Pulmonary Embolization Evaluation Quiz
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Questions and Answers

What is the most useful diagnostic modality for establishing a diagnosis of dyspnea?

  • Imaging studies
  • Physical examination
  • Laboratory tests
  • History (correct)
  • What percentage of instances is the diagnosis established by history in studies of dyspnea?

  • 90%
  • 50%
  • 100%
  • 75% (correct)
  • What causes exertional dyspnea in both cardiac and pulmonary diseases?

  • Paroxysmal nocturnal dyspnea
  • Wheezing
  • Airway obstruction (correct)
  • Excessive airway secretions
  • Which misconception is commonly associated with paroxysmal nocturnal dyspnea?

    <p>Unique to heart failure</p> Signup and view all the answers

    What can cause dyspnea and force a patient to sit up to clear the airway due to airway obstruction?

    <p>Large-airway bronchospasm</p> Signup and view all the answers

    What manifestation is wheezing considered in relation to heart failure and obstructive lung disease?

    <p>Nonspecific</p> Signup and view all the answers

    What symptoms should a physician inquire about if embolization is suspected?

    <p>Pleuritic chest pain and leg edema</p> Signup and view all the answers

    Why is careful inquiry for historical evidence of recurrent pulmonary embolization important?

    <p>If pulmonary hypertension is encountered</p> Signup and view all the answers

    What might weight increase indicate in a patient?

    <p>Signs of worsening CHF</p> Signup and view all the answers

    What does the observation of contractions of the accessory muscles of respiration suggest?

    <p>Severe difficulty in breathing</p> Signup and view all the answers

    Which sign implies critical tracheal stenosis?

    <p>Retraction of the supraclavicular fossa</p> Signup and view all the answers

    How can air flow obstruction be observed in a patient?

    <p>Having the patient blow out as hard and fast as possible</p> Signup and view all the answers

    What is the most informative measurement for detecting obstructive and restrictive defects during pulmonary function tests?

    <p>Ratio of FEV1 to vital capacity</p> Signup and view all the answers

    Which test is important when an infiltrate is detected and tuberculosis is suspected?

    <p>Ziehl-Neelsen stain for acid-fast bacilli</p> Signup and view all the answers

    In restrictive lung disease, which of the following is true?

    <p>FEV1 to vital capacity ratio is close to 1.0</p> Signup and view all the answers

    What should be considered when patients are suspected of having tracheal stenosis?

    <p>Flow-volume studies</p> Signup and view all the answers

    Which measurement is associated with a poor 5-year survival rate among patients with COPD?

    <p>FEV1 less than 1.0 L/s</p> Signup and view all the answers

    When are sputum cytology tests indicated according to the text?

    <p>When hemoptysis has developed</p> Signup and view all the answers

    Which study reviewed the comparative advantages and disadvantages of computed tomography and older imaging approaches for acute pulmonary embolism?

    <p>Schoepf UJ, Goldhaber SZ, Costello P.Spiral computed tomography for acute pulmonary embolism</p> Signup and view all the answers

    Which trial found significant palliation among COPD patients with 20 mg of sustained-release morphine per day?

    <p>Abernathy AP, Currow DC, Frith P, et al.Randomised, double blind, placebo controlled crossover trial of sustained release morphine for the management of refractory dyspnea.BMJ 2003</p> Signup and view all the answers

    Which review argued that a high degree of accuracy can be achieved in diagnosing and excluding emphysema with validated criteria?

    <p>Schneider H-G, Lam L, Lokuge A, et al.B-type natriuretic peptide testing, clinical outcomes, and health services use in emergency department patients with dyspnea: a randomized trial</p> Signup and view all the answers

    Which trial found no effect on clinical outcomes or health services use in emergency department patients with dyspnea?

    <p>Schneider H-G, Lam L, Lokuge A, et al.B-type natriuretic peptide testing, clinical outcomes, and health services use in emergency department patients with dyspnea: a randomized trial</p> Signup and view all the answers

    Which study found limited usefulness in screening for left ventricular hypertrophy and systolic dysfunction using plasma natriuretic peptides?

    <p>Vasan RS, Benjamin EJ, Larson MG, et al.Plasma natriuretic peptides for community screening for left ventricular hypertrophy and systolic dysfunction: the Framingham Heart Study.JAMA 2002</p> Signup and view all the answers

    Which review critically assessed the uses of blood gas determinations?

    <p>Raffin TA.Indications for arterial blood gas analysis.Ann Intern Med 1986</p> Signup and view all the answers

    Which lung condition is most likely characterized by retraction of the intercostal muscles on inspiration?

    <p>Emphysema</p> Signup and view all the answers

    What is the significance of coarse crackles heard in early inspiration and throughout expiration on lung auscultation?

    <p>Related to interstitial lung disease</p> Signup and view all the answers

    Why is eliciting wheezing on maximal forced exhalation not recommended for diagnosing asthma?

    <p>It is neither sensitive nor specific</p> Signup and view all the answers

    When would fine crackles be heard during lung auscultation?

    <p>Mid-to-late inspiration and occasionally on expiration</p> Signup and view all the answers

    What does increased anterior–posterior diameter of the chest suggest?

    <p>Chronic Obstructive Pulmonary Disease (COPD)</p> Signup and view all the answers

    Why do normal findings on lung examination not rule out pulmonary pathology?

    <p>They reduce the probability of severe pathology</p> Signup and view all the answers

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