodesis.

malignancy

What is the most common cause of a chylothorax?

malignancy

What is the most likely cause of a large unilateral pleural effusion in a 70 year old patient?

malignancy

What medication would likely be the least often ordered during the emergency department management of an acute asthma attack?

methylxanthines

Which of the following medications is generally only used if the patient still has debilitating symptoms from stable COPD, despite inhaled bronchodilator therapy?

methylxanthines

Other causes of lung cancer include all of the following EXCEPT which one?

microwave radiation

What diagnostic procedure might be done by a lone respiratory therapist in order to determine the presence of ventilator-associated pneumonia?

mini bronchoalveolar lavage

Which of the following white blood cells is most commonly implicated in the inflammatory process of ARDS?

neutrophils

What finding is usually used to confirm the diagnosis of pneumonia?

new infiltrate on chest radiograph

Would a patient being fed through a jejunostomy tube be more likely to develop nosocomial pneumonia than if he were fed totally via the parenteral route?

no, less likely

It is not clear whether your patient has COPD or asthma. Which of the following characteristics is most closely associated with the diagnosis of asthma?

normalization of the FEV1 after use of a bronchodilator

Which of the following factors has been shown to positively correlate with obstructive sleep apnea?

obesity of the upper body

Which of the following side effects is associated with the use of inhaled corticosteroids?

oral candidiasis

What treatment for patients with COPD has been shown to improve long-term survival?

oxygen

Which of the following medications has been shown to be useful in the treatment of almost all interstitial lung diseases?

oxygen

What is a common cause of persistent fever in intensive care unit (ICU) patients with pneumonia?

parapneumonic effusions

What is considered to be the major problem with the use of CPAP in patients with obstructive sleep apnea?

patient compliance

What does the National Asthma Education Project (NAEP) recommend be measured at home in patients with moderate to severe asthma?

peak expiratory flow

What antibiotic is the drug of choice for the patient with nonresistant S. pneumoniae?

penicillin

What is the most commonly used oral anticoagulant?

warfarin


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