Pulmonary Embolization Evaluation Quiz

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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?

Unique to heart failure 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?

Large-airway bronchospasm Signup and view all the answers

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

Nonspecific Signup and view all the answers

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

Pleuritic chest pain and leg edema Signup and view all the answers

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

If pulmonary hypertension is encountered Signup and view all the answers

What might weight increase indicate in a patient?

Signs of worsening CHF Signup and view all the answers

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

Severe difficulty in breathing Signup and view all the answers

Which sign implies critical tracheal stenosis?

Retraction of the supraclavicular fossa Signup and view all the answers

How can air flow obstruction be observed in a patient?

Having the patient blow out as hard and fast as possible Signup and view all the answers

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

Ratio of FEV1 to vital capacity Signup and view all the answers

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

Ziehl-Neelsen stain for acid-fast bacilli Signup and view all the answers

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

FEV1 to vital capacity ratio is close to 1.0 Signup and view all the answers

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

Flow-volume studies Signup and view all the answers

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

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

When are sputum cytology tests indicated according to the text?

When hemoptysis has developed 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?

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

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

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 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?

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 Signup and view all the answers

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

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 Signup and view all the answers

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

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 Signup and view all the answers

Which review critically assessed the uses of blood gas determinations?

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

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

Emphysema Signup and view all the answers

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

Related to interstitial lung disease Signup and view all the answers

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

It is neither sensitive nor specific Signup and view all the answers

When would fine crackles be heard during lung auscultation?

Mid-to-late inspiration and occasionally on expiration Signup and view all the answers

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

Chronic Obstructive Pulmonary Disease (COPD) Signup and view all the answers

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

They reduce the probability of severe pathology Signup and view all the answers