Podcast
Questions and Answers
A patient presents with a chronic cough, fatigue, and night sweats. Sputum samples show the presence of acid-fast bacilli. Which of the following is the MOST appropriate next step in managing this patient?
A patient presents with a chronic cough, fatigue, and night sweats. Sputum samples show the presence of acid-fast bacilli. Which of the following is the MOST appropriate next step in managing this patient?
- Start the patient on a multi-drug anti-tuberculosis regimen after confirming with a nucleic acid amplification test (NAAT). (correct)
- Initiate a broad-spectrum antibiotic such as azithromycin to cover common bacterial infections.
- Order a chest CT scan to rule out other potential causes of chronic cough, such as lung cancer.
- Prescribe an antitussive medication to alleviate the cough and improve patient comfort.
A child presents with fever, cough, and marked wheezing, especially during expiration. The pediatrician suspects bronchiolitis. Which of the following management strategies is LEAST appropriate in managing this condition?
A child presents with fever, cough, and marked wheezing, especially during expiration. The pediatrician suspects bronchiolitis. Which of the following management strategies is LEAST appropriate in managing this condition?
- Monitor oxygen saturation and provide supplemental oxygen to maintain saturation above 90%.
- Administer a trial of bronchodilators like albuterol to assess response in airway reactivity.
- Provide supportive care, including nasal suctioning and adequate hydration.
- Prescribe routine antibiotics to prevent secondary bacterial infections. (correct)
A patient with a history of asthma presents with acute dyspnea, wheezing, and a peak expiratory flow (PEF) rate at 40% of their personal best. After initial treatment with a short-acting beta-agonist, the patient shows minimal improvement. Which of the following is the MOST appropriate next step in managing this acute asthma exacerbation?
A patient with a history of asthma presents with acute dyspnea, wheezing, and a peak expiratory flow (PEF) rate at 40% of their personal best. After initial treatment with a short-acting beta-agonist, the patient shows minimal improvement. Which of the following is the MOST appropriate next step in managing this acute asthma exacerbation?
- Administer a systemic corticosteroid (e.g., oral prednisone or intravenous methylprednisolone). (correct)
- Discharge the patient with instructions to follow up with their primary care physician in 1 week.
- Immediately intubate the patient due to the lack of response to initial bronchodilator therapy.
- Administer a leukotriene receptor antagonist such as montelukast.
A patient with a history of travel to the southwestern United States presents with cough, fever, and fatigue. A chest X-ray reveals pulmonary infiltrates and hilar lymphadenopathy. Serological testing is positive for Coccidioides. Which of the following interventions is MOST appropriate for this patient?
A patient with a history of travel to the southwestern United States presents with cough, fever, and fatigue. A chest X-ray reveals pulmonary infiltrates and hilar lymphadenopathy. Serological testing is positive for Coccidioides. Which of the following interventions is MOST appropriate for this patient?
Which of the following clinical findings would be MOST concerning as a red flag in a patient presenting with hemoptysis?
Which of the following clinical findings would be MOST concerning as a red flag in a patient presenting with hemoptysis?
A previously healthy adult presents with a sudden onset of dyspnea, pleuritic chest pain, and a non-productive cough following a long-haul flight. The patient's oxygen saturation is 88% on room air. Which of the following is the MOST critical initial step in managing this patient?
A previously healthy adult presents with a sudden onset of dyspnea, pleuritic chest pain, and a non-productive cough following a long-haul flight. The patient's oxygen saturation is 88% on room air. Which of the following is the MOST critical initial step in managing this patient?
A 6-month-old infant presents with rhinorrhea, cough, and wheezing. The infant has a fever of 101°F (38.3°C) and increased work of breathing. The physician suspects Respiratory Syncytial Virus (RSV) bronchiolitis. Which of the following is the MOST effective intervention to reduce the risk of severe disease in high-risk infants?
A 6-month-old infant presents with rhinorrhea, cough, and wheezing. The infant has a fever of 101°F (38.3°C) and increased work of breathing. The physician suspects Respiratory Syncytial Virus (RSV) bronchiolitis. Which of the following is the MOST effective intervention to reduce the risk of severe disease in high-risk infants?
A patient presents with a persistent cough that has lasted for more than 3 weeks. The cough is dry, non-productive, and is exacerbated by exposure to irritants like smoke and dust. The patient denies fever, shortness of breath, or other systemic symptoms. Which of the following is the MOST appropriate initial diagnostic test to evaluate this patient's chronic cough?
A patient presents with a persistent cough that has lasted for more than 3 weeks. The cough is dry, non-productive, and is exacerbated by exposure to irritants like smoke and dust. The patient denies fever, shortness of breath, or other systemic symptoms. Which of the following is the MOST appropriate initial diagnostic test to evaluate this patient's chronic cough?
A construction worker presents to the clinic complaining of acute onset of dyspnea. Upon auscultation, you note stridor. Which of the following is the MOST likely diagnosis?
A construction worker presents to the clinic complaining of acute onset of dyspnea. Upon auscultation, you note stridor. Which of the following is the MOST likely diagnosis?
Which of the following physical exam findings would be MOST suggestive of pneumonia rather than simple bronchitis?
Which of the following physical exam findings would be MOST suggestive of pneumonia rather than simple bronchitis?
An elderly patient with a history of COPD presents to the emergency department with worsening dyspnea, increased sputum production, and fever. The patient's arterial blood gas shows a pH of 7.30, PaCO2 of 60 mmHg, and PaO2 of 55 mmHg. Which of the following is the MOST appropriate initial intervention for this patient?
An elderly patient with a history of COPD presents to the emergency department with worsening dyspnea, increased sputum production, and fever. The patient's arterial blood gas shows a pH of 7.30, PaCO2 of 60 mmHg, and PaO2 of 55 mmHg. Which of the following is the MOST appropriate initial intervention for this patient?
Which of the following diagnostic tests is MOST useful in differentiating between influenza and COVID-19 in a patient presenting with acute respiratory symptoms?
Which of the following diagnostic tests is MOST useful in differentiating between influenza and COVID-19 in a patient presenting with acute respiratory symptoms?
A patient with a known history of asthma is admitted to the hospital for an acute exacerbation. Despite initial treatment with oxygen, nebulized beta-agonists, and systemic corticosteroids, the patient's condition continues to worsen, and they develop altered mental status. Which of the following is the MOST appropriate next step in managing this patient?
A patient with a known history of asthma is admitted to the hospital for an acute exacerbation. Despite initial treatment with oxygen, nebulized beta-agonists, and systemic corticosteroids, the patient's condition continues to worsen, and they develop altered mental status. Which of the following is the MOST appropriate next step in managing this patient?
A 2-year-old child is brought to the emergency department with sudden onset of cough, stridor, and difficulty breathing. The parents report that the child was playing with small toys just before the symptoms started. Which of the following is the MOST appropriate immediate intervention for this child?
A 2-year-old child is brought to the emergency department with sudden onset of cough, stridor, and difficulty breathing. The parents report that the child was playing with small toys just before the symptoms started. Which of the following is the MOST appropriate immediate intervention for this child?
Which of the following is the MOST important component of patient education for individuals diagnosed with acute bronchitis to prevent overuse of antibiotics?
Which of the following is the MOST important component of patient education for individuals diagnosed with acute bronchitis to prevent overuse of antibiotics?
A patient presents with dyspnea and is suspected of having a pulmonary issue. The emergency physician wants to quickly differentiate between cardiac and pulmonary etiologies of dyspnea. Which of the following would be MOST appropriate?
A patient presents with dyspnea and is suspected of having a pulmonary issue. The emergency physician wants to quickly differentiate between cardiac and pulmonary etiologies of dyspnea. Which of the following would be MOST appropriate?
Which of the following is the MOST appropriate referral for a patient with suspected tuberculosis?
Which of the following is the MOST appropriate referral for a patient with suspected tuberculosis?
When should a cough warrant a referral to a pulmonologist?
When should a cough warrant a referral to a pulmonologist?
A patient is diagnosed with pneumonia and started on antibiotics. When is the MOST appropriate time for follow up?
A patient is diagnosed with pneumonia and started on antibiotics. When is the MOST appropriate time for follow up?
Which is the BEST approach to treating an uncomplicated upper respiratory infection?
Which is the BEST approach to treating an uncomplicated upper respiratory infection?
Flashcards
Bronchitis
Bronchitis
Inflammation of the bronchi, often caused by viral infection.
Valley Fever
Valley Fever
Fungal infection caused by Coccidioides immitis or C. posadasii.
Acute Asthma Exacerbation
Acute Asthma Exacerbation
Sudden worsening of asthma symptoms (wheezing, coughing, shortness of breath).
COVID-19
COVID-19
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Bronchiolitis
Bronchiolitis
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Cough
Cough
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Upper Respiratory Infections (URIs)
Upper Respiratory Infections (URIs)
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Respiratory Syncytial Virus (RSV)
Respiratory Syncytial Virus (RSV)
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Influenza (Flu)
Influenza (Flu)
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Dyspnea
Dyspnea
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Pneumonia
Pneumonia
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Hemoptysis
Hemoptysis
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Tuberculosis (TB)
Tuberculosis (TB)
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Foreign Body Aspiration
Foreign Body Aspiration
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Study Notes
- Overview of common respiratory conditions including bronchitis, valley fever, acute asthma exacerbation, COVID-19, bronchiolitis, cough, upper respiratory infections (URIs), respiratory syncytial virus (RSV), influenza, dyspnea, pneumonia, hemoptysis, tuberculosis, and foreign body aspiration.
Bronchitis
- Inflammation of the bronchial tubes, causing cough with mucus.
- Diagnosis involves assessing symptoms and ruling out other conditions like pneumonia.
- Red flags include difficulty breathing, high fever, and chest pain.
- Treatment is typically supportive with rest, fluids, and cough suppressants.
- Patient education focuses on avoiding irritants and proper hand hygiene.
Valley Fever (Coccidioidomycosis)
- Fungal infection caused by Coccidioides immitis.
- Diagnosis includes lab tests and imaging.
- Red flags are severe chest pain, shortness of breath, and systemic symptoms.
- Treatment may involve antifungal medications and supportive care.
Acute Asthma Exacerbation
- Sudden worsening of asthma symptoms, such as wheezing and shortness of breath.
- Diagnosis involves assessing respiratory function and triggers.
- Red flags are severe respiratory distress and cyanosis.
- Treatment includes bronchodilators and corticosteroids.
- Patient education focuses on proper inhaler technique and trigger avoidance.
COVID-19
- Viral infection caused by SARS-CoV-2 with symptoms ranging from mild to severe.
- Diagnosis involves PCR testing
- Red flags include difficulty breathing, persistent chest pain, and confusion.
- Treatment: Varies based on severity, may include antiviral medications and supportive care.
Bronchiolitis
- Viral infection affecting the small airways in infants and young children.
- Diagnosis is typically clinical, based on symptoms.
- Red flags include severe respiratory distress and dehydration.
- Treatment is primarily supportive.
- Patient education focuses on recognizing signs of worsening respiratory distress.
Cough
- A reflex to clear the airways of irritants or mucus, can be acute or chronic.
- Diagnosis involves assessing the characteristics and associated symptoms.
- Red flags include hemoptysis, difficulty breathing, and persistent cough.
- Treatment depends on the underlying cause.
Upper Respiratory Infections (URIs)
- Infections of the nose, throat, and upper airways, commonly caused by viruses.
- Diagnosis is typically clinical, based on symptoms like cough, congestion, and sore throat.
- Red flags include high fever, difficulty breathing, and dehydration.
- Treatment: Symptomatic relief with rest, fluids, and over-the-counter medications.
Respiratory Syncytial Virus (RSV)
- Common viral infection causing bronchiolitis and pneumonia, especially in infants.
- Diagnosis involves clinical assessment and sometimes lab testing.
- Red flags include severe respiratory distress and apnea.
- Treatment is primarily supportive.
Influenza
- Viral infection causing fever, cough, body aches, and fatigue.
- Diagnosis involves rapid influenza testing (swab).
- Red flags include difficulty breathing, chest pain, and altered mental status.
- Treatment may include antiviral medications.
Dyspnea
- Shortness of breath.
- Diagnosis involves assessing underlying causes, such as asthma or heart failure.
- Red flags include sudden onset, severe respiratory distress, and chest pain.
- Treatment targets the underlying cause.
Pneumonia
- Infection of the lungs causing inflammation and fluid buildup.
- Diagnosis involves chest X-rays and lab tests.
- Red flags include severe respiratory distress, sepsis, and altered mental status.
- Treatment includes antibiotics and supportive care.
Hemoptysis
- Coughing up blood.
- Diagnosis involves identifying the source and cause of bleeding.
- Red flags include large amounts of blood.
- Treatment depends on the underlying cause.
Tuberculosis
- Bacterial infection caused by Mycobacterium tuberculosis, usually affecting the lungs.
- Diagnosis involves sputum tests, skin tests, and chest X-rays.
- Red flags include hemoptysis, night sweats, and weight loss.
- Treatment includes a long course of antibiotics.
Foreign Body Aspiration
- Inhalation of an object into the airway.
- Diagnosis involves history and imaging.
- Red flags include sudden onset of choking, coughing, and difficulty breathing.
- Treatment involves removing the foreign object.
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